Achieving Strong Teamwork Practices in Hospital Labor and Delivery Units by Donna O. Farley

Author:Donna O. Farley [Farley, Donna O.]
Language: eng
Format: epub
ISBN: 978-0-8330-5118-9
Publisher: RAND Corporation
Published: 2010-08-10T16:00:00+00:00

Teamwork Training and Coaching

To learn from sites’ experiences with teamwork training, we examined three aspects of the training process: initial training on teamwork practices, ongoing coaching and reinforcement during implementation, and refresher training.

Best Approaches for Initial Training on the Teamwork Model and Practices. As described in the previous section, the sites took quite different approaches to the provision of teamwork training to their L&D unit staff. Two of the sites provided initial training to all the unit staff, although they differed in the pace at which the training was given. The others trained only a portion of the staff, then relied on the trained staff to train and coach the remaining staff in real time as teamwork practices were being implemented. Despite these differences, we heard very similar feedback from the sites regarding how the initial training should be designed and carried out.

The sites emphasized that the training should be interactive and that it should be multidisciplinary in terms of both the participants and the teachers. The use of interactive classes with videos and clinical scenarios specific to the unit made it realistic to the participants. Several of them found that it was effective to have medical doctors (MDs) and RNs teaching the sessions together. They also found that the environment and class size were important and that a class of about 15 participants was about the right size. One site specifically reported that use of the small-group approach was effective for them. Another site suggested that the training should be separate from the normal workday and include time for social interactions among participants.

Adequate time should be taken to develop the curriculum, to ensure the quality of the training provided. In addition, the curriculum should be modified to be relevant to the unit. Use of an outside consultant also was helpful, to provide expertise and an objective perspective. One site noted that it used the “parking-lot” method to record issues and concerns that participants raised so they could be addressed during later discussions. This proved to be invaluable because it assured people that their concerns were not being dismissed.

One site took six months to train all its staff, thus creating, for some staff, a delay between the time of their training and actual start of actions to implement the teamwork practices they were taught. As a result, the people who were trained early had forgotten the material when it came time to implement, and they needed reinforcement of their training at the start of implementation. The site team concluded that it might be better to condense the training to shorten this lag time.

Best Ways to Provide Ongoing Guidance to Unit Staff on Teamwork Practices. As the sites implemented teamwork improvements, they used a variety of techniques to reinforce and coach unit staff on use of effective teamwork practices. All of them reported that such re­inforcement was critically important because they were working to change existing behaviors that were comfortable to staff, even if they were not optimal for effective teamwork. They noted that everyone must coach everyone, as “we are all learning as we go.

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