Factors and interventions determining the functioning of health care teams in county-level hospitals in less affluent areas of China: a qualitative study

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Abstract

Background: Teamwork is essential for the quality and safety of care, and research
on teamwork in health care has developed rapidly in many countries. However,
evidence from less affluent, non-Western countries is scarce, while improving
teamwork may be especially relevant to be able to increase the quality of care in
these settings. This study aims to understand the main factors that influence, and
interventions used to improve, the functioning of health care teams in the context
of county-level hospitals in less affluent areas of China.
Methods: We conducted semistructured interviews to explore the factors that
influence team functioning and the interventions implemented to improve team
functioning in these hospitals. 15 hospital presidents and 15 team leaders were
selected as respondents.
Results: From the interviews, we have identified five main factors that influence
team functioning in these hospitals: “stuck in the middle”, local county setting,
difficulty in attracting and retaining talent, strong focus on task design, and
strong focus on leadership. The interventions for improving team functioning
can mostly be categorized as the following: 1) measures to attract and retain
talent (e.g., increase salary, train talent in national or provincial level hospitals,
and provide fast-track promotions), 2) interventions focused on monodisciplinary
teams (e.g., changing the team structure and leadership, and skill training), and
3) interventions to establish and improve multidisciplinary teams (e.g., simulation
training and continuous team process improvements).
Conclusion: With the introduction of multidisciplinary teams, interventions into
team processes have started to receive more attention. The findings depict an
overview of the main factors and interventions as specifically relevant for team
functioning in county-level hospitals in less affluent areas of China and may
help these hospitals benefit from additional process interventions to improve
teamwork and the quality of care.
Original languageEnglish
Article number1082070
JournalFrontiers in Public Health
Volume11
DOIs
Publication statusPublished - 28 Sept 2023

Bibliographical note

Funding Information:
We would like to thank Yun Zhang and Jing Zhou from the Health Human Resources Development Center of the National Health Commission of China, and Yan’an Wang and Xiaoxiao Wan from the Health County Media for their help with respondent selection. We also thank all the respondents and their hospitals for their supports and contributions to this study.

Funding Information:
This work was supported by China Scholarship Council (Grant number: 201906160092). This funder has no role in the study design, data collection, data analysis, interpretation of data, and writing the manuscript.

Publisher Copyright:
Copyright © 2023 Wang, van Wijngaarden, Buljac-Samardzic and van de Klundert.

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