ArticleBMJ open quality2020
'Team capital' in quality improvement teams: findings from an ethnographic study of front-line quality improvement in the NHS.
Article in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Addressing Challenges Associated With Loaner Instrument Sets.AORN journal · 2026Article
- Lessons from using the Normalisation Process Theory to understand adherence to guidance on MgSOImplementation science communications · 2025Article
- Designing, delivering and evaluating a specialty-specific quality improvement course for the rheumatology multidisciplinary team.Rheumatology advances in practice · 2025Article
- Standalone Regulatory Agreements for Product-Development Collaborations in the Medical Products Industry.Therapeutic innovation & regulatory science · 2024Article
- Effects of a team Quality Improvement method in a national clinical audit programme of four clinical specialties in Ministry of Health hospitals in Saudi Arabia.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Article
- "If we work as a team, there are success stories." Unpacking team members' perceptions and experiences of what impacts team performance in a maternal and neonatal quality improvement programme in South Africa, before, and during COVID-19.PLOS global public health · 2024Article
- Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies.BMJ quality & safety · 2022Article
- 'Team ethnography visual maps': Methods for identifying the ethnographic object in multiple sites of fieldwork.Ethnography · 2021Article
- Exploring healthcare staff narratives to understand the role of quality improvement methods in innovative practices during COVID-19.BMC health services research · 2021Article
- Mass production methods for mass vaccination: improving flow and operational performance in a COVID-19 mass vaccination centre using Lean.BMJ open quality · 2021Article
- Article
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundTeamwork is important in the design and delivery of initiatives in complex healthcare systems but the specifics of quality improvement (QI) teams are not well studied.
objectiveTo explain the functioning of front-line healthcare teams working on patient-centred QI using Bourdieu's sociological construct of capital.
methodsOne medical ward from each of six NHS Trusts in England participated in the study, purposively selected for a range of performance levels on patient experience metrics. Three ethnographers conducted focused ethnography for 1 year, using interviews and observations to explore the organisation, management and delivery of patient-centred QI projects by the six front-line teams. Data were analysed using Bourdieu's typology of the four forms of capital: economic, social, symbolic and cultural.
resultsWhile all teams implemented some QI activities to improve patient experience, progress was greater where teams included staff from a broad range of disciplines and levels of seniority. Teams containing both clinical and non-clinical staff, including staff on lower grades such as healthcare assistants and clerks, engaged more confidently with patient experience data than unidisciplinary teams, and implemented a more ambitious set of projects. We explain these findings in terms of 'team capital'.
conclusionTeams that chose to restrict membership to particular disciplines appeared to limit their capital, whereas more varied teams were able to draw on multiple resources, skills, networks and alliances to overcome challenges. Staff of varying levels of seniority also shared and valued a broader range of insights into patient experience, including informal knowledge from daily practice. The construct of 'team capital' has the potential to enrich understanding of the mechanism of teamwork in QI work.
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