What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team

IntroductionNeonatal resuscitation is a team-based activity involving many decisions and tasks. Non-technical factors, such as teamwork, are increasingly recognized as impacting how well-neonatal resuscitation is performed, and therefore influencing infant outcomes. Prior studies on teamwork in neon...

Full description

Bibliographic Details
Main Authors: Krystyna Ediger, Marghalara Rashid, Brenda Hiu Yan Law
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2022.845671/full
_version_ 1811329512852422656
author Krystyna Ediger
Marghalara Rashid
Brenda Hiu Yan Law
author_facet Krystyna Ediger
Marghalara Rashid
Brenda Hiu Yan Law
author_sort Krystyna Ediger
collection DOAJ
description IntroductionNeonatal resuscitation is a team-based activity involving many decisions and tasks. Non-technical factors, such as teamwork, are increasingly recognized as impacting how well-neonatal resuscitation is performed, and therefore influencing infant outcomes. Prior studies on teamwork in neonatal resuscitation have focused on quantification of teamwork behaviors, or the effects of team training. This study aimed to explore healthcare providers' own perception of teamwork in this specialized environment to identify perceived barriers and facilitators to effective team functioning.MethodsThis single-center exploratory sequential mixed methods study used two phases. First, semi-structured interviews were conducted, and thematic analysis used to identify themes. Subsequently, interview data informed the development of quantitative surveys to explore selected themes in the wider team.ResultsFrom ten semi-structured interviews, seven themes were identified including: (1) Team Composition, (2) Effective Communication, (3) Team leadership, (4) Hierarchy, (5) Team Training, (6) Debriefing, and (7) Physical Environment. Perceived teamwork facilitators include role assignment, familiarity, team composition, talking out loud to maintain shared mental models, leadership, and team training. Perceived barriers included time pressures, ad hoc team, ineffective leadership, and space limitations. Selected themes (Communication, Speaking up, Hierarchy, and Leadership) were further explored via electronic surveys distributed via email to all members of the resuscitation team. There were 105 responses; a response rate of ~53%. All respondents agreed or strongly agreed that speaking up is important; however, not all felt comfortable doing so. Neonatal fellows (14%) and nurses (12%) were most likely to report not feeling comfortable speaking up. All respondents agreed that team communication is important to an effective resuscitation. Most respondents (91.5%) agreed that a hierarchy exists within the team; 54.3% believed that hierarchy positively contributes to effective resuscitation. All respondents agreed or strongly agreed that having a clearly defined leader is important in delivery room resuscitations. Ineffective leadership was the most cited reason for poor team communication.ConclusionsIn this mixed methods study of perceptions of teamwork within a specialized, multi-disciplinary neonatal resuscitation team, communication, hierarchy, and leadership were positively perceived and facilitates teamwork. However, even in this environment, some nurses and trainees expressed discomfort with speaking up.
first_indexed 2024-04-13T15:46:29Z
format Article
id doaj.art-6ee712a4e0e54a87a7a3e0f40b3bc916
institution Directory Open Access Journal
issn 2296-2360
language English
last_indexed 2024-04-13T15:46:29Z
publishDate 2022-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Pediatrics
spelling doaj.art-6ee712a4e0e54a87a7a3e0f40b3bc9162022-12-22T02:40:59ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-04-011010.3389/fped.2022.845671845671What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation TeamKrystyna EdigerMarghalara RashidBrenda Hiu Yan LawIntroductionNeonatal resuscitation is a team-based activity involving many decisions and tasks. Non-technical factors, such as teamwork, are increasingly recognized as impacting how well-neonatal resuscitation is performed, and therefore influencing infant outcomes. Prior studies on teamwork in neonatal resuscitation have focused on quantification of teamwork behaviors, or the effects of team training. This study aimed to explore healthcare providers' own perception of teamwork in this specialized environment to identify perceived barriers and facilitators to effective team functioning.MethodsThis single-center exploratory sequential mixed methods study used two phases. First, semi-structured interviews were conducted, and thematic analysis used to identify themes. Subsequently, interview data informed the development of quantitative surveys to explore selected themes in the wider team.ResultsFrom ten semi-structured interviews, seven themes were identified including: (1) Team Composition, (2) Effective Communication, (3) Team leadership, (4) Hierarchy, (5) Team Training, (6) Debriefing, and (7) Physical Environment. Perceived teamwork facilitators include role assignment, familiarity, team composition, talking out loud to maintain shared mental models, leadership, and team training. Perceived barriers included time pressures, ad hoc team, ineffective leadership, and space limitations. Selected themes (Communication, Speaking up, Hierarchy, and Leadership) were further explored via electronic surveys distributed via email to all members of the resuscitation team. There were 105 responses; a response rate of ~53%. All respondents agreed or strongly agreed that speaking up is important; however, not all felt comfortable doing so. Neonatal fellows (14%) and nurses (12%) were most likely to report not feeling comfortable speaking up. All respondents agreed that team communication is important to an effective resuscitation. Most respondents (91.5%) agreed that a hierarchy exists within the team; 54.3% believed that hierarchy positively contributes to effective resuscitation. All respondents agreed or strongly agreed that having a clearly defined leader is important in delivery room resuscitations. Ineffective leadership was the most cited reason for poor team communication.ConclusionsIn this mixed methods study of perceptions of teamwork within a specialized, multi-disciplinary neonatal resuscitation team, communication, hierarchy, and leadership were positively perceived and facilitates teamwork. However, even in this environment, some nurses and trainees expressed discomfort with speaking up.https://www.frontiersin.org/articles/10.3389/fped.2022.845671/fullinfantnewbornneonatal resuscitationteamworkcommunication barriers
spellingShingle Krystyna Ediger
Marghalara Rashid
Brenda Hiu Yan Law
What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
Frontiers in Pediatrics
infant
newborn
neonatal resuscitation
teamwork
communication barriers
title What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
title_full What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
title_fullStr What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
title_full_unstemmed What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
title_short What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team
title_sort what is teamwork a mixed methods study on the perception of teamwork in a specialized neonatal resuscitation team
topic infant
newborn
neonatal resuscitation
teamwork
communication barriers
url https://www.frontiersin.org/articles/10.3389/fped.2022.845671/full
work_keys_str_mv AT krystynaediger whatisteamworkamixedmethodsstudyontheperceptionofteamworkinaspecializedneonatalresuscitationteam
AT marghalararashid whatisteamworkamixedmethodsstudyontheperceptionofteamworkinaspecializedneonatalresuscitationteam
AT brendahiuyanlaw whatisteamworkamixedmethodsstudyontheperceptionofteamworkinaspecializedneonatalresuscitationteam