Effects of team-based quality improvement learning on two teams providing dementia care.

Objective: To determine the effects of a structured team-based learning approach to quality improvement (QI) on the performance 12 months later of two teams caring for patients with dementia. Design: Before and after prospective study. Setting: Staff working in two inpatient services in National Health Service Trusts in England, one providing orthopaedic surgery (Team A) and one caring for elderly people with mental health conditions, including dementia (Team B). Team A consisted of nurses; Team B included doctors, nurses, therapists, mental health support workers and administrators. Methods: QI training and support, assessment of the performance of teams and team coaching were provided to the two teams. QI training integrated tools for teamworking and a structured approach to QI. Team members completed the Aston Team Performance Inventory, a validated tool for assessing team performance, at the start of the QI work (time 1) and 1 year later (time 2). Results: A year after the QI training and team QI project, Team A members perceived themselves as a high-performing team, reflected in improvement in 24 of 52 components measured in the Inventory; Team B was initially a poorly performing team and had improvements in 42 of 52 components a year later. Conclusion: This study demonstrates that a structured team-based learning approach to QI has effects a year later on the performance of teams in clinical settings, as measured by a validated team performance tool.