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Cited by 70Health Policy Implementation ScienceTeam Dynamics and PerformanceHealth Sciences Research and Education

Teamwork and implementation of innovations in healthcare and human service settings: a systematic review

Open access
McGuier, Elizabeth A., Kolko, David J., Aarons, Gregory A., Schachter, Allison, Klem, Mary Lou, Diabes, Matthew A., Weingart, Laurie R., Salas, Eduardo +1 more·2024·Implementation Science
DOI 10.1186/s13012-024-01381-9PMC PMC11247800
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Abstract

Background: Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations. However, team constructs and team-based implementation approaches have received little attention in the implementation science literature. This systematic review summarizes empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings. Methods: We searched MEDLINE, CINAHL, APA PsycINFO and ERIC for peer-reviewed empirical articles published from January 2000 to March 2022. Additional articles were identified by searches of reference lists and a cited reference search for included articles (completed in February 2023). We selected studies using quantitative, qualitative, or mixed methods to examine associations between team constructs and implementation outcomes in healthcare and human service settings. We used the Mixed Methods Appraisal Tool to assess methodological quality/risk of bias and conducted a narrative synthesis of included studies. GRADE and GRADE-CERQual were used to assess the strength of the body of evidence. Results: Searches identified 10,489 results. After review, 58 articles representing 55 studies were included. Relevant studies increased over time; 71% of articles were published after 2016. We were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. Qualitative findings with high confidence were: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier. Conclusions: Teamwork matters for implementation. However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies. Greater specificity and rigor are needed to understand how teamwork influences implementation processes and outcomes. We provide recommendations for improving the conceptualization, description, assessment, analysis, and interpretation of research on teams implementing innovations. Trial registration: This systematic review was registered in PROSPERO, the international prospective register of systematic reviews. Registration number: CRD42020220168.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of 58 articles from 55 studies found that teamwork matters for implementation of innovations in healthcare and human service settings, especially through team stability, adaptive functioning, and communication. Quantitative synthesis was not possible because team constructs and implementation outcomes overlapped too little across studies.

Key findings

  • Searches identified 10,489 results; 58 articles representing 55 studies were included, with 71% published between 2016 and early 2023. Studies were 33 qualitative, 15 quantitative, and 10 mixed methods.
  • High-confidence qualitative findings were: staffing shortages and turnover hinder implementation; adaptive team functioning (positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better outcomes, while problems in team functioning are barriers; and open, ongoing, effective communication facilitates implementation, while poor communication is a barrier.
  • Quantitative synthesis was not possible: there was no overlap among team input variables and implementation outcomes, and very little overlap among team processes/states and implementation outcomes, so no estimates of effects could be generated. When evidence quality could be rated, it was rated very low.
  • Only 4 articles were rated both high quality and high relevance; the narrative synthesis included 32 articles rated moderate/high quality and moderate/high relevance and excluded 26 articles rated low quality and/or relevance.

Methods

  • Searched MEDLINE, CINAHL, APA PsycINFO, and ERIC for peer-reviewed empirical articles published January 2000 to March 2022, plus reference-list and cited-reference searches completed February 2023.
  • Included quantitative, qualitative, or mixed methods studies in healthcare or human service settings that assessed at least one team construct and its influence on implementation processes/outcomes; excluded study protocols, reviews, commentaries, team-building interventions, and teams created to implement the innovation.
  • Used the Mixed Methods Appraisal Tool for quality/risk of bias, narrative synthesis following SWiM, and GRADE/GRADE-CERQual for strength of evidence; registered in PROSPERO (CRD42020220168).

Limitations

  • Stated: the review may have missed relevant articles; it did not search gray literature or conference abstracts or contact authors for unreported data; organizing studies by the IMOI framework is likely imperfect; and diverse innovations/settings may mask findings specific to certain innovations or settings.
  • Stated: many studies provided limited descriptions of teams, and in some cases the distinction between clinical teams and implementation/quality improvement teams was unclear.
  • Evident from the text: heterogeneity and poor specification/measurement of team constructs and implementation outcomes limited synthesis; most included studies were not both high quality and high relevance, and quantitative evidence was sparse and non-overlapping.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s13012-024-01381-9

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 108 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Approximately one-third of studies (n = 21) did not report specific implementation outcomes but described implementation determinants (i.e., barriers and facilitators).

