Christian N. Burchill

Bio: Christian N. Burchill is an academic researcher from Cleveland Clinic. The author has contributed to research in topics: Medicine & Psychological intervention. The author has an hindex of 6, co-authored 16 publications receiving 358 citations. Previous affiliations of Christian N. Burchill include University of Pennsylvania & Case Western Reserve University.

The Link Between Teamwork and Patients’ Outcomes in Intensive Care Units

Abstract: • BACKGROUND Links between teamwork and outcomes have been established in a number of fields Investigations into this link in healthcare have yielded equivocal results • OBJECTIVE To examine the relationship between the level of self-identified teamwork in the intensive care unit and patients’ outcomes • METHOD A total of 394 staff members of 17 intensive care units completed the Group Development Questionnaire and a demographic survey The questionnaire is a reliable and valid measure of team development and effectiveness Each unit’s predicted and actual mortality rates for the month in which data were collected were obtained Pearson product moment correlations and analyses of variance were used to analyze the data • RESULTS Staff members of units with mortality rates that were lower than predicted perceived their teams as functioning at higher stages of group development They perceived their team members as less dependent and more trusting than did staff members of units with mortality rates that were higher than predicted Staff members of high-performing units also perceived their teams as more structured and organized than did staff members of lower-performing units • CONCLUSIONS The results of this study and others establish a link between teamwork and patients’ outcomes in intensive care units The evidence is sufficient to warrant the implementation of strategies designed to improve the level of teamwork and collaboration among staff members in intensive care units (American Journal of Critical Care 2003;12:527-534)

Survey design research: a tool for answering nursing research questions.

Abstract: The clinical nurse specialist is in a unique position to identify and study clinical problems in need of answers, but lack of time and resources may discourage nurses from conducting research. However, some research methods can be used by the clinical nurse specialist that are not time-intensive or cost prohibitive. The purpose of this article is to explain the utility of survey methodology for answering a number of nursing research questions. The article covers survey content, reliability and validity issues, sample size considerations, and methods of survey delivery.

The Relationship between Patients' Perceptions of Team Effectiveness and their Care Experience in the Emergency Department

Abstract: Background Effective teamwork is important in the fast-paced Emergency Department (ED) setting. Most of the teamwork literature addresses the provider's perspective of teamwork rather than the patient's perspective. Objective Examine the relationship between patients' perceptions of teamwork and care experience in the ED. Methods We conducted a cross-sectional survey study of adult patients seen at the University of Pennsylvania ED during the fall of 2011. Patients rated overall satisfaction, pain management, trust, and confidence in the team and likelihood of treatment compliance (outcomes) and four components of team effectiveness (role clarity, shared goals, relationships, and job satisfaction) on a Likert scale. We examined the relationship between patients' perception of teamwork and the outcomes using multivariate analysis, controlling for sociodemographic factors. Results We collected 1010 surveys. Patients rated the individual components of teamwork equally, with about 70% rating teamwork as "Very High." Most patients who rated teamwork highly also rated their confidence and trust in their providers highly (80–90%) compared to 20% of those who rated teamwork lower. The relative risk ratios between high and low teamwork were 4.1 (95% confidence interval [CI] 2.8–5.9) for overall satisfaction, 3.9 (95% CI 2.7–5.8) for satisfaction with pain treatment, 5.3 (95% CI 3.6–7.8) for confidence in providers, and 1.9 (95% CI 1.5–2.5) for likelihood to follow-up treatment recommendations. Conclusions Patient satisfaction and willingness to adhere to treatment recommendations are highly correlated with patients' perceptions of ED teamwork.

Take teamwork to new heights.

Abstract: Teamwork follows the dynamic path of group development. The authors evaluate their survey of teamwork in 14 ICUs and explain how nurse managers can evaluate and increase teamwork with a unit assessment process.

Teamwork and patient safety in dynamic domains of healthcare: a review of the literature.

Abstract: Aims/background This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care Results Evidence from three main areas of research supports the relationship between teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that teamwork plays an important role in the causation and prevention of adverse events (2) Research focusing on healthcare providers' perceptions of teamwork demonstrated that (a) staff's perceptions of teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care (3) Observational studies on teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective teamwork Conclusion In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review This will help to improve team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care

Planning and studying improvement in patient care : The use of theoretical perspectives

Abstract: A consistent finding in articles on quality improvement in health care is that change is difficult to achieve. According to the research literature, the majority of interventions are targeted at health care professionals. But success in achieving change may be influenced by factors other than those relating to individual professionals, and theories may help explain whether change is possible. This article argues for a more systematic use of theories in planning and evaluating quality-improvement interventions in clinical practice. It demonstrates how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality-improvement strategies.

What Do We Know about Health Care Team Effectiveness? A Review of the Literature

Abstract: This review of health care team effectiveness literature from 1985 to 2004 distinguishes among intervention studies that compare team with usual (nonteam) care; intervention studies that examine the impact of team redesign on team effectiveness; and field studies that explore relationships between team context, structure, processes, and outcomes. The authors use an Integrated Team Effectiveness Model (ITEM) to summarize research findings and to identify gaps in the literature. Their analysis suggests that the type and diversity of clinical expertise involved in team decision making largely accounts for improvements in patient care and organizational effectiveness. Collaboration, conflict resolution, participation, and cohesion are most likely to influence staff satisfaction and perceived team effectiveness. The studies examined here underscore the importance of considering the contexts in which teams are embedded. The ITEM provides a useful framework for conceptualizing relationships between multiple dimensions of team context, structure, processes, and outcomes.

Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82

Abstract: Over the past two decades, there has been an exponential and enthusiastic adoption of simulation in healthcare education internationally. Medicine has learned much from professions that have established programs in simulation for training, such as aviation, the military and space exploration. Increased demands on training hours, limited patient encounters, and a focus on patient safety have led to a new paradigm of education in healthcare that increasingly involves technology and innovative ways to provide a standardized curriculum. A robust body of literature is growing, seeking to answer the question of how best to use simulation in healthcare education. Building on the groundwork of the Best Evidence in Medical Education (BEME) Guide on the features of simulators that lead to effective learning, this current Guide provides practical guidance to aid educators in effectively using simulation for training. It is a selective review to describe best practices and illustrative case studies. This Guide is the second part of a two-part AMEE Guide on simulation in healthcare education. The first Guide focuses on building a simulation program, and discusses more operational topics such as types of simulators, simulation center structure and set-up, fidelity management, and scenario engineering, as well as faculty preparation. This Guide will focus on the educational principles that lead to effective learning, and include topics such as feedback and debriefing, deliberate practice, and curriculum integration – all central to simulation efficacy. The important subjects of mastery learning, range of difficulty, capturing clinical variation, and individualized learning are also examined. Finally, we discuss approaches to team training and suggest future directions. Each section follows a framework of background and definition, its importance to effective use of simulation, practical points with examples, and challenges generally encountered. Simulation-based healthcare education has great potential for use throughout the healthcare education continuum, from undergraduate to continuing education. It can also be used to train a variety of healthcare providers in different disciplines from novices to experts. This Guide aims to equip healthcare educators with the tools to use this learning modality to its full capability.