Development of an instrument to measure person-centred teamwork in hospital nursing units

Abstract

Introduction and background Hospital units are dynamic, high-paced and challenging environments and effective teamwork is vital to high performance teams in hospital units. Teamwork and person-centredness are two strategies that improve patient outcomes and staff satisfaction and retention. Healthcare has become increasingly dynamic and demanding. Person-centredness as a strategy is supported by the World Health Organization (WHO) to assist the whole multi-disciplinary team with the patient and significant other, to reach the patient desired outcomes. Teamwork is recognised by the multi-disciplinary team as a way of ensuring holistic and achievable patient outcomes. The concept of person-centred teamwork has not been defined or explored in current literature. Only the measurement of either teamwork or person- centeredness has been explored. There are elaborate instruments available that measure the two concepts as separate entities. The concept of person-centred teamwork has not been explored and to date there is no instrument to measure the concept. Being able to measure person-centred teamwork will enable teams and management to give tangible feedback and revise improvement strategies on person-centred teamwork. Aim and objectives The development of an instrument to measure person-centred teamwork in hospital nursing units. To define person-centred teamwork and develop an instrument to measure person-centred teamwork in hospital units. In order to achieve the aim, the study wished to answer the following question: How can the concept “person-centred teamwork” be developed into an instrument to measure person-centred teamwork? In order to achieve the aim, the study was conducted in phases with the following objectives: • Phase 1: Concept clarification Objective 1: To conduct a concept analysis of person-centred teamwork. Objective 2: To reach consensus on the definition and attributes of person-centred teamwork. • Phase 2: Item development Objective 3: To reach consensus on items to be included in an instrument to measure personcentred teamwork in a hospital setting. Abstract vi Alida H. Viljoen 2024 o Sub-objective 3.1: To generate items for an instrument to measure person-centred teamwork. o Sub-objective 3.2: To reach consensus on items to measure person-centred teamwork. • Phase 3 and 4: Scale development and evaluation Objective 4: To validate an instrument to measure healthcare workers’ perceptions of personcentred teamwork in hospital units. Research design and methodology A multi-method multi-phased design, using both qualitative and quantitative approaches, was used to develop an instrument to measure person-centred teamwork in a hospital unit. The data collection included a concept analysis, methodological search for instrument items, two Delphi studies, pre-testing and sampling of the instrument. With the assistance of a statistician validation of the instrument was done. Results The concept analysis determined four attributes and a definition for person-centred teamwork. The attributes and definition was taken through a Delphi study with international experts, to obtain consensus on it. Consensus was obtained and this formed the basis of the methodological search on instrument items to measure person-centredness or teamwork. The items were analysed, refined and reduced to 43 items that were taken to a Delphi study with international experts to obtain consensus on the items to measure person-centred teamwork. Consensus was reached on 38 items, which were pre-tested and validated. The 38 items then underwent psychometric testing by 388 participants in two selected hospitals in South Africa. A statistician tested the findings of 38 items for validity and reliability and found to be valid and reliable to assess person-centred teamwork in the hospital setting. Conclusion This study was initiated from the need to be able to understand and measure person-centred teamwork. The instrument was found to be valid and reliable in measuring person-centred teamwork. The ability to measure person-centred teamwork will assist the implementation and ongoing improvement of person-centred teams. Person-centred teamwork will allow the outcomes set from a management perspective to be measurable and improved upon based on the results of the instrument. Abstract vii Alida H. Viljoen 2024 Keywords Concept analysis, Delphi technique instrument, measurement, person-centred teamwork, psychometric testing, validation