    “Approximately one-third of studies (n = 21) did not report specific implementation outcomes but described implementation determinants (i.e., barriers and facilitators).”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Team size was positively correlated with fidelity in a mixed methods study of DBT.

    “In a mixed methods study, team size was positively correlated with fidelity, and qualitative data suggested that team size may increase as a result of successful implementation [47].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] Ditty MS, Landes SJ, Doyle A, Beidas RS. It takes a village: A mixed method analysis of inner setting variables and Dialectical Behavior Therapy implementation. Adm Policy Ment Health. 2015;42(6):672–81. source

      Not checked in the free run.

  • Findingcitation

    Team workload (number of patients seen) was negatively associated with sustainment of trauma-focused therapies in VA mental health clinics.

    “In VA mental health clinics, team workload (i.e., number of patients seen) was negatively associated with sustainment of trauma-focused therapies [68].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Mohr DC, Rosen CS, Schnurr PP, Orazem RJ, Noorbaloochi S, Clothier BA, et al. The influence of team functioning and workload on sustainability of trauma-focused evidence-based psychotherapies. PS. 2018;69(8):879–86. source

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  • Findingown data

    After review, 58 articles representing 55 studies were included.

    “After review, 58 articles representing 55 studies were included.”
    • Also stated in: § Search results · plain
      “After full-text review, 58 articles from 55 studies were included in analyses [40–97].”
    Quote in the paperNot a substantial claim
  • Findingcitation

    In primary care, there were mixed perceptions of stable vs. rotating staff when adding a new team role (i.e., health coach).

    “Lastly, another study in primary care found mixed perceptions of stable vs. rotating staff when adding a new team role (i.e., health coach); some team members liked rotating through different roles while others wanted more stability [94].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [94] Van der Wees PJ, Friedberg MW, Guzman EA, Ayanian JZ, Rodriguez HP. Comparing the implementation of team approaches for improving diabetes care in community health centers. BMC Health Serv Res. 2014;14(1):608. source

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  • Classified as probably not a substantial claim. 34
  • May combine two claims. 44

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Searches identified 10,489 results.

    “Searches identified 10,489 results.”
    • Also stated in: § Search results · plain
      “A total of 10,489 results were included in title/abstract review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Studies were conducted in inpatient healthcare (n = 22), outpatient/ambulatory healthcare (n = 21), mental health settings (n = 9), and other settings (n = 6).

    “Studies were conducted in inpatient healthcare (n = 22), outpatient/ambulatory healthcare (n = 21), mental health settings (n = 9), and other settings (e.g., residential facilities, multiple settings; n = 6).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In surgical teams, rigid professional roles and a hierarchical team culture constrained open discussion and created contention over how and when a 'time-out' should be completed, resulting in inconsistent use and poor fidelity.

    “Similarly, in surgical teams, rigid professional roles and a hierarchical team culture constrained open discussion and created contention over how and when a “time-out” should be completed, resulting in inconsistent use and poor fidelity [50, 53].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [50] Gillespie BM, Chaboyer W, Wallis M, Fenwick C. Why isn’t “time out” being implemented? An exploratory study. Qual Saf Health Care. 2010;19(2):103–6. source

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    • cites [53] Gillespie BM, Withers TK, Lavin J, Gardiner T, Marshall AP. Factors that drive team participation in surgical safety checks: a prospective study. Patient Saf Surg. 2016;10(3):1–9.

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies.

    “However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes.

    “Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes;”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier.

    “Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    All quantitative studies were descriptive observational studies.

    “All quantitative studies were descriptive observational studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A study of surgical teams found variations in membership stability but no association between stability and 'implementation success'.

    “A study of surgical teams found variations in membership stability but no association between stability and “implementation success” (i.e., composite measure based on number of uses of new technique, proportion of uses, and changes in use) [48, 49].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Edmondson AC. Speaking up in the operating room: How team leaders promote learning in interdisciplinary action teams. J Manage Stud. 2003;40(6):1419–52. source

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    • cites [49] Edmondson AC, Bohmer RM, Pisano GP. Disrupted routines: Team learning and new technology implementation in hospitals. Adm Sci Q. 2001;46(4):685–716. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes.

