“Teamwork in hospitals”: A quasi-experimental study protocol applying a Human Factors approach

ISRCTN ISRCTN13997367
DOI https://doi.org/10.1186/ISRCTN13997367
Secondary identifying numbers 15/0018 Norwegian Nurses Organization
Submission date
23/05/2017
Registration date
30/05/2017
Last edited
15/06/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Effective teamwork and communication are critical parts to ensuring patient safety in today’s healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals; however there is a need for more research using different health care settings, countries and using different people and professionals. This study uses two parts in order to address its aim of translating and validating teamwork questionnaires and investigating healthcare personnel’s perception of teamwork in hospitals (Part 1) and to exploring the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2).

Who can participate?
Health care professionals aged 18 and older and patients aged 18 and older who are able to understand Norwegian.

What does the study involve?
This study has two parts. The first part of this study takes place in hospitals labelled A and B and asks health care workers to answer a questionnaire about team work and their perception of it in hospitals. The responses from this questionnaire are used to direct the second part of the study. In the second part of the study, participating healthcare workers from Hospital C take part in an inter-professional teamwork programme that includes one day of team training. Participants are given an electronic survey to answer questions about team work before the programme, and six and 12 months after the programme. The same survey is given to two surgical control wards at Hospital D and E that did not receive the programme in order to compare the results. Participants from Hospital C also undergo focus group interviews done before the teamwork programme and six and 12 months after. Patients from hospital C also can take part in a paper survey about quality before the health care workers teamwork programme and six and 12 months after or have their data from their medical records recorded from before and during the programme.

What are the possible benefits and risks of participating?
There are no benefits or risks with participating.

Where is the study run from?
This study is being run from the Norwegian University of Science and Technology (Norway) and takes place in 5 hospitals in Norway.

When is the study starting and how long is it expected to run for?
January 2015 to December 2021

Who is funding the study?
1. Norwegian University of Science and Technology, Gjøvik (Norway)
2. University of Stavanger (Norway)

Who is the main contact?
1. Dr Randi Ballangrud PhD (Public)
randi.ballangrud@ntnu.no
2. Professor Marie Louise Hall-Lod (Scientific)

Contact information

Dr Randi Ballangrud
Public

Norwegian University of Science and Technology
Gjøvik
P.O. Box 191
Gjøvik
2802
Norway

ORCiD logoORCID ID 0000-0003-0403-0509
Phone +47 611 35323
Email randi.ballangrud@ntnu.no
Prof Marie Louise Hall-Lod
Scientific

Norwegian University of Science and Technology, P.O. Box 191
Gjøvik
2802
Norway

ORCiD logoORCID ID 0000-0003-3385-3731

Study information

Study designPart 1 (Study 1 and 2): Descriptive design (cross-sectional design) Part 2 (Study 3-6): Quasi-experimental interventional design
Primary study designInterventional
Secondary study design
Study setting(s)Hospital
Study typeOther
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleThe impact of an teamwork intervention on healthcare professionals and patients in a surgical ward
Study hypothesisThe overall aim of the project is to translate and validate teamwork questionnaires and investigate healthcare personnel’s perception of teamwork in hospitals, and to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome.
Ethics approval(s)Norwegian Centre for Research Data:
Part 1, sub-studies 1 and 2: 09/06/2015, ref: 43295,
Part 2, sub-study 3: 12/01/2016, ref: 46323
Part 2, sub-study 4: 04/02/2016, ref: 46872,
Part 2, sub-study 5: 18/03/2016, ref: 47853,
Part 2, sub-study 6: 15/06/2016, ref: 47878

Regional committees for medical and Health Research Ethics in East Norway:
Part 2, sub-studies 4-6: 15/03/2016, ref: 2016/78
ConditionHealthcare professionals perception and attitude of teamwork and patients perception of quality of care
InterventionThe study comprises of two parts and includes different sub-studies for assessment.

Part 1:
The aim of the first party of the study is to translate and validate teamwork questionnaires for a Norwegian hospital setting and investigate healthcare personnel’s perception of teamwork in hospitals and includes sub study one and sub study two. This takes place in Hospitals labelled A and B. Participants are invited to respond to three (T-TPQ, T-TAQ and CSACD) Norwegian translated teamwork questionnaires and then the psychometric tested questionnaires are planned used as outcome measures in Part 2 of the study.

Part 2:
The aim of this part of the study is to explore the impact of an inter-professional teamwork intervention in a surgical ward and includes different sub studies labelled sub study three, four, five and six. Hospital C takes part in sub-studies three, four, five and six. Hospital D and E act as controls and each contributes one surgical control ward each without any teamwork interventions and take part in sub study three.

The inter-professional teamwork intervention in a surgical ward at Hospital C is planned according to the TeamSTEPPS-recommended “Model of Change”, and is organized into three phases. Phase one which includes setting the stage and deciding what to do, phase two which includes making it happen through training and implementation and phase three which includes making it stick, using monitoring, integrating, and providing coaching for the initiatives to be sustained over time.

