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Measuring the Interprofessional Health of the Pediatric Cardiovascular Operating Room Work Environment
Jason M Thornton1, Jean A Connor2, Patricia A Dwyer3
1From the Nursing/Patient Services, Cardiac Intensive Care Unit & Cardiovascular Operating Rooms, Cardiovascular and Critical Care, Patient Services, Boston Children's Hospital, Boston, Mass.
Insights
This study assessed pediatric cardiovascular operating room (CVOR) work environments using the Healthy Work Environments Assessment Tool (HWEAT). A benchmark score of 3.50 was established to improve interprofessional collaboration and patient care.
Area of Science:
- Healthcare Management
- Patient Safety
- Interprofessional Collaboration
Background:
- Pediatric cardiac surgery demands complex teamwork for optimal patient outcomes.
- Unhealthy work environments are linked to adverse patient events and staff turnover.
- Assessing the interprofessional health of pediatric cardiovascular operating room (CVOR) environments is crucial.
Purpose of the Study:
- To describe the interprofessional health of pediatric CVOR work environments in the US.
- To establish a healthy work environment (HWE) benchmark score for these settings.
- To identify areas for improvement in pediatric CVORs.
Main Methods:
- Surveyed interprofessional staff in 11 US pediatric CVORs using the American Association of Critical Care Nurses Healthy Work Environments Assessment Tool (HWEAT).
- Aggregated, summarized, and stratified survey responses by role.
- Utilized an e-Delphi approach to achieve expert consensus on a benchmark target.
Main Results:
- 179 surveys (60% response rate) were analyzed across 11 centers.
- The overall interprofessional mean HWEAT score was 3.55 (range: 2.65-4.34), with all standards scoring in the "good" range.
- Effective decision-making received the highest mean score (3.69), while meaningful recognition scored lowest (3.26). Surgeons reported higher scores (3.79) than nurses (3.41).
Conclusions:
- This is the first study to use the AACN HWEAT in US pediatric CVORs.
- The established benchmark score of 3.50 can guide improvement strategies.
- Fostering a HWE is essential for high-quality patient outcomes and clinical excellence in pediatric cardiac surgery.
Introduction:
Pediatric cardiac surgery is complex and has significant risk, requiring interprofessional teamwork for optimal outcomes. Unhealthy work environments have been linked to poor patient outcomes, staff dissatisfaction, and intention to leave. We describe the interprofessional health of pediatric cardiovascular operating room (CVOR) work environments in the United States and the establishment of a healthy work environment (HWE) benchmark score.
Methods:
Utilizing the American Association of Critical Care Nurses Healthy Work Environments Assessment Tool (HWEAT), interprofessional staff from 11 pediatric CVORs were surveyed. Responses were aggregated, summarized, and stratified by role to examine differences. The following phase used an e-Delphi approach to obtain expert consensus on a benchmark target.
Results:
Across 11 centers, 179 (60%) completed surveys were reviewed. The interprofessional mean HWEAT score was 3.55 (2.65-4.34). Mean scores for each standard were within the "good" range. Participants reported the highest scores for effective decision-making, with a mean of 3.69 (3.00-4.20). Meaningful recognition scored lowest, mean 3.26 (2.33-4.07). When stratified, surgeons reported higher overall HWE scores (M = 3.79, SD = 0.13) than nurses (M = 3.41, SD = 0.19; P = 0.02, two-tailed). The proposed benchmark was 3.50.
Conclusions:
This is the first time the American Association of Critical Care Nurses HWEAT has been used to describe the interprofessional health of work environments in pediatric CVORs in the United States. The targeted benchmark can support pediatric CVOR improvement strategies. Creating and sustaining an HWE is an interprofessional opportunity to support high-quality patient outcomes and clinical excellence.
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