    “Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes;”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Team longevity and history of change were not associated with implementation outcomes.

    “In these studies, team longevity and history of change were not associated with implementation outcomes [47, 68].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [47] Ditty MS, Landes SJ, Doyle A, Beidas RS. It takes a village: A mixed method analysis of inner setting variables and Dialectical Behavior Therapy implementation. Adm Policy Ment Health. 2015;42(6):672–81. source

      Not checked in the free run.

    • cites [68] Mohr DC, Rosen CS, Schnurr PP, Orazem RJ, Noorbaloochi S, Clothier BA, et al. The influence of team functioning and workload on sustainability of trauma-focused evidence-based psychotherapies. PS. 2018;69(8):879–86. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A dedicated and stable team in which members were selected and trained together in the use of a new surgical technique led to quicker uptake and better integration into practice.

    “Another study found that a dedicated and stable team in which members were selected and trained together in the use of a new surgical technique led to quicker uptake and better integration into practice, theorizing that dedicated and stable teams increased trust, motivation, and collaborative problem-solving [81].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Randell R, Honey S, Alvarado N, Greenhalgh J, Hindmarsh J, Pearman A, et al. Factors supporting and constraining the implementation of robot-assisted surgery: a realist interview study. BMJ Open. 2019;9(6):e028635. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The most common implementation outcomes were fidelity (n = 16) and other specified implementation outcomes (n = 15). Less frequently identified implementation outcomes included adoption (n = 5), sustainment (n = 4), reach (n = 4), and perceptions of the innovation (n = 3).

    “The most common implementation outcomes were fidelity (n = 16) and other specified implementation outcomes (e.g., “extent of use,” “implementation success”) (n = 15). Less frequently identified implementation outcomes included adoption (n = 5), sustainment (n = 4), reach (n = 4), and perceptions of the innovation (e.g., acceptability, appropriateness, feasibility; n = 3).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    Because only one study examined interdependence, no review findings were made.

    “Because only one study examined interdependence, no review findings were made.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Relevant studies increased over time; 71% of articles were published after 2016.

    “Relevant studies increased over time; 71% of articles were published after 2016.”
    • Also stated in: § Search results · plain
      “Three articles on this topic (5%) were published between 2000 and 2007, 14 (24%) between 2008 and 2015, and 41 (71%) between 2016 and early 2023.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most studies examined team processes/states (n = 53); fewer examined team inputs (n = 27). Only two studies examined a team effectiveness outcome.

    “Most studies examined team processes/states (n = 53); fewer examined team inputs (n = 27). Only two studies examined a team effectiveness outcome.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Two studies of team size found mixed results, and workload, longevity, and history of change were examined in only one study each.

    “Two studies of team size found mixed results, and workload, longevity, and history of change were examined in only one study each.”
    Quote in the paperNot a substantial claim

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    Findingown data

    Fourteen articles were rated as high relevance, 22 as moderate, and 22 as low relevance.

    “Fourteen articles were rated as high relevance, 22 as moderate, and 22 as low relevance.”
    Quote in the paperNot a substantial claim

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    Findingcitation

    Staff shortages, turnover, and high workloads hindered guideline implementation in Kenyan hospitals.

    “Similarly, staff shortages, turnover, and high workloads hindered guideline implementation in Kenyan hospitals [75].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [75] Nzinga J, Mbindyo P, Mbaabu L, Warira A, English M. Documenting the experiences of health workers expected to implement guidelines during an intervention study in Kenyan hospitals. Implementation Sci. 2009;4(1):44. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    There were 33 qualitative, 15 quantitative, and 10 mixed methods studies.

    “There were 33 qualitative, 15 quantitative, and 10 mixed methods studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Dedicated and stable team members facilitate implementation while instability in team membership is a barrier to implementation.

    “Dedicated and stable team members facilitate implementation, while instability in team membership is a barrier to implementation”
    • Also stated in: § Synthesis: team inputs & implementation outcomes · plain
      “We found: 1) Dedicated and stable team members facilitate implementation while instability in team membership is a barrier to implementation (moderate confidence);”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingreasoning

    We were unable to generate estimates of effects or ratings of evidence quality.