One day of team training consisting of four hours classroom training (lectures, videos, role-plays and discussions) and two hours of high-fidelity simulation for all healthcare personnel in the surgical intervention ward is conducted. To ensure the quality of the educational programme, the classroom training and simulation training is piloted. The one day of team training is carried out by four trainers (nurses and physicians) from the intervention ward in collaboration with members of the research group. A strategy for further implementation of the teamwork system into clinical practice is conducted by an inter-professional change team with members from the surgical intervention ward.

Participants are assessed based on which sub-study their hospital takes part in.

Sub-study three: An electronic survey with four teamwork questionnaire (Teamwork Perceptions Questionnaire (T-TPQ), Teamwork Attitude Questionnaire (T-TAQ), Collaboration and Satisfaction About Care Decisions (CSACD) and Hospital Survey on Patient Safety Culture (HSOPSC)) is administered to all healthcare personnel at three occasions (before the intervention, and after six and 12 months at both the intervention ward and the control wards.

Sub-study four: Focus group interviews with healthcare personnel at the intervention ward is conducted on three occasions (before the intervention, and after six and 12 months).

Sub-study five: A survey with paper version of the questionnaire Quality from Patient’s Perspective is administered to patients at the intervention ward on three occasions (before the intervention and after six and 12 months).

Sub-study six: Anonymous patient data from local registers and from medical records (by use of Global Trigger Tool) are released from the intervention ward before and during the intervention period.
Intervention typeBehavioural
Primary outcome measure1. Healthcare personnel perception of team work and team decision making and attitude towards teamwork is measured using the Teamwork Perceptions Questionnaire, Teamwork Attitude Questionnaire, Collaboration and Satisfaction About Care Decisions questionnaire and Hospital Survey on Patient Safety Culture at baseline and after six and 12 months.
2. Patients perception and quality of care is measured using Quality from Patient’s Perspective at baseline and after six and 12 months at the end of the intervention.
Secondary outcome measuresPatients register data is measured using medical records and local registers during the intervention period.
Overall study start date01/01/2015
Overall study end date31/12/2021

Eligibility

Participant type(s)Mixed
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPart 1- 650, Part 2: 150 healthcare personnel, 225 patients, 532 patient records
Total final enrolment1097
Participant inclusion criteriaHealth professional with permanent employment.

Patients:
1. Aged 18 years or older
2. Able to understand Norwegian
3. In a mental and physical health condition that makes it ethically justifiable to participate
Participant exclusion criteria1. Children and patients that do not understand Norwegian
2. Patients in a mental or physical health condition that not makes it ethically justifiable to participate
Recruitment start date01/10/2015
Recruitment end date01/07/2017

Locations

Countries of recruitment

  • Norway

Study participating centres

Norwegian University of Science and Technology
Teknologiveien
Gjøvik
2815
Norway
University of Stavanger
P.O. Box 8600 Forus
Stavanger
4036
Norway
Innlandet Hospital Trust Division Lillehammer
Anders Sandvigs gate 17
Lillehammer
2609
Norway
Ringerike Hospital
Vestre Viken Hospital Trust
Arnhold Dybsjordsvei 1
Hønefoss
3511
Norway
Innlandet Hospital Trust Division Gjøvik
Kyrre Grepps gate 11
Gjøvik
2919
Norway
Vestfold Hospital Trust, Tønsberg
Halfdan Wilhelmsens alle 17
Tønsberg
3116
Norway
Hospital of Southern Norway Trust, Kristiansand
Egsveien 100
Kristiansand
4604
Norway

Sponsor information

Norwegian Nurses Organisation
Other

Tollbugata 22
Postboks 456
Sentrum
Oslo
0104
Norway

ROR logo "ROR" https://ror.org/01822d048

Funders

Funder type

University/education

Norwegian University of Science and Technology, Gjøvik

No information available

University of Stavanger

No information available

Results and Publications

Intention to publish date01/06/2022
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal. Part 1 is expected to be published in autumn of 2017 and Part 2 is expected to be published in 2018 to 2019
IPD sharing planThe data is not expected to be available because the participants representing healthcare professionals from a small surgical intervention ward. Data will be held at the Norwegian University of Science and Technology’s research server.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 29/06/2017 16/09/2019 Yes No
Results article implementation results 14/09/2019 16/09/2019 Yes No
Results article 08/02/2022 15/06/2023 Yes No
Results article 03/02/2021 15/06/2023 Yes No
Results article Qualitative results 08/07/2020 15/06/2023 Yes No
Results article Qualitative results 23/07/2021 15/06/2023 Yes No

Editorial Notes

15/06/2023: Publication references added.
12/01/2022: The following changes were made to the trial record:
1. Total final enrolment added.
2. The intention to publish date was changed from 31/12/2019 to 01/06/2022.
09/12/2020: The overall trial end date was changed from 31/12/2020 to 31/12/2021.
16/09/2019: Publication reference added.
11/12/2018: The overall trial end date has been updated from 31/12/2017 to 31/12/2020.
11/10/2017: internal review.