Quest for quality and improved performance: Quality enhancing interventions

Patient care teams

December 2009

Marije Bosch
Marjan Faber
Gerlienke Voerman
Juliëtte Cruijsberg
Richard Grol
Marlies Hulscher
Michel Wensing

Key points

  • In 8 studies, a team member was added because of their additional clinical expertise. Although some positive results were reported in terms of process, there were mixed results in relation to patient outcomes.
  • 5 studies focused on improving coordination. Patient outcomes seemed to show some positive results, but there was little evidence that resource use and costs reduced as a result of improved coordination in patient care teams (although some studies reported shorter length of stay).
  • There was little evidence that the combination of enhanced coordination and expertise added value compared with enhanced clinical expertise only or improved coordination only.
  • Very little information was found on the determinants of team effectiveness, such as the presence or absence of a team leader and task descriptions for team members.

The establishment or enhancement of a patient care team is therefore increasingly considered a key method for improving the quality of healthcare. However, as yet, it is unclear whether teams are as effective as they are supposed to be, and under what conditions team effectiveness is optimal.

This systematic review groups studies according to the particular objectives of the teams. By aggregating the results to these subgroups, the authors aimed to draw some headline measures about the effectiveness of different types of teams. In addition, determinants for team effectiveness were collected.

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