    “Accordingly, we were unable to generate estimates of effects or ratings of evidence quality.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Flatter hierarchies supported guideline implementation in pediatric primary care; practices with low compliance to guidelines had more hierarchical relationships while practices with high compliance had more shared decision-making.

    “Flatter hierarchies (i.e., more equal distribution of power and authority) supported guideline implementation in pediatric primary care; practices with low compliance to guidelines had more hierarchical relationships while practices with high compliance had more shared decision-making [97].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [97] Wiener-Ogilvie S, Huby G, Pinnock H, Gillies J, Sheikh A. Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: Qualitative comparative case study in primary care. BMC Fam Pract. 2008;9(1):32. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    There were 20 high quality articles, 23 moderate quality articles, and 15 low quality articles.

    “There were 20 high quality articles, 23 moderate quality articles, and 15 low quality articles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Task interdependence was positively associated with reach but not time to adoption in multidisciplinary child abuse teams implementing a mental health screening/referral protocol.

    “In multidisciplinary child abuse teams implementing a mental health screening/referral protocol, task interdependence (i.e., reliance on team members to share resources and coordinate workflows) was positively associated with reach but not time to adoption.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] McGuier EA, Aarons GA, Byrne KA, Campbell KA, Keeshin B, Rothenberger SD, et al. Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol. Implementation Science Communications. 2023;4(1):13. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    DBT team size was not associated with the number of DBT components adopted and was negatively associated with reach.

    “In contrast, another study found that DBT team size was not associated with the number of DBT components adopted and was negatively associated with reach, suggesting reach may reflect high workloads [72].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Navarro-Haro MV, Harned MS, Korslund KE, DuBose A, Chen T, Ivanoff A, et al. Predictors of adoption and reach following Dialectical Behavior Therapy Intensive Training™. Community Ment Health J. 2019;55(1):100–11. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Outcome interdependence was significantly negatively correlated with time to adoption but not reach.

    “Outcome interdependence (i.e., extent to which outcomes are evaluated at the team vs. individual level) was significantly negatively correlated with time to adoption but not reach.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] McGuier EA, Aarons GA, Byrne KA, Campbell KA, Keeshin B, Rothenberger SD, et al. Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol. Implementation Science Communications. 2023;4(1):13. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Adaptive team functioning, characterized by positive affective states, effective behavior processes, and shared cognitive states, facilitates implementation and is associated with better implementation outcomes.

    “We found with high confidence that 1) Adaptive team functioning, characterized by positive affective states (e.g., trust, mutual respect, belonging), effective behavior processes (e.g., frequent communication and coordination), and shared cognitive states (e.g., clear roles, shared mental models of how to provide care), facilitates implementation and is associated with better implementation outc”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Problems in team functioning, including negative affective states, problematic behavioral processes, and a lack of shared cognitive states, act as barriers to implementation and are associated with poor implementation outcomes.

    “2) Problems in team functioning, including negative affective states (e.g., tension, lack of trust), problematic behavioral processes (e.g., conflict, competition, poor communication), and a lack of shared cognitive states (e.g., unclear roles, lack of shared awareness, competing goals), act as barriers to implementation and are associated with poor implementation outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Negative affective states, fear of judgment, conflict, and lack of safety hinder implementation.

    “Negative affective states, fear of judgment, conflict, and lack of safety hinder implementation (moderate confidence).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Three studies examined associations between teamwork and adoption, with no significant associations found.

    “Three studies examined associations between teamwork and adoption, with no significant associations found.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    High quality studies tended to involve clinical interventions with strong research evidence and clinics in structured and often team-based healthcare systems.

    “In this review, high quality studies tended to involve clinical interventions with strong research evidence (e.g., DBT) and clinics in structured and often team-based healthcare systems (e.g., VA).”
    Quote in the paperNot a substantial claim

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    Findingown data

    The literature was heterogeneous, and many studies lacked specificity regarding team composition and implementation activities and outcomes.

    “Overall, the literature was heterogeneous, and many studies lacked specificity regarding team composition and implementation activities and outcomes.”
    Quote in the paperSubstantial claim

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    Findingown data

    Teamwork was defined and measured inconsistently and with limited precision across studies, which hindered the ability to draw conclusions about how teams influence implementation processes and outcomes.

