Patients' views of teamwork in the emergency department offer insights about team performance

Abstract

Background: Research into efforts to engage patients in the assessment of health-care teams is limited. Objective: To explore, through qualitative methods, patient awareness of teamwork-related behaviours observed during an emergency department (ED) visit. Design: Researchers used semi-structured question guides for audio-recorded interviews and analysed their verbatim transcripts. Setting and participants: Researchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face-to-face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED). Results: SMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health-care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient-centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients' observations of team members relate to patients' views of team effectiveness. Analysis also indicated that patients viewed health-care team members' interactions with each other as proxy for how team members actually felt about patients. Discussion: Results from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients' understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team. Conclusion: Patients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training.