MARC 主機 00000cam  2200493 a 4500 
001    671531658 
005    20110204000000.0 
008    101022s2010    caua   e b    000 0 eng c 
010    2010938595 
020    0833050559 
020    9780833050557 (pbk.) 
027    RAND/TR-842-OSD 
035    (OCoLC)671531658 
043    n-us--- 
245 00 Achieving strong teamwork practices in hospital labor and 
       delivery units /|cDonna O. Farley... [et al.] 
260    Santa Monica :|bRand Corporation Center for Military 
       Health Policy Research,|cc2010 
300    xxiv, 124 p. :|bill. ;|c28 cm 
490 1  Technical report ;|vTR-842-OSD 
504    Includes bibliographical references (p. 121-124) 
505 0  Introduction and background -- Study design and methods --
       Findings regarding teamwork implementation -- Effects of 
       teamwork improvement on unit staff and patient outcomes --
       Synthesis of findings and conclusions -- Appendix A: Tools
       and strategies for teamwork -- Appendix B: Matrix of 
       questions and stakeholders for site visits -- Appendix C: 
       Monthly update teleconference: longitudinal labor and 
       delivery teamwork study -- Appendix D: Questions for final
       assessment: longitudinal labor and delivery teamwork study
       -- Appendix E: Team performance observation tool -- 
       Appendix F: Staff survey questionnaire -- Appendix G: 
       Regression results for staff perceptions and knowledge 
520    A RAND study of teamwork-improvement initiatives in 
       hospital labor and delivery (L&D) units was designed to 
       document and learn from the experiences and outcomes of 
       five L&D units as they implemented improvements in their 
       teamwork practices over a one-year period. The study had 
       two objectives: (1) better understand the conditions and 
       actions required for hospital L&D units to achieve 
       effective and sustainable teamwork practices, and (2) 
       assess the extent to which successful adoption of teamwork
       practices may influence the experiences of L&D staff and 
       patient outcomes. Substantial progress is possible in one 
       year of implementing teamwork practices, which can improve
       proximal outcomes, such as staff knowledge and 
       perceptions. More than a year of implementation effort is 
       required to achieve a high level of performance on 
       teamwork practices. Two dynamics might be involved in 
       later years of implementation: (1) momentum from the first
       year might continue into later years, such that subsequent
       implementation might reinforce continued improvement, and 
       (2) it might not be possible to sustain high intensity in 
       implementation beyond the first year. The study results 
       reinforce the importance of developing and implementing a 
       well-crafted strategy by training staff in the L&D units, 
       working consistently with staff to introduce practices, 
       and providing coaching on effective use of practices. The 
       study identified some key factors required by any given 
       strategy for teamwork improvement, but it did not point to
       a standard template for implementation. This result 
       implies that there may not be one fixed "intervention" 
       that could be tested in comparative-control studies to 
       develop further evidence for teamwork practices 
590    EAS: HM 
650  0 Hospitals|xEmployees 
650  0 Hospitals|xMaternity services|zUnited States 
650  0 Labor (Obstetrics)|zUnited States 
650  2 Medical Staff, Hospital|xpsychology 
650  2 Birthing Centers|xorganization & administration 
650  2 Delivery, Obstetric 
650  2 Cooperative Behavior 
650  2 Delivery Rooms|xstandards 
650  2 Patient Care Team 
650  2 Models, Theoretical 
700 1  Farley, Donna 
710 2  Center for Military Health Policy Research 
830  0 Technical report (Rand Corporation) ;|vTR-842-OSD 
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