    “Teamwork was defined and measured inconsistently and with limited precision across studies, which hindered our ability to draw conclusions about how teams influence implementation processes and outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Effective team-based care and higher quality teamwork are associated with improvements in care access and quality, patient safety, patient satisfaction, clinical outcomes, and costs.

    “Effective team-based care and higher quality teamwork are associated with improvements in care access and quality, patient safety, patient satisfaction, clinical outcomes, and costs [2, 4–9].”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [2] Reiss-Brennan B, Brunisholz KD, Dredge C, Briot P, Grazier K, Wilcox A, et al. Association of integrated team-based care with health care quality, utilization, and cost. JAMA. 2016;316(8):826–34. source

      Not checked in the free run.

    • cites [4] Lipton HL. Home is where the health is: Advancing team-based care in chronic disease management. Arch Intern Med. 2009;169(21):1945–8. source

      Not checked in the free run.

    • cites [5] Dinh JV, Traylor AM, Kilcullen MP, Perez JA, Schweissing EJ, Venkatesh A, et al. Cross-disciplinary care: A systematic review on teamwork processes in health care. Small Group Research. 2020;51(1):125–66. source

      Not checked in the free run.

    • cites [6] Fiscella K, McDaniel SH. The complexity, diversity, and science of primary care teams. Am Psychol. 2018;73(4):451–67. source

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    • cites [7] Herbert JL, Bromfield LM. A quasi-experimental study of the Multi-Agency Investigation & Support Team (MIST): A collaborative response to child sexual abuse. Child Abuse Negl. 2020;27:104827.

      Not checked in the free run.

    • cites [8] Reiss-Brennan B. Mental Health Integration: Normalizing Team Care. J Prim Care Community Health. 2014;5(1):55–60. source

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    • cites [9] Schmutz J, Manser T. Do team processes really have an effect on clinical performance? A systematic literature review. Br J Anaesth. 2013;110(4):529–44. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Team-based care is intended to include multiple professionals with varying skills and expertise.

    “Team-based care is intended to include multiple professionals with varying skills and expertise [1, 3].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, et al. Core principles and values of effective team-based health care. NAM Perspectives. 2012. Available from: https://nam.edu/perspectives-2012-core-principles-values-of-effective-team-based-health-care/ Cited 2020 Sep 23 source

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    • cites [3] Katkin JP, Kressly SJ, Edwards AR, Perrin JM, Kraft CA, Richerson JE, et al. Guiding principles for team-based pediatric care. Pediatrics. 2017;140(2):e20171489. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Team-based care requires shared responsibility for outcomes and increases team members' dependence on one another to complete work.

    “It requires shared responsibility for outcomes and increases team members’ dependence on one another to complete work [1, 3, 4].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [1] Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, et al. Core principles and values of effective team-based health care. NAM Perspectives. 2012. Available from: https://nam.edu/perspectives-2012-core-principles-values-of-effective-team-based-health-care/ Cited 2020 Sep 23 source

      Not checked in the free run.

    • cites [3] Katkin JP, Kressly SJ, Edwards AR, Perrin JM, Kraft CA, Richerson JE, et al. Guiding principles for team-based pediatric care. Pediatrics. 2017;140(2):e20171489. source

      Not checked in the free run.

    • cites [4] Lipton HL. Home is where the health is: Advancing team-based care in chronic disease management. Arch Intern Med. 2009;169(21):1945–8. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Healthcare and human service providers often work in team-based settings where professionals work collaboratively with one another and service recipients toward shared goals.

    “Healthcare and human service providers (e.g., clinicians, case managers) often work in team-based settings where professionals work collaboratively with one another and service recipients toward shared goals [1, 2].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, et al. Core principles and values of effective team-based health care. NAM Perspectives. 2012. Available from: https://nam.edu/perspectives-2012-core-principles-values-of-effective-team-based-health-care/ Cited 2020 Sep 23 source

      Not checked in the free run.

    • cites [2] Reiss-Brennan B, Brunisholz KD, Dredge C, Briot P, Grazier K, Wilcox A, et al. Association of integrated team-based care with health care quality, utilization, and cost. JAMA. 2016;316(8):826–34. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Title/abstract screening and review of full-text articles were conducted by pairs of trained independent reviewers in DistillerSR.

