Research Project Proposal

Research Project Proposal | Karen J. Vander Laan PhD, MSN, RN

Copyright 2012 Spectrum Health Nursing Research. All Rights Reserved.
Date Submitted: 3.26.14

Proposal Sponsor (Director): Keverne Lehman

Submitted by: Judy Westers

Proposal Sponsor (Executive): Shawn Ulreich


1. What is the research problem or opportunity the project will address?

Teamwork is the most statistically significant predictor of quality as perceived by patients, families,
staff, and doctors (E.C. Murphy).
Healthy teams have given priority to relationship management (D. Wright).
Relationship-based Care is the vehicle to give us the structures and processes that produce excellent
teamwork. We continue to learn more about applying the principles of RBC as we mature in our
understanding. Recently a 13
th
element of care delivery, Staffing and Scheduling, was introduced.
Several patient care units are primed to begin implementing strategies that aim to improve
relationships and teamwork. Using B. Kalischs Nursing Teamwork Survey (NST), we can gain insight
into the status of teamwork here at SHGR and store valuable data for current and future research.
With the Gallup survey scheduled at lengthy intervals, units desire a periodic check in with their team
so they develop mini surveys to evaluate action plans.
Is the Kalisch NTS perhaps a more appropriate interim measure of the nursing work environment in
between Gallup surveys? Could the Teamwork survey guide and measure interventions to improve
Teamwork and the delivery of nursing care on the nursing units?


2. What is being proposed?

Conduct a baseline survey using the NTS of Dr. B. Kalisch on clinical units that deliver nursing care.
Maintain a database with Teamwork data that can be used in current and future research questions
such as:
What is the status of teamwork right now?
Do Teamwork and HCAHPS have a positive relationship?
Does Teamwork improve when nursing units reduce the number of work partners that
employees experience?
Does Teamwork improve when team assignments are geographically planned so that team
members work closely together?
Do Teamwork and turnover have a negative relationship?
Do the perceptions of employees about adequate staffing correlate with actual staffing?
Do units with higher Teamwork have shorter orientations for new staff?
Do safety and Teamwork have a positive relationship?

Research Project Proposal | Karen J. Vander Laan PhD, MSN, RN
Copyright 2012 Spectrum Health Nursing Research. All Rights Reserved.

3. What is the value of the research project to (complete all that apply):

Patients / Family Members

Interdisciplinary Team Members

Organization
Teamwork is valued by
patients and families.
Teamwork is measured on
patient satisfaction surveys.
Higher functioning teams are
safer.
Teams have more trust of
each other when teamwork is
high.
Teams are more effective in
their care delivery when
teamwork is high.
More effective work is
accomplished when
teamwork is improved.


Teamwork predicts:
Improved patient & employee
satisfaction
Decreased readmission rates
Trusting relationships
between nurses and patients
Collaborative relationships
between nurses and other
interdisciplinary team
members
Increased caring.
Quality.
Decreased costs in:
o Turnover
o NSI
o Safety Events
Increased reimbursements in:
o Increase HCAHPS
o Increase market
share
Publishing original research
places SH at the forefront of
quality care.
Spectrum Healths Strategic Plan You / Your Inquiry Team Community / Profession
Safety and Teamwork are
integrally connected.
The patient experience is
impacted by Teamwork.
They are positively correlated.
This will strengthen our care
delivery model that is based
on Watsons Caring Science.
This will add to the body of
nursing knowledge and
evidence that caring for team
members improves
outcomes.
Partnership with Dr. Kalisch
improves research
relationships
The nursing profession
benefits from additional
evidence that quality nursing
care makes a difference in
patient outcomes.

4. What are the expected outcomes of the research project?

The NTS can be used to begin a new program of Spectrum Health nursing research.
We expect to find positive relationships between Teamwork and:
Caring
HCAHPS
Safety
Staff Satisfaction
Quality
We expect to find negative relationships between Teamwork and:
Falls
CAUTI
CLABSI
HAPU
30-Day Readmissions
Nursing Turnover
Medication Error
Documentation errors and omissions

Research Project Proposal | Karen J. Vander Laan PhD, MSN, RN
Copyright 2012 Spectrum Health Nursing Research. All Rights Reserved.
5. Briefly describe background evidence for this project.

