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Interventions to Redesign Patient Care Do Not Improve Outcomes

Nurses reported improvement in median teamwork climate score, but no improvement in hospitalized patient outcomes

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Nov. 1, 2023 (HealthDay News) — Interventions to redesign care for hospitalized patients are not associated with improved patient outcomes, according to a study published online Oct. 31 in the Annals of Internal Medicine.

Kevin J. O’Leary, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes in a pragmatic controlled trial conducted in medical units at four U.S. hospitals. The primary outcomes were teamwork climate among health care professionals and patient-experienced adverse events.

The researchers found that the median teamwork climate score was higher after than before the intervention only for the 77 nurses among 155 professionals who completed pre- and postintervention surveys (median score, 88.0 versus 80.0). Among the 3,773 patients, the percentage with at least one adverse event was higher after than before the intervention (change, 1.61 percentage points) in control units. Compared with before the intervention, the percentage of patients with at least one adverse event after the intervention was similar in intervention units (change, 0.43 percentage points). No significant difference in change was seen in a difference-in-differences analysis. No differences were seen in length of stay, readmissions, or patient experience.

“Health care leaders should consider our findings in the context of their improvement priorities before implementing similar interventions,” the authors write.

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