    “Title/abstract screening and review of full-text articles were conducted by pairs of trained independent reviewers in DistillerSR.”
    Quote in the paperNot a substantial claim

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    Study design and conductcitation

    The review was conducted in accordance with PRISMA and SWiM guidance.

    “The review was conducted in accordance with PRISMA and SWiM guidance [25, 26]; relevant checklists are in Additional File 1.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The Mixed Methods Appraisal Tool (MMAT) was used to evaluate quality and risk of bias for each included study.

    “The Mixed Methods Appraisal Tool (MMAT) [34] was used to evaluate quality and risk of bias for each included study.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Implementation outcomes were often inconsistently defined and poorly reported.

    “Similarly, because implementation outcomes were often inconsistently defined and poorly reported [28–30], we broadened our scope to include studies that identified team constructs as implementation determinants (i.e., barriers/facilitators) without explicitly defining and measuring an implementation outcome.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Lengnick-Hall R, Gerke DR, Proctor EK, Bunger AC, Phillips RJ, Martin JK, et al. Six practical recommendations for improved implementation outcomes reporting. Implement Sci. 2022;17(1):16. source

      Not checked in the free run.

    • cites [29] Proctor EK, Bunger AC, Lengnick-Hall R, Gerke DR, Martin JK, Phillips RJ, et al. Ten years of implementation outcomes research: a scoping review. Implement Sci. 2023;18(1):31. source

      Not checked in the free run.

    • cites [30] Chapman A, Rankin NM, Jongebloed H, Yoong SL, White V, Livingston PM, et al. Overcoming challenges in conducting systematic reviews in implementation science: a methods commentary. Syst Rev. 2023;12(1):116. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Relevant data from each article was extracted into an Excel spreadsheet by one reviewer, and a second reviewer conducted a line-by-line review and verification.

    “Relevant data from each article was extracted into an Excel spreadsheet by one reviewer (AS). A second reviewer (EAM) conducted a line-by-line review and verification.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    This systematic review was registered in PROSPERO (registration number: CRD42020220168) and conducted following the published protocol.

    “This systematic review was registered (PROSPERO; registration number: CRD42020220168) and conducted following the published protocol [24].”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Interrater agreement was good for assessment of study quality (81% agreement on MMAT questions) and ratings of relevance (88% agreement).

    “Interrater agreement was good for assessment of study quality (81% agreement on MMAT questions) and ratings of relevance (88% agreement).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The IMOI framework recognizes that team interactions are dynamic and complex, with processes unfolding over time and feedback loops between processes, outcomes, and inputs.

    “The IMOI framework recognizes that team interactions are dynamic and complex, with processes unfolding over time and feedback loops between processes, outcomes, and inputs [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Ilgen DR, Hollenbeck JR, Johnson M, Jundt D. Teams in organizations: From input-process-output models to IMOI models. Annu Rev Psychol. 2005;56:517–43. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Extensive research has identified barriers and facilitators to implementation of new practices at the individual provider, organization, and system levels; however, the team level has received little empirical attention.

    “Extensive research has identified barriers and facilitators to implementation of new practices at the individual provider, organization, and system levels; however, the team level has received little empirical attention [20, 21].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] McGuier EA, Kolko DJ, Stadnick NA, Brookman-Frazee L, Wolk CB, Yuan CT, et al. Advancing research on teams and team effectiveness in implementation science: An application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Implementation Research and Practice. 2023;1(4):26334895231190856. source

      Not checked in the free run.

    • cites [21] Williams NJ, Beidas RS. Annual research review: The state of implementation science in child psychology and psychiatry: A review and suggestions to advance the field. J Child Psychol Psychiatry. 2019;60:430–50. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Web of Science bibliographic database indexes more than 21,000 scientific journals.

    “This bibliographic database indexes more than 21,000 scientific journals [31].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Pranckutė R. Web of Science (WoS) and Scopus: The Titans of Bibliographic Information in Today’s Academic World. Publications. 2021;9(1):12. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Conflicts were resolved through re-review, discussion between reviewers, and when needed, discussion with a senior team member.

    “Conflicts were resolved through re-review, discussion between reviewers, and when needed, discussion with a senior team member (EAM).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    We assessed the strength of the overall body of evidence with GRADE for quantitative studies and GRADE-CERQual for qualitative studies.

