Teamwork Before and During COVID-19: The Good, the Same, and the Ugly….

Rehder, Kyle J; Adair, K Carrie; Eckert, Erin; Lang, Richard W; Frankel, Allan S; Proulx, Joshua; Sexton, J Bryan

Teamwork Before and During COVID-19: The Good, the Same, and the Ugly….

dc.contributor.author	Rehder, Kyle J
dc.contributor.author	Adair, K Carrie
dc.contributor.author	Eckert, Erin
dc.contributor.author	Lang, Richard W
dc.contributor.author	Frankel, Allan S
dc.contributor.author	Proulx, Joshua
dc.contributor.author	Sexton, J Bryan
dc.date.accessioned	2022-10-03T02:04:38Z
dc.date.available	2022-10-03T02:04:38Z
dc.date.issued	2022-09
dc.date.updated	2022-10-03T02:04:37Z
dc.description.abstract	Objectives The COVID 19 pandemic placed unprecedented strain on healthcare systems and workers, likely also impacting patient safety and outcomes. This study aimed to understand how teamwork climate changed during that pandemic and how these changes affected safety culture and workforce well-being. Methods This cross-sectional observational study of 50,000 healthcare workers (HCWs) in 3 large U.S. health systems used scheduled culture survey results at 2 distinct time points: before and during the first year of the COVID 19 pandemic. The SCORE survey measured 9 culture domains: teamwork climate, safety climate, leadership engagement, improvement readiness, emotional exhaustion, emotional exhaustion climate, thriving, recovery, and work-life balance. Results Response rate before and during the pandemic was 75.45% and 74.79%, respectively. Overall, HCWs reporting favorable teamwork climate declined (45.6%-43.7%, P < 0.0001). At a facility level, 35% of facilities saw teamwork climate decline, while only 4% saw an increase in teamwork climate. Facilities with decreased teamwork climate had associated decreases in every culture domain, while facilities with improved teamwork climate maintained well-being domains and saw improvements in every other culture domain. Conclusions Healthcare worker teamwork norms worsened during the COVID-19 pandemic. Teamwork climate trend was closely associated with other safety culture metrics. Speaking up, resolving conflicts, and interdisciplinary coordination of care were especially predictive. Facilities sustaining these behaviors were able to maintain other workplace norms and workforce well-being metrics despite a global health crisis. Proactive team training may provide substantial benefit to team performance and HCW well-being during stressful times.
dc.identifier	01209203-990000000-00067
dc.identifier.issn	1549-8417
dc.identifier.issn	1549-8425
dc.identifier.uri	https://hdl.handle.net/10161/26016
dc.language	eng
dc.publisher	Ovid Technologies (Wolters Kluwer Health)
dc.relation.ispartof	Journal of patient safety
dc.relation.isversionof	10.1097/pts.0000000000001070
dc.title	Teamwork Before and During COVID-19: The Good, the Same, and the Ugly….
dc.type	Journal article
duke.contributor.orcid	Adair, K Carrie\|0000-0003-4886-0002
duke.contributor.orcid	Sexton, J Bryan\|0000-0002-0578-2924
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Pediatrics
pubs.organisational-group	Psychiatry & Behavioral Sciences
pubs.organisational-group	Pediatrics, Critical Care Medicine
pubs.organisational-group	Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychology
pubs.publication-status	Published
pubs.volume	Publish Ahead of Print