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INTRODUCTION: The health organizations of today are highly complex and specialized. Given this scenario, there is a need for health professionals to work collaboratively within interprofessional work teams to ensure quality and safe care. To strengthen interprofessional teamwork, it is imperative that health organizations enhance strategic human resources management by promoting team member satisfaction. OBJECTIVE: To analyze the satisfaction of members in interprofessional teams and to explore interpersonal relationships, leadership, and team climate in a hospital context. METHODOLOGY: This study is an explanatory sequential mixed methods (quantitative/qualitative) study of 53 teams (409 professionals) at a university hospital in Santiago, Chile. The first phase involved quantitative surveys with team members examining team satisfaction, transformational leadership, and team climate. Social network analysis was used to identify interactions among team members (cohesion and centrality). The second phase involved interviews with 15 professionals belonging to teams with the highest and lowest team satisfaction scores. Findings of both phases were integrated. RESULTS: Significant associations were found among variables, and the linear regression model showed that team climate (ß = 0.26) was a better predictor of team satisfaction than team leadership (ß = 0.17). Registered nurse was perceived as the profession with the highest score on the transformational leadership measure (mean = 64), followed by the physician (mean = 33). Team networks with the highest and lowest score of team satisfaction showed differences in cohesion and centrality measures. Analysis of interviews identified five themes: attributes of interprofessional work; collaboration, communication, and social interaction; interprofessional team innovation; shared leadership; and interpersonal relationship interface work/social. Integration of findings revealed that team member satisfaction requires participation and communication, common goals and commitment for patient-centered care, clear roles and objectives to support collaborative work, and the presence of a transformational leader to strengthen well-being, dialog, and innovation. CONCLUSIONS: Results have the potential to contribute to the planning and decision-making in the field of human resources, providing elements to promote the management of health teams and support team member satisfaction. In turn, this could lead to job permanence especially where the local health needs are more urgent.
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Actitud del Personal de Salud , Comunicación , Conducta Cooperativa , Relaciones Interprofesionales , Satisfacción en el Trabajo , Grupo de Atención al Paciente , Personal de Hospital , Adulto , Chile , Femenino , Hospitales , Humanos , Liderazgo , Masculino , Satisfacción Personal , Investigación Cualitativa , UniversidadesRESUMEN
BACKGROUND AND OBJECTIVES: Effective relationship and collaboration between doctors and nurses is considered the main factor in achieving positive medical results, which is the most important goal of the healthcare system. This study aims to compare attitude of doctors and nurses toward factors associated with doctor-nurse collaboration, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses' autonomy. METHODS: In this cross sectional, descriptive-comparative study, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration was used to assess doctor-nurse collaboration in four domains, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses' autonomy. To this end, descriptive (mean, standard deviation) and inferential statistics including independent t test, Chi-square, and variance analysis were used. RESULTS: According to the results obtained, compared to doctors, nurses showed a more positive attitude toward shared education and teamwork, caring as opposed to curing, and physicians' dominance, but there was no significant difference between the two groups in nurses' autonomy. CONCLUSION: With regard to doctor-nurse collaboration, it is essential that doctors and nurses be acculturated in the course of their academic education. Moreover, policies to change pattern of professional relationships from hierarchical to complementary can be effective in enhancing professional autonomy of nurses and reducing impaired professional interactions.
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Introduction Patient care in the trauma-surgical intensive care unit (SICU) requires trust and effective communication between nurses and physicians. Our SICU suffered from poor communication and trust between nurses and physicians, negatively impacting the working environment and, potentially, patient care. Methods A SICU Task Force studied communication practices and identified areas for improvement, leading to several interventions. The daily physician rounding was altered to improve communication and to enhance the role of the registered nurses (RN) in rounds. Additionally, a formal night resident rounding time was implemented. Results A post-intervention survey focusing on cooperation, teamwork, and appreciation between nurses and physicians revealed improvement in these domains. Informal feedback from nurses and physicians indicated improved working relationships and satisfaction with the SICU environment. However, results of a national survey performed after the intervention did not show the same level of improvement. Conclusions A Task Force consisting of SICU nurses and physicians can effectively study a widespread communication issue and implement targeted interventions. While informal feedback may indicate improvement, it can be difficult to demonstrate improvement using formal surveys.
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Este artigo apresenta resultados parciais de pesquisa que visou a apreender como os trabalhadores vivenciam as relações interprofissionais no contexto das práticas de atenção à saúde em doenças infecciosas em setor de internação hospitalar de instituto de pesquisa. Enfoca o trabalho em equipe a partir da rotina dos profissionais que lá atuam e das reuniões multiprofissionais em saúde. O referencial teórico-metodológico articulou contribuições da ergologia de Schwartz com reflexões da Política Nacional de Humanização. A pesquisa qualitativa utilizou técnicas de observação participante e entrevistas semiestruturadas para a produção de dados. A análise do material empírico foi realizada com base no referencial da análise de conteúdo em sua vertente temática. Dentre os principais resultados, observou-se que os trabalhadores desejam encontrar uma forma efetiva de trabalhar em equipe que resulte numa atenção à saúde integral e humanizada, porém prevalece uma postura de espera pelo sujeito das mudanças. Isto demonstra a necessidade de se fomentar o protagonismo desses sujeitos, tornando visível a gestão que os trabalhadores da saúde fazem do seu próprio processo de trabalho, bem como aprimorar mecanismos de gestão participativa com a ampliação do grau de transversalização entre os sujeitos envolvidos no cuidado, numa perspectiva de gestão em que todos sejam corresponsáveis pelos rumos da atenção prestada.
The article focuses on team work within multiprofessional health meetings. It presents results of a research that intended to understand how workers experience the interrelationships, in the context of health care practices in infectious diseases in the hospitalization sector of a Research Institute. The theoretical and methodological references articulated contributions of Schwartz's Ergology and the National Policy of Humanization. The qualitative research used observation techniques and semi-structured interviews. The analysis of empirical material was based on the technique of content analysis in its thematic analysis. Among the main results, we found that workers want to find an effective way to work in teams, resulting in a comprehensive and humanizing health care, but a prevailing attitude of waiting for the subject of change, demonstrates the need to make the management they do of their own work process become visible, to encourage the protagonism of subjects and a management perspective in which all subjects can feel coresponsible for the direction of health care provided.