The role of team climate in improving the quality of chronic care delivery: a longitudinal study among professionals working with chronically ill adolescents in transitional care programmes
Open accessAbstract
OBJECTIVES: This study aimed to (1) evaluate the effectiveness of implementing transition programmes in improving the quality of chronic care delivery and (2) identify the predictive role of (changes in) team climate on the quality of chronic care delivery over time. SETTINGS: This longitudinal study was undertaken with professionals working in hospitals and rehabilitation units that participated in the transition programme 'On Your Own Feet Ahead!' in the Netherlands. PARTICIPANTSS: A total of 145/180 respondents (80.6%) filled in the questionnaire at the beginning of the programme (T1), and 101/173 respondents (58.4%) did so 1 year later at the end of the programme (T2). A total of 90 (52%) respondents filled in the questionnaire at both time points. Two-tailed, paired t tests were used to investigate improvements over time and multilevel analyses to investigate the predictive role of (changes in) team climate on the quality of chronic care delivery. INTERVENTIONS: Transition programme. PRIMARY OUTCOME MEASURES: Quality of chronic care delivery measured with the Assessment of Chronic Illness Care Short version (ACIC-S). RESULTS: The overall ACIC-S score at T1 was 5.90, indicating basic or intermediate support for chronic care delivery. The mean ACIC-S score at T2 significantly improved to 6.70, indicating advanced support for chronic care. After adjusting for the quality of chronic care delivery at T1 and significant respondents' characteristics, multilevel regression analyses showed that team climate at T1 (p<0.01) and changes in team climate (p<0.001) predicted the quality of chronic care delivery at T2. CONCLUSIONS: The implementation of transition programmes requires a supportive and stimulating team climate to enhance the quality of chronic care delivery to chronically ill adolescents.
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Improvements in team climate were associated with greater improvement in care delivery.
“Additionally, improvements in team climate were associated with greater improvement in care delivery [45].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [45]
More positive team climate at study start was associated with greater improvements in quality of chronic care delivery one year later in 29 teams implementing transition programs for adolescents with chronic health conditions.
“More positive team climate, measured by the Team Climate Inventory (i.e., shared vision, participative safety, task orientation, support for innovation), at study start was associated with greater improvements in quality of chronic care delivery one year later [45].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [45]
The influence of team climate on care delivery generalizes across teams and settings.
“These findings were consistent across teams working with different patient populations, suggesting the influence of team climate generalizes across teams and settings [45].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [45]
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- Authors
- Cramm, J. M., Strating, M. M. H., & Nieboer, A. P.
- Affiliations
- Erasmus University Rotterdam (NL)
- Corresponding author
- Cramm, Jane M
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2014-05
- Volume
- 4
- Issue
- 5
- Pages
- e005369
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4039831
- OpenAlex
- W2147333890
- Cited by
- 42
- References
- 49
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 1
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- team climate, care transitions, chronically ill adolescents, quality of care, transition programs, healthcare workers, rehabilitation units, hospital care
- MeSH terms
- Transitional Care, Adolescent, Adult, Chronic Disease, Delivery of Health Care, Female, Follow-Up Studies, Humans, Interprofessional Relations, Male, Middle Aged, Quality of Health Care, Young Adult
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