What Happened When a Heart Failure Unit Asked for Help with Its Culture?

Communication and teamwork are essential for providing safe and effective health care, particularly in light of increasingly complex health care teams comprising multiple disciplines. In late 2021, the Heart Failure Center of Excellence (HF Center) at Tampa General Hospital sought assistance from senior leadership to improve communication and teamwork in their center. In response, senior leaders established an intervention team with a goal to design and implement a customized solution to improve the culture of the HF Center. The intervention team consisted of the Chief Executive Officer, who has a Doctor of Business Administration (D.B.A.) degree, two Ph.D.-level industrial-organizational psychologists who were part of an existing internal culture and leadership research team, and an internal M.A.-level organizational development senior director. The execution proceeded in three stages. First, the nature of the problem was assessed by surveying all HF Center members from frontline staff to senior management. Second, a communication and teamwork intervention was designed and delivered. Finally, the impact of the intervention was evaluated by comparing surveys from before and after the intervention. A baseline survey supported a qualitative approach to identify the HF Center's issues as seen by its members, including physicians, other care staff, and leadership. The first question was multiple-choice, to determine their role in the team. That was followed by six open-ended questions asking respondents to provide one to three adjectives that best describe their team; to note the best thing about the team; to describe the team culture, team communication, and team trust (one question for each); and to offer suggestions for improvement. A content analysis by the intervention team identified communication as a major issue in the HF Center. The intervention solution was an application of the Survey Feedback method in which the results of the survey were fed back during a half-day retreat, and the HF Center members used those results to craft their own plan to improve the identified issues. The same questions were repeated in a November 2022 survey, with sentiment analysis showing a marked improvement in terms of more positive and fewer negative comments. In addition, a comparison of results from the annual Press Ganey engagement survey showed improvements in teamwork from May-June 2021 (before the intervention) to June 2023 (after the intervention). The results of the two annual surveys and the two intervention surveys suggest the effectiveness of a customized Survey Feedback approach that included team-building exercises that enabled the HF Center team to discuss results and come up with their own solutions. Allowing all team members from frontline to senior management the opportunity to participate supports engagement and acceptance, which can contribute to the success of the intervention.