A quantitative examination of team leadership, team behavior, and patient outcomes at a Level I trauma center.

In this study, I address the critical need to optimize team performance and patient outcomes in high-stress clinical environments. Despite advancements, preventable adverse outcomes in trauma persist, with 30% of trauma-related deaths deemed preventable with optimal care (Institute of Medicine, 2016). Inconsistent team performance in trauma centers leads to variations in patient outcomes (American College of Surgeons, 2018). Ineffective communication and leadership within trauma teams significantly contribute to preventable outcomes, underscoring the necessity for improved team dynamics (Salas et al., 2008). I employed a quantitative, non-experimental methodology to investigate relationships among team leader behaviors—transformational, transactional, and passive—team citizenship behaviors—speaking up, cooperation, and knowledge sharing—and patient outcomes, specifically 30-day mortality. I analyzed a de-identified dataset of 132 cases from a Level I trauma center in the Southwestern United States. Expert physician reviewers scored video observations using the surgeons' team leadership and team behavior model. Using descriptive statistics, I summarized case characteristics, including patient age, Injury Severity Score (ISS), and 30-day mortality. I confirmed good inter-rater reliability with the Intraclass Correlation Coefficient (ICC). I then used Spearman's Rho correlation to explore relationships between team leadership and team citizenship behaviors, while chi-square tests examined associations with 30-day mortality. Mann-Whitney