Team Effectiveness and Organizational Context in the Implementation of a Clinical Innovation
Abstract
OBJECTIVES: The study examined the relationship between care delivery team effectiveness, management support, organizational culture, and the extent of implementation of a clinical innovation. METHODS: The study involved 6 target clinic areas in 78 Department of Veterans Affairs medical centers that participated in the national implementation of Advanced Clinic Access (ACA). Primary data were collected through staff surveys and structured interviews; secondary analyses were conducted using administrative databases. Hierarchical linear models were used to test the influence of team effectiveness and organizational context on implementation ratings. RESULTS AND CONCLUSIONS: Team effectiveness as measured by team knowledge and skills was significantly associated with the extent of ACA implementation in both primary and specialty care. Team functioning was significant only in primary care. Management support as measured by personal leadership support for quality improvement and the importance of reduced wait times was also significantly associated with ACA implementation, but practical management support and organizational culture were not. Team effectiveness partially mediated the relationship between extent of implementation and personal leadership support. Findings support the underlying theory that implementation of clinical innovations depends on both individual staff and a more complex dynamic of individuals operating within work units in the larger organization.
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Greater team knowledge and skills were associated with greater implementation of key changes to improve access to care.
“The second study found that greater team knowledge and skills were associated with greater implementation of key changes to improve access to care; team problem recognition was not associated with implementation [62].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [62]
Team problem recognition was not associated with implementation.
“The second study found that greater team knowledge and skills were associated with greater implementation of key changes to improve access to care; team problem recognition was not associated with implementation [62].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [62]
Better team functioning was associated with greater implementation of changes to improve access to care in VA clinics.
“One found that better team functioning was associated with greater implementation of changes to improve access to care in VA clinics [62].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [62]
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- Authors
- Lukas, C. V., Mohr, D. C., & Meterko, M.
- Affiliations
- Boston University (US)
- Venue
- Quality Management in Health Care
- Published
- 2009-01
- Volume
- 18
- Issue
- 1
- Pages
- 25-39
- ISSN
- 1063-8628 (ISSN-L)
- OpenAlex
- W2332098057
- Cited by
- 47
- References
- 34
- Citations by year
- 2024: 6 · 2023: 5 · 2022: 1 · 2020: 8 · 2019: 2 · 2018: 3 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 1
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Quality Management in Health Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Keywords
- team effectiveness, organizational context, management support, organizational culture, veterans' health care, team functioning, leadership support, waiting time, primary care, specialist care, quality improvement
- MeSH terms
- Cooperative Behavior, Diffusion of Innovation, Hospitals, Veterans, Humans, Interviews as Topic, Medical Staff, Hospital, Quality of Health Care, Organizational Culture, Efficiency, Organizational
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