TY - JOUR
T1 - Improving teamwork in maternity services
T2 - A rapid review of interventions
AU - Harris, Jenny
AU - Beck, Sarah
AU - Ayers, Nicola
AU - Bick, Debra
AU - Lamb, Benjamin W.
AU - Aref-Adib, Mehrnoosh
AU - Kelly, Tony
AU - Green, James S.A.
AU - Taylor, Cath
N1 - Funding Information:
This work was funded by the University of Surrey’s using allocation from Research England's QR Strategic Priorities Fund (QR SPF). This funding supports universities to link effectively with policy research priorities and opportunities, from the local to the international. Allocations are given to universities to build on activity already under way, and to build capacity for future activity.
Funding Information:
DB is Editor in Chief of ‘Midwifery’. BWL has previously received funding from Health Education England and Cancer Alliances for training cancer MDTs in assessment and quality improvement methods in the UK; CT, JH and JG have previously received funding from NHS organisations within England and Scotland for supporting cancer teamwork improvement; JG is the Director of Green Cross Medical Ltd that developed MDT-FIT for use by National Health Service Cancer Teams in the UK. All other authors have no potential conflicts of interest. All other authors have no potential conflicts of interest.
Publisher Copyright:
© 2022
PY - 2022/5/31
Y1 - 2022/5/31
N2 - Background: Teamwork is essential for providing safe, effective and women-centred maternity care and several high profile investigations have highlighted the adverse conseqences of dysfuntional teamwork. Maternity teams may need support to identify the most relevant intervention(s) for improving teamwork. Objective: To identify and describe current ‘off-the-shelf’ teamwork interventions freely or commercially available to support improvements to teamworking in UK maternity services and conduct a gap analysis to identify areas for future development. Design: Rapid scoping review Methods: A multi-component search process was used to identify teamwork interventions, comprising: (1) bibliographic database search (Medline, PsycINFO, CINAHL, MIDRS, NICE evidence research database); (2) identification of relevant policies and UK reports; and (3) expert input from key stakeholders (e.g., maternity service clinicians, managers, policymakers, and report authors). Data were extracted including the scope and content of each intervention and a gap analysis used to map interventions to the integrated team effectiveness model (ITEM) and structure level (macro, meso, micro) and results presented narratively. Findings: Ten interventions were identified. Interventions were heterogeneous in their purpose and scope; six were classified as training courses, three were tools involving observational or diagnostics instruments, and one was a programme involving training and organisational re-design. Interventions were focused on teamwork in obstetric emergencies (n = 5), enhancing routine care (n = 4) or understanding workplace cultures (n = 1). Users of interventions could vary, from whole organisations, to departments, to individual team members. All interventions focused on micro (e.g., team leadership, communication, decision-making, cohesion, and problem solving), with two also focused on meso aspects of teamwork (resources, organisational goals). Evidence for intervention effective on objective outcomes was limited. Conclusions: Interventions that address key aspects of teamworking are available, particularly for improving safety in obstetric emergency situations. Most interventions, however, are focused on micro features, ignoring the meso (organisational) and macro (systems) features that may also impact on team effectiveness. Evidence-based team improvement interventions that address these gaps are needed. Such interventions would support team ownership of quality improvement, leading to improvements in outcomes for service users, staff and organisations.
AB - Background: Teamwork is essential for providing safe, effective and women-centred maternity care and several high profile investigations have highlighted the adverse conseqences of dysfuntional teamwork. Maternity teams may need support to identify the most relevant intervention(s) for improving teamwork. Objective: To identify and describe current ‘off-the-shelf’ teamwork interventions freely or commercially available to support improvements to teamworking in UK maternity services and conduct a gap analysis to identify areas for future development. Design: Rapid scoping review Methods: A multi-component search process was used to identify teamwork interventions, comprising: (1) bibliographic database search (Medline, PsycINFO, CINAHL, MIDRS, NICE evidence research database); (2) identification of relevant policies and UK reports; and (3) expert input from key stakeholders (e.g., maternity service clinicians, managers, policymakers, and report authors). Data were extracted including the scope and content of each intervention and a gap analysis used to map interventions to the integrated team effectiveness model (ITEM) and structure level (macro, meso, micro) and results presented narratively. Findings: Ten interventions were identified. Interventions were heterogeneous in their purpose and scope; six were classified as training courses, three were tools involving observational or diagnostics instruments, and one was a programme involving training and organisational re-design. Interventions were focused on teamwork in obstetric emergencies (n = 5), enhancing routine care (n = 4) or understanding workplace cultures (n = 1). Users of interventions could vary, from whole organisations, to departments, to individual team members. All interventions focused on micro (e.g., team leadership, communication, decision-making, cohesion, and problem solving), with two also focused on meso aspects of teamwork (resources, organisational goals). Evidence for intervention effective on objective outcomes was limited. Conclusions: Interventions that address key aspects of teamworking are available, particularly for improving safety in obstetric emergency situations. Most interventions, however, are focused on micro features, ignoring the meso (organisational) and macro (systems) features that may also impact on team effectiveness. Evidence-based team improvement interventions that address these gaps are needed. Such interventions would support team ownership of quality improvement, leading to improvements in outcomes for service users, staff and organisations.
KW - Interventions
KW - Maternity
KW - Multidisciplnary team
KW - Quality improvement
KW - Rapid review
KW - Teamwork
UR - http://www.scopus.com/inward/record.url?scp=85125262995&partnerID=8YFLogxK
U2 - 10.1016/j.midw.2022.103285
DO - 10.1016/j.midw.2022.103285
M3 - Article
AN - SCOPUS:85125262995
SN - 0266-6138
VL - 108
JO - MIDWIFERY
JF - MIDWIFERY
M1 - 103285
ER -
