Academic medical center · ICU interdisciplinary team
Fixing handoffs the org chart could not fix
Care Team Effectiveness measured how nursing, pharmacy, therapy and medical staff actually worked together and located the breakdown at a specific transition rather than in a specific discipline.
Illustrative composite scenario. Built from the HealthDNA™ instrument design and common deployment patterns to show how a wave runs and how leaders read the output. It is not a report of a named client engagement and the figures are modeled examples rather than measured customer results.
- Setting
- Academic medical center ICU
- Respondents
- 52 across nursing, medicine, pharmacy, respiratory and therapy
- Instrument
- Care Team Effectiveness Assessment™
- Cycle
- Baseline wave, facilitated debrief, re-pulse at 90 days
The situation
- n/aRounds ran long, plans changed after rounds and each discipline privately blamed another.
- n/aSatisfaction surveys were positive, which made the friction easy to dismiss.
- n/aNo existing measure captured the team as a team rather than as a set of departments.
How the wave was run
Survey the whole team
Every discipline on the unit responded to the same instrument, so no group's view was assumed.
Compare discipline views
Gaps between disciplines mattered more than the overall score.
Debrief together
One facilitated session with all disciplines present, using the dimension gaps as the agenda.
What the data showed
| Dimension | Reading | What it meant |
|---|---|---|
| Role clarity | High within disciplines, low across them | Everyone knew their own job and not each other's decision rights. |
| Communication and handoff | Lowest dimension overall | The breakdown was at the transition, not inside any one discipline. |
| Mutual respect | Solid | This was a structure problem and saying so defused the blame cycle. |
What leadership changed
- ✓Rewrote the rounding script so each discipline states its decision and its dependency out loud.
- ✓Named a single person accountable for the post-rounds plan change communication.
- ✓Added a two-minute end-of-rounds confirmation of who is doing what by when.
- ✓Re-pulsed at 90 days to test whether the handoff dimension moved.
The 90-day cadence
- 1Days 1-30: joint debrief and rounding-script rewrite.
- 2Days 31-60: run the new script daily; track post-rounds plan changes.
- 3Days 61-90: re-pulse and compare communication and role-clarity scores by discipline.
The overall team score barely moved the needle for leadership. The gap between how nursing and medicine rated the same dimension is what changed the conversation.
Instruments used
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