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Effects of team-based quality improvement learning on two teams providing dementia care
  1. Nancy Dixon1,
  2. Lorna Wellsteed2
  1. 1Strategic Services, Healthcare Quality Quest, Romsey, UK
  2. 2Wellsteed Associates, Mortimer, UK
  1. Correspondence to Nancy Dixon; Nancy.Dixon{at}


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.

  • teamwork
  • team training
  • quality improvement methodologies
  • quality improvement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors ND provided the QI interventions with the teams and drafted this paper. LW worked with the teams to complete the ATPI assessments and provided team coaching for both teams, prepared a report on the team’s pre/post-QI intervention performance on the ATPI and provided comments on the draft of this paper.

  • Funding The quality improvement interventions and the team assessment work with the teams described was supported by Health Education England, Wessex.

  • Competing interests The authors are employed by commercial entities that provide consultancy and training on quality improvement and teamworking.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Teams agreed for the data to be presented as long as the teams are anonymous.

  • Patient consent for publication Not required.

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