Patient Safety

SS 34 - Patient Safety

248 - Use of Relational Coordination Scale to Assess Perceptions of Physician Teamwork Skills by Clinical and Administrative Staff

Wednesday, October 24
8:15 AM - 8:25 AM
Location: Room 008

Use of Relational Coordination Scale to Assess Perceptions of Physician Teamwork Skills by Clinical and Administrative Staff
S. Kazi1, A. Dietz2, M. Rosen1, T. L. DeWeese3, and D. Song4; 1Johns Hopkins University School of Medicine, Baltimore, MD, 2US Department of Veterans Affairs, Baltimore, MD, 3Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 4Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD

Purpose/Objective(s): The quality of relationships within a healthcare setting has been shown to impact quality of care and quality improvement success. Delivery of care in radiation oncology requires physicians to work with a variety of providers such a nurses and therapists. Physicians may have differing perspectives as to the quality of their working relationships than do their counterparts, with physicians often estimating those as more positive. We hypothesized that patterns of communication and relationships between team members and physicians could be meaningfully evaluated.

Materials/Methods: The Relational Coordination Scale is a validated instrument for assessing quality of communication and relationships, and measures teamwork on 6 dimensions: timeliness, accuracy, problem solving, shared goals, shared knowledge and respect. Each dimension is rated on a 5-point scale. We asked dosimetrists, nurses, physicists, therapists, and administrative staff to anonymously rate 15 attending physicians within a radiation oncology department using the RC scale.

Results: Of 135 staff invited, 67 (52%) completed the survey over 2 months. IRB approval (exempt status) was received. For each dimension, we measured rates of physicians being positively rated (above midpoint on the scale, i.e. 4-5/5). Analysis of variability of positive responses by respondent group revealed highest variability reported by administrative staff for Completeness of work, by dosimetry for Timeliness, by nursing for Timeliness, by physics for Timeliness, and by therapists for Completeness. Overall, timeliness was rated with the greatest variability across individual physicians (mean positive rating 43 - 99%). Nurses were found to give higher ratings to physicians on timeliness compared to administrative staff, physics, and therapy (F [4, 75] = 3.18, p < .02). We also compared individual physicians by percentage of positive ratings for each dimension and respondent group. Aggregating on dimensions across respondent groups displayed variations across physicians, as well as some individual physicians receiving lower ratings across multiple dimensions and respondent groups, indicating gaps in communication and teamwork.

Conclusion: The relational coordination scale revealed variations in perceptions among support staff about teamwork and communication skills of radiation oncologists, particularly on completeness of work and timeliness of communication. We have utilized these data as part of evaluation of workflow and annualized feedback for physicians, towards targeted improvement of nontechnical skills in coordinating and working with staff.

Author Disclosure: S. Kazi: None. A. Dietz: None. T.L. DeWeese: None. D. Song: Stock; Roche.

Sadaf Kazi, PhD

Disclosure:
Employment
Johns Hopkins University: Human factors researcher: Employee

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