Context in Quality of Care: Improving Teamwork and Resilience

Daniel S Tawfik; John Bryan Sexton; Kathryn C Adair; Heather C Kaplan; Jochen Profit

doi:10.1016/j.clp.2017.04.004

Context in Quality of Care: Improving Teamwork and Resilience

Clin Perinatol. 2017 Sep;44(3):541-552. doi: 10.1016/j.clp.2017.04.004. Epub 2017 Jul 8.

Authors

Daniel S Tawfik¹, John Bryan Sexton², Kathryn C Adair², Heather C Kaplan³, Jochen Profit⁴

Affiliations

¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, 770 Welch Road, Suite 435, Stanford, CA 94304, USA; Lucile Packard Children's Hospital, 725 Welch Road, Palo Alto, CA 94304, USA. Electronic address: dtawfik@stanford.edu.
² Department of Psychiatry, Duke University School of Medicine, Duke University Health System, 2213 Elba Street, Durham, NC 27705, USA; Duke Patient Safety Center, Duke University Health System, 2213 Elba Street, Durham, NC 27705, USA.
³ Department of Pediatrics, Perinatal Institute, James M. Anderson Centre for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7009, Cincinnati, OH 45229, USA.
⁴ Lucile Packard Children's Hospital, 725 Welch Road, Palo Alto, CA 94304, USA; Perinatal Epidemiology and Health Outcomes Research Unit, Neonatology, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford University, 1265 Welch Road, MSOB, MC: 5415, Stanford, CA 94305, USA; California Perinatal Quality Care Collaborative, 1265 Welch Road, MSOB, MC: 5415, Stanford, CA 94305, USA.

Abstract

Quality improvement in health care is an ongoing challenge. Consideration of the context of the health care system is of paramount importance. Staff resilience and teamwork climate are key aspects of context that drive quality. Teamwork climate is dynamic, with well-established tools available to improve teamwork for specific tasks or global applications. Similarly, burnout and resilience can be modified with interventions such as cultivating gratitude, positivity, and awe. A growing body of literature has shown that teamwork and burnout relate to quality of care, with improved teamwork and decreased burnout expected to produce improved patient quality and safety.

Keywords: Burnout; Quality; Resilience; Safety climate; Teamwork.

Publication types

Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Burnout, Professional*
Cooperative Behavior*
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Intensive Care, Neonatal / standards*
Patient Care Team*
Quality of Health Care*
Resilience, Psychological*

Grants and funding

R01 HD084679/HD/NICHD NIH HHS/United States