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  • Original Article
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Variation in caregiver perceptions of teamwork climate in labor and delivery units

Abstract

Objective:

To test the psychometric soundness of a teamwork climate survey in labor and delivery, examine differences in perceptions of teamwork, and provide benchmarking data.

Design:

Cross-sectional survey of labor and delivery caregivers in 44 hospitals in diverse regions of the US, using the Safety Attitudes Questionnaire teamwork climate scale.

Results:

The response rate was 72% (3382 of 4700). The teamwork climate scale had good internal reliability (overall α=0.78). Teamwork climate scale factor structure was confirmed using multilevel confirmatory factor analyses (CFI=0.95, TLI=0.92, RMSEA=0.12, SRMRwithin=0.04, SRMRbetween=0.09). Aggregation of individual-level responses to the L&D unit-level was supported by ICC (1)=0.06 (P<0.001), ICC (2)=0.83 and mean rwg(j)=0.83. ANOVA demonstrated differences between caregivers F (7, 3013)=10.30, P<0.001 and labor and delivery units, F (43, 1022)=3.49, P<0.001. Convergent validity of the scale scores was measured by correlations with external teamwork-related items: collaborative decision making (r=0.780, P<0.001), use of briefings (r=0.496, P<0.001) and perceived adequacy of staffing levels (r=0.593, P<0.001).

Conclusion:

We demonstrate a psychometrically sound teamwork climate scale, correlate it to external teamwork-related items, and provide labor and delivery teamwork benchmarks. Further teamwork climate research should explore the links to clinical and operational outcomes.

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Acknowledgements

This work was funded in part by Agency for Healthcare Research and Quality Grant # 1PO1HS1154401

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Correspondence to J B Sexton.

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Sexton, J., Holzmueller, C., Pronovost, P. et al. Variation in caregiver perceptions of teamwork climate in labor and delivery units. J Perinatol 26, 463–470 (2006). https://doi.org/10.1038/sj.jp.7211556

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