Studies Find that Interprofessional Collaboration Improves Patient Outcomes
Two separate studies focused on teamwork and communication among doctors, nurses and other health care professionals conclude that patients have better outcomes when their health care providers work in a collaborative fashion.
The first study, published in December 2011 Archives of Surgery, found a drop in the annual surgical morbidity rates in Veterans Health Administration (VHA) facilities that implemented a medical team training program designed to boost communication and teamwork among doctors and nurses. Study co-author Douglas Paull, MD, and colleagues examined data from 120,000 surgeries performed at 74 VHA hospitals between 2006 and 2008. They found that the 42 hospitals that had implemented the VHA’s medical team training approach, called the Veterans Health Administration Surgical Quality Improvement Program, reduced the incidence of post-surgical complications at a significantly higher rate than at the 32 VHA hospitals that had not.
According to the researchers, the VHA program includes pre- and post-surgery meetings of the surgical team, guided by a checklist, giving staff the opportunity to identify potential trouble spots and other obstacles to a safe and successful operation.
A separate study in the January/February issue of the Annals of Family Medicine examines a program called TEAMcare, in which a nurse care manager collaborates with physicians and patients to develop individualized care plans for patients with complex medical conditions.
A team of researchers conducted a randomized controlled trial between 2007 and 2009 in 14 primary care clinics in Washington State. All 214 patients in the study suffered from depression, and had either poorly controlled diabetes or heart disease. Researchers focused on several measures of program effectiveness, comparing the TEAMcare patients with patients receiving the clinics’ normal standard of care. The conclusion: TEAMcare produced “frequent and timely treatment adjustment by primary care physicians, along with increased patient self-monitoring, improved control of diabetes, depression, and heart disease…”
Write Elizabeth H. B. Lin, MD, MPH, and her co-authors, "Results of this trial suggest that improving specific patient and clinician behaviors (close monitoring of disease control parameters and timely treatment adjustments to achieve individualized goals) can improve disease control and quality of life among patients with multiple conditions and complex healthcare needs.”
- Read a Medpage Today story on the VHA study.
- Read an abstract of the VHA study.
- Read a Medpage Today story on the TEAMcare study.
- Read an abstract of the TEAMcare study.
Electronic Health Records Seen as Key Tool for Hospital Nurses
A recent analysis of survey data finds that hospitals that use electronic health records score better on several measures of quality of care, including patient safety, than hospitals that do not have such a system.
Researchers at the University of Pennsylvania School of Nursing examined data from a survey of 16,352 nurses working in 316 hospitals in four states, correlating the relationship between hospitals’ use of basic electronic health records and nurses’ assessment of their hospitals’ quality of care outcomes. Authors Ann Kutney-Lee, PhD, RN, and Deena Kelly, MS, RN, found that “nurses working in hospitals with basic EHRs consistently reported that poor patient safety and other quality outcomes occurred less frequently than reported by nurses working in hospitals without an EHR.” They concluded, “Our findings suggest that the implementation of a basic EHR may result in improved and more efficient nursing care, better care coordination and patient safety.”
ANA Survey Reveals Nurses’ Concerns about Work Environment
A new survey from the American Nurses Association finds that such safety measures as patient-lifting equipment and safe needle devices are more common today than they were a decade ago, but that nurses continue to be concerned about a variety of hazards on the job.
The nurse respondents listed the same top three work safety problems that emerged from ANA’s 2001 survey on the same topic: “the acute or chronic effects of stress and overwork (74 percent of respondents); disabling musculoskeletal injury (62 percent); and risk of contracting an infectious disease (43 percent).” By contrast, nurses’ concerns about contracting HIV or hepatitis from a needle stick have decreased, as have worries about developing a latex allergy.
Other safety-related findings:
- “Concerns about an on-the-job assault have increased from 25 percent to 34 percent, though a smaller percentage reported actually being physically assaulted compared to 2001.”
- “Although about two-thirds say that patient lifting and transfer devices are available, less than one-third say they use them frequently.”
More than 4,600 nurses responded to the survey