TY - JOUR
T1 - Interdisciplinary Team Meetings in Practice
T2 - an Observational Study of IDTs, Sensemaking Around Care Transitions, and Readmission Rates
AU - Leykum, Luci K
AU - Noël, Polly H.
AU - Penney, Lauren S.
AU - Mader, Michael
AU - Lanham, Holly J.
AU - Finley Garcia, Erin
AU - Pugh, Jacqueline A.
N1 - Publisher Copyright:
© 2022, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/2
Y1 - 2023/2
N2 - Background: Interdisciplinary teams (IDTs) have been implemented to improve collaboration in hospital care, but their impact on patient outcomes, including readmissions, has been mixed. These mixed results might be rooted in differences in organization of IDT meetings between hospitals, as well as variation in IDT characteristics and function. We hypothesize that relationships between IDT members are an important team characteristic, influencing IDT function in terms of how members make sense of what is happening with patients, a process called sensemaking Objective: (1) To describe how IDT meetings are organized in practice, (2) assess differences in IDT member relationships and sensemaking during patient discussions, and (3) explore their potential association with risk-stratified readmission rates (RSRRs). Design: Observational, explanatory convergent mixed-methods case-comparison study of IDT meetings in 10 Veterans Affairs hospitals. Participants: Clinicians participating in IDTs and facility leadership. Approach: Three-person teams observed and recorded IDT meetings during week-long visits. We used observational data to characterize relationships and sensemaking during IDT patient discussions. To assess sensemaking, we used 2 frameworks that reflected sensemaking around each patient’s situation generally, and around care transitions specifically. We examined the association between IDT relationships and sensemaking, and RSRRs. Key Results: We observed variability in IDT organization, characteristics, and function across 10 hospitals. This variability was greater between hospitals than between teams at the same hospital. Relationship characteristics and both types of sensemaking were all significantly, positively correlated. General sensemaking regarding each patient was significantly negatively associated with RSRR (− 0.65, p = 0.044). Conclusions: IDTs vary not only in how they are organized, but also in team relationships and sensemaking. Though our design does not allow for inferences of causation, these differences may be associated with hospital readmission rates.
AB - Background: Interdisciplinary teams (IDTs) have been implemented to improve collaboration in hospital care, but their impact on patient outcomes, including readmissions, has been mixed. These mixed results might be rooted in differences in organization of IDT meetings between hospitals, as well as variation in IDT characteristics and function. We hypothesize that relationships between IDT members are an important team characteristic, influencing IDT function in terms of how members make sense of what is happening with patients, a process called sensemaking Objective: (1) To describe how IDT meetings are organized in practice, (2) assess differences in IDT member relationships and sensemaking during patient discussions, and (3) explore their potential association with risk-stratified readmission rates (RSRRs). Design: Observational, explanatory convergent mixed-methods case-comparison study of IDT meetings in 10 Veterans Affairs hospitals. Participants: Clinicians participating in IDTs and facility leadership. Approach: Three-person teams observed and recorded IDT meetings during week-long visits. We used observational data to characterize relationships and sensemaking during IDT patient discussions. To assess sensemaking, we used 2 frameworks that reflected sensemaking around each patient’s situation generally, and around care transitions specifically. We examined the association between IDT relationships and sensemaking, and RSRRs. Key Results: We observed variability in IDT organization, characteristics, and function across 10 hospitals. This variability was greater between hospitals than between teams at the same hospital. Relationship characteristics and both types of sensemaking were all significantly, positively correlated. General sensemaking regarding each patient was significantly negatively associated with RSRR (− 0.65, p = 0.044). Conclusions: IDTs vary not only in how they are organized, but also in team relationships and sensemaking. Though our design does not allow for inferences of causation, these differences may be associated with hospital readmission rates.
KW - care transitions
KW - interdisciplinary teams
KW - readmissions
KW - sensemaking
UR - http://www.scopus.com/inward/record.url?scp=85135853877&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85135853877&partnerID=8YFLogxK
U2 - 10.1007/s11606-022-07744-6
DO - 10.1007/s11606-022-07744-6
M3 - Article
C2 - 35962296
AN - SCOPUS:85135853877
SN - 0884-8734
VL - 38
SP - 324
EP - 331
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 2
ER -