Team Based Approach in Delivery of Care: A Comparison and Quality Improvement Project

Thomas E. Payne


The purpose of this project was to compare two care delivery models that used either a non-team based approach versus a team based approach and how these models impact patient care outcomes. The results of this project will be used as a baseline to develop and implement a web-based database in order to track nurse practitioner outcomes in a level one trauma center in the Southeastern United States as part of a quality improvement project. The evidence in the literature was sparse in terms of articles that examined team based delivery of care outcomes in an inpatient hospital setting. However, in articles that addressed delivery of care models in an outpatient arena it was felt that a team based approach to delivery of care was superior to a non-team based approach. Three variables were examined comparing the non-team based delivery of care and the team based delivery of care. Data were accessed from various databases within the hospital system and included length of stay, patient complaints, and adverse events. The Health Care Systems Model guided this project due to its open system approach, utilization of both internal and external environments, and system feedback. Data for the non-team based approach and team based approach to delivery of care were analyzed using t-tests assuming unequal variances comparing the non-team based with team based delivery of care. The results led to the rejection of the null hypothesis that a team based approach to delivery of care will demonstrate worse outcomes than a non-team based approach to delivery of care in two of the variables with a 99% confidence interval. The results are consistent with the literature that addresses team based approaches to delivery of care in an outpatient setting. There was statistical significance in each of the variables examined. More importantly a baseline was established that is clinically relevant in that outcomes can be tracked for quality improvement purposes. In the future the three variables will be tracked quarterly and analyzed for quality improvement.