Abstract
Palliative care practice guidelines recommend experts collaborate on interdisciplinary teams to ensure high-quality care. However, there is limited knowledge of how various palliative care teamwork structures and processes influence care quality. This study describes palliative care team structures (eg, certification, setting) and processes (eg, leadership, communication) and examines their influence on perceptions of palliative care quality. A cross-sectional design addresses the research aims. Providers completed an online survey from May 2013 to May 2014 that included demographic and organizational questions, and the TeamSTEPPS Teamwork Perceptions Questionnaire. Of the 460 participants with outcome data, 81.1% were registered nurses; 89.9% were female. Most participants reported care quality as excellent in their settings (50.4%). Excellent quality was associated with male gender (P = .032), formal team membership (P = .001), hospice/palliative care unit employment (P < .000), non-acute care settings (P = .040), less education (P = .016), and collaborating with more disciplines (P = .003). All TeamSTEPPS scales were associated with excellent quality of care (P < .000). In the logistic model, team structure (odds ratio [OR], 1.132; confidence interval [CI], 1.047-1.225; P = .002), communication (OR, 1.095; CI, 1.014-1.182; P = .021), and collaboration with more disciplines (OR, 1.138; CI, 1.030-1.253; P = .011) were associated with excellent care quality. Interprofessional education and enhanced organizational structures to encourage collaboration may improve palliative care quality.