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007    cr cnu---unuuu 
008    110303s2010    cau     ob    000 0 eng d 
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020    9780833051189|q(electronic bk.) 
020    0833051180|q(electronic bk.) 
027    RAND/TR-842-OSD 
035    (OCoLC)705004916|z(OCoLC)694090245|z(OCoLC)781315288
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043    n-us--- 
049    CKEA 
050  4 RG652|b.A24 2010eb 
082 04 618.2009593|222 
245 00 Achieving strong teamwork practices in hospital labor and 
       delivery units /|cDonna O. Farley [and others]. 
264  1 Santa Monica :|bRand Corporation Center for Military 
       Health Policy Research,|c2010. 
300    1 online resource (xxiv, 124 pages). 
336    text|btxt|2rdacontent 
337    computer|bc|2rdamedia 
338    online resource|bcr|2rdacarrier 
347    data file|2rda 
490 1  Technical report ;|vTR-842-OSD 
504    Includes bibliographical references (pages 121-124). 
505 0  Introduction and background -- Study design and methods --
       Findings regarding teamwork implementation -- Effects of 
       teamwork improvement on unit staff and patient outcomes --
       Synthesis of findings and conclusions -- Appendix A: Tools
       and strategies for teamwork -- Appendix B: Matrix of 
       questions and stakeholders for site visits -- Appendix C: 
       Monthly update teleconference: longitudinal labor and 
       delivery teamwork study -- Appendix D: Questions for final
       assessment: longitudinal labor and delivery teamwork study
       -- Appendix E: Team performance observation tool -- 
       Appendix F: Staff survey questionnaire -- Appendix G: 
       Regression results for staff perceptions and knowledge. 
520    A RAND study of teamwork-improvement initiatives in 
       hospital labor and delivery (L and D) units was designed 
       to document and learn from the experiences and outcomes of
       five L and D units as they implemented improvements in 
       their teamwork practices over a one-year period. The study
       had two objectives: (1) better understand the conditions 
       and actions required for hospital L and D units to achieve
       effective and sustainable teamwork practices, and (2) 
       assess the extent to which successful adoption of teamwork
       practices may influence the experiences of L and D staff 
       and patient outcomes. Substantial progress is possible in 
       one year of implementing teamwork practices, which can 
       improve proximal outcomes, such as staff knowledge and 
       perceptions. More than a year of implementation effort is 
       required to achieve a high level of performance on 
       teamwork practices. Two dynamics might be involved in 
       later years of implementation: (1) momentum from the first
       year might continue into later years, such that subsequent
       implementation might reinforce continued improvement, and 
       (2) it might not be possible to sustain high intensity in 
       implementation beyond the first year. The study results 
       reinforce the importance of developing and implementing a 
       well-crafted strategy by training staff in the L and D 
       units, working consistently with staff to introduce 
       practices, and providing coaching on effective use of 
       practices. The study identified some key factors required 
       by any given strategy for teamwork improvement, but it did
       not point to a standard template for implementation. This 
       result implies that there may not be one fixed 
       "intervention" that could be tested in comparative-control
       studies to develop further evidence for teamwork 
       practices. 
588 0  Print version record. 
650  0 Hospitals|xEmployees. 
650  0 Hospitals|xMaternity services|zUnited States. 
650  0 Labor (Obstetrics)|zUnited States. 
650  2 Medical Staff, Hospital|xpsychology. 
650  2 Delivery Rooms|xstandards. 
650  2 Cooperative Behavior. 
650  2 Delivery, Obstetric. 
650  2 Patient Care Team. 
650  7 HEALTH & FITNESS|xPregnancy & Childbirth.|2bisacsh 
650  7 MEDICAL|xHospital Administration & Care.|2bisacsh 
650  7 Hospitals|xEmployees.|2fast|0(OCoLC)fst01430505 
650  7 Hospitals|xMaternity services.|2fast|0(OCoLC)fst00961389 
650  7 Labor (Obstetrics)|2fast|0(OCoLC)fst00989845 
651  7 United States.|2fast|0(OCoLC)fst01204155 
700 1  Farley, Donna. 
710 2  Center for Military Health Policy Research. 
776 08 |iPrint version:|tAchieving strong teamwork practices in 
       hospital labor and delivery units.|dSanta Monica : Rand 
       Corporation Center for Military Health Policy Research, 
       2010|z9780833050557|w(DLC)  2010938595|w(OCoLC)671531658 
830  0 Technical report (Rand Corporation) ;|vTR-842-OSD. 
914    ocn705004916 
994    92|bCKE