In 2006 Relationship-based Care (RBC) was introduced and subsequently implemented as our care
delivery model and part of our professional practice model. RBC was built on the theoretical foundation
of Jean Watsons Caring Science. Caring presence, as described by Watson, and teamwork are
intimately connected. Teamwork strengthens the foundation of RBC by building trusting relationships
between colleagues.
B. Kalisch has completed several research studies at Spectrum Health and continues to support
teamwork in her formal writing. Her work was extensively used for the development of the 13
th
element
of care delivery Staffing and Scheduling.
Dr. Kalisch recently approved the use of the NTS at Spectrum Health and is willing to partner with
Spectrum Health so that continued normative testing can be completed on the survey. We will agree to
share survey data (which contains no personally identifying information) with Dr. Kalisch for the
purposes of instrument testing.

6. Briefly describe the proposed methods for this project.

In partnership with the Nursing Research Department, we propose that:
The survey will be developed in an electronic format (B. Kalisch approved). Survey Monkey is
our preferred medium. The Nursing Research Administrative Secretary has the skills and time
available to develop the survey.
The survey will be launched from the nursing research department by the Nursing Research
Administrative Secretary at specified intervals.
We propose that the workload be managed by setting survey intervals and launch months that
would distribute the workload over the whole year so that any single month would not be
overburdened with data collection or launching.
The survey data will be exported to Excel for data analysis by the Nursing Research
Administrative Secretary at specified intervals.
The Senior Nurse Researcher facilitates and oversees Spectrum Health nursing research
studies using the Teamwork data.

7. Briefly describe the feasibility of this project.

Potential Driving Forces:
Interest and agreements have already been
confirmed with Dr. Beatrice Kalisch PhD,
University of Michigan.
The NTS instrument has already been validated.
Several nursing units have expressed interest in
promoting teamwork interventions in their
staffing, scheduling and assignment elements of
RBC. The NTS would provide valuable baseline
and longitudinal data to evaluate these
interventions.

Potential Restraining Forces:
Competing priorities of nursing leadership for
resources and time to focus attention on the
project.
Using the Nursing Research Department human
and time resources, which are limited.



Research Project Proposal | Karen J. Vander Laan PhD, MSN, RN
Copyright 2012 Spectrum Health Nursing Research. All Rights Reserved.
8. What resources may the project involve or need to be successful? (Give details if known)


Money / funding
- % effort for the research program team (Karen / Viola /
Judy)
- % effort for research study teams
- Dissemination activities related to studies


Computer or technology for data processing
- Survey Monkey license
- Assistance from statistics interns


Legal formal agreement between SH Nursing
Research & Dr. Bea Kalisch re: survey use and data
sharing

Time
Research program team to develop and launch
program
- Research teams to develop and launch studies
utilizing the NTS data
- Staff members to complete the survey and data
collection and management.

People / Staff
Nursing research department administrative secretary
time for launching and data management.
- RBC nurse educator for promoting project.
- Nurse managers for engaging staff participation,
- Staff nurses to complete surveys
- Senior Nurse Researcher for program oversight and
study consultation and management of data
sharing.


Education or development
- Promotion of NTS instrument and data to measure
teamwork for SH inquiry activities

9. List Identified Stakeholders for this research project.

For decision-making:
Nursing director
Nursing executive
Senior Nurse Researcher
RBC Nurse Educator
For information:
Health Sciences Library
Center for Exceptional Experience
For assistance:
Senior Nurse Researcher
Statisticians for data analysis
RBC Nurse Educator
Research Partners
Nursing Research Administrative Secretary
Health Science Library


10. Recommendation:
The interest to participate in research to validate RBC and Watsons theory provides Spectrum Health
the opportunity to engage the academic community and validate the work of professional nursing.
Measuring Teamwork provides the basis for designing interventions to strengthen care delivery, safety
and quality.

We recommend using the survey at periodic intervals in clinical areas to maintain a database for
current and future research. A target for the baseline survey of all Spectrum Health nursing units
would be FY 2015, Quarter 1.




Research Project Proposal | Karen J. Vander Laan PhD, MSN, RN
Copyright 2012 Spectrum Health Nursing Research. All Rights Reserved.
11. Sponsor comments:








Proposal Endorsement
The undersigned endorse this proposal and recommend that the research project be supported and
further planning commence.


_____________________________________________________________________

____________

Director Sponsor: Date

_____________________________________________________________________

____________

Executive Sponsor: Date