Validity and Usefulness of Members Reports of Implementation Progress in a Quality Improvement Initiative

Findings from the Team Check-up Tool (TCT)

Team-based interventions can be effective for improving health care quality in a number of settings and populations, for example, reducing blood infections in intensive care unit (ICU) patients, reducing hospital stays for stroke patients and improving end-of-life care. Greater team effectiveness can lead to stronger intervention effects and more positive outcomes. However, team functioning, leadership and organizational support can vary across teams and time—and be hard to measure.

These researchers sought to demonstrate that a short instrument, the Team Check-up Tool (TCT) could reliably track and monitor team progress in a quality improvement (QI) intervention. They used data from a randomized controlled trial of a QI intervention in 46 ICUs. The intervention to reduce bloodstream infections used a five-step process to improve safety, teamwork and communication in the unit. Each month ICU QI team leaders collected anonymous TCT surveys (which took less than 10 minutes to complete) from team members and mailed them to the researchers. Team leaders were asked to indicate the frequency with which 13 potential barriers slowed team progress.

The researchers found TCT a reliable, valid and responsive new tool that can “help improve the probability of success and advance the science of QI.”