    “We assessed the strength of the overall body of evidence with GRADE for quantitative studies [37] and GRADE-CERQual for qualitative studies [38, 39].”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    GRADE ratings were made independently with discrepancies resolved through consensus discussion; GRADE-CERQual ratings were made through iterative discussions as recommended.

    “GRADE ratings were made independently with discrepancies resolved through consensus discussion; GRADE-CERQual ratings were made through iterative discussions as recommended [39].”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Quality evaluations were conducted by two independent reviewers with discrepancies resolved through consensus discussion.

    “Quality evaluations were conducted by two independent reviewers (EAM, MAD) with discrepancies resolved through consensus discussion.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Ratings of relevance were conducted by two independent reviewers with discrepancies resolved through consensus discussion.

    “Ratings were conducted by two independent reviewers (EAM, CBW) with discrepancies resolved through consensus discussion.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    We conducted a narrative synthesis of included studies following guidelines for synthesis without meta-analysis (SWiM).

    “We conducted a narrative synthesis of included studies following guidelines for synthesis without meta-analysis (SWiM) [36].”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Team effectiveness outcomes are multidimensional and include performance, team viability, and the impact of the team on members' development.

    “Team effectiveness outcomes are multidimensional and include performance (i.e., productivity, efficiency, and quality of the team’s work), team viability, and the impact of the team on members’ development [12, 17–19].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [12] Mathieu JE, Maynard MT, Rapp T, Gilson L. Team effectiveness 1997–2007: A review of recent advancements and a glimpse into the future. J Manag. 2008;34(3):410–76.

      Not checked in the free run.

    • cites [17] Hackman JR. A normative model of work team effectiveness. Arlington, VA: Office of Naval Research; 1983. Available from: https://apps.dtic.mil/sti/citations/ADA136398 Cited 2022 May 16

      Not checked in the free run.

    • cites [18] Mathieu JE, Hollenbeck JR, van Knippenberg D, Ilgen DR. A century of work teams in the Journal of Applied Psychology. J Appl Psychol. 2017;102(3):452–67. source

      Not checked in the free run.

    • cites [19] Rosen MA, Dietz AS. Team performance measurement. In: The Wiley Blackwell Handbook of the Psychology of Team Working and Collaborative Processes. John Wiley & Sons, Ltd; 2017. p. 479–502. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Diversity of innovations and settings provides greater external validity for our findings but may mask some findings specific to certain innovations or settings.

    “Diversity of innovations and settings provides greater external validity for our findings but may mask some findings specific to certain innovations or settings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The review's results generally align with conventional wisdom and scientific research outside of healthcare, increasing confidence in the findings.

    “Our results generally align with conventional wisdom and scientific research outside of healthcare, increasing confidence in the findings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    It is possible that the review failed to identify some relevant articles or data.

    “As with all systematic reviews, it is possible that we failed to identify some relevant articles or data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There is increasing attention to the use of teams in implementation frameworks.

    “There is increasing attention to use of teams in implementation frameworks [20, 111]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [20] McGuier EA, Kolko DJ, Stadnick NA, Brookman-Frazee L, Wolk CB, Yuan CT, et al. Advancing research on teams and team effectiveness in implementation science: An application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Implementation Research and Practice. 2023;1(4):26334895231190856. source

      Not checked in the free run.

    • cites [111] Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Greater specificity and rigor are needed in research to advance understanding of how teamwork influences implementation processes and outcomes.

    “greater specificity and rigor are needed to advance our understanding of how teamwork influences implementation processes and outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    The organization of studies by the IMOI framework is likely imperfect given the broad array of team constructs included and poor reporting in many studies.

    “Our organization of studies by the IMOI framework is likely imperfect given the broad array of team constructs included and poor reporting in many studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There are well-established theories of team effectiveness that could inform hypotheses about how specific team constructs affect implementation.

    “In addition, there are well-established theories of team effectiveness that could inform hypotheses about how specific team constructs affect implementation [104–107].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [104] Hackman JR. From causes to conditions in group research. J Organ Behav. 2012;33(3):428–44. source

      Not checked in the free run.

    • cites [105] Tannenbaum SI, Salas E. Teams that work: The seven drivers of team effectiveness. Illustrated. New York, NY: Oxford University Press; 2020. p. 272. source

      Not checked in the free run.

    • cites [106] Tuckman BW. Developmental sequence in small groups. Psychol Bull. 1965;63:384–99. source

      Not checked in the free run.

    • cites [107] Salas E, Stagl KC, Burke CS. 25 years of team effectiveness in organizations: Research themes and emerging needs. In: International Review of Industrial and Organizational Psychology 2004. John Wiley & Sons, Ltd. 2004; p. 47–91. Available from: https://onlinelibrary.wiley.com/doi/abs/https://doi.org/10.1002/0470013311.ch2   Cited 2022 May 16 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The review did not search gray literature or conference abstracts or contact authors for unreported data.

    “We did not search gray literature or conference abstracts or contact authors for unreported data.”
    Quote in the paperNot a substantial claim
62 of 62

  • The paper relies on this without support.

    Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations.

    “Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations.”
    “Implementation of new practices in team-based service settings requires team members to work together to respond to changing demands and expectations.”

  • The paper relies on this without support.

    Implementation efforts increasingly rely on teams, and responses to a new practice are likely to be influenced by team characteristics and processes.

    “This is a problem because implementation efforts increasingly rely on teams, and responses to a new practice are likely to be influenced by team characteristics and processes.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A team-based approach is better suited to understand and address end-user needs, offering diverse perspectives.

    “and is better suited to understand and address end-user needs, offering diverse perspectives.20,21”

    From Structured Development of Learning and Assessment Tasks to Prevent Generative AI Misuse and Enhance AI Literacy in the Faculty in Physiotherapy Education (2025) · cites this paper as [21]

    The Background describes team-based care as involving professionals with varying skills and expertise who collaborate with service recipients, supporting the point about diverse perspectives. It does not say that a team-based approach is better suited than another approach to understand and address end-user needs. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

The citation lists haven’t been fetched yet

References 116 · Cited by 70

Research works printed but not linked: 4

  1. Mathieu JE, Maynard MT, Rapp T, Gilson L. Team effectiveness 1997–2007: A review of recent advancements and a glimpse into the future. J Manag. 2008;34(3):410–76.
  2. Kozlowski SWJ, Bell BS. Work groups and teams in organizations: Review update. In: Schmitt N, Highhouse S, editors. Handbook of Psychology (Vol 12): Industrial and Organizational Psychology. 2nd ed. Hoboken, NJ: Wiley; 2013. p. 111.
  3. Effective Practice and Organisation of Care (EPOC). Data collection form. EPOC Resources for review authors. Norwegian Knowledge Centre for the Health Services. 2013. Available from: http://epoc.cochrane.org/epoc-specific-resources-review-authors.
  4. DiazGranados D, Woods JJ, Wilder A, Curtis MT. Team dynamics in the air: A review of team research relevant to aviation. Human factors in aviation and aerospace. 2023. p. 199–215.

Authors
McGuier, E. A., Kolko, D. J., Aarons, G. A., Schachter, A., Klem, M. L., Diabes, M. A., Weingart, L. R., Salas, E., & Wolk, C. B.
Affiliations
  • University of Pittsburgh (US)
  • University of California San Diego (US)
  • Leonard Davis Institute of Health Economics (US)
  • Carnegie Mellon University (US)
Corresponding author
McGuier, Elizabeth A.
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2024-07-15
Volume
19
Issue
1
Pages
49-49
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-024-01381-9
PMC
PMC11247800
OpenAlex
W4400655624
Cited by
70
References
116
Citations by year
2026: 39 · 2025: 28 · 2024: 2 · 2023: 1
FWCI
6.20
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Rice Research Repository (Rice University) (submittedVersion, cc-by)
Funders
  • National Institute of Mental Health (MH123729, MH124914, MH126231)
  • National Cancer Institute (U01CA275118)
  • National Institute on Drug Abuse (DA049891)
  • Agency for Healthcare Research and Quality (HS026862)
  • Collaboration and Conflict Research Lab at Carnegie Mellon University
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
teamwork, innovation implementation, team functioning, affective states, team communication, labor shortage, employee turnover, implementation barriers, implementation outcomes, evidence-based practice, healthcare teams
MeSH terms
Implementation Science, Cooperative Behavior, Delivery of Health Care, Humans, Patient Care Team, Evidence-Based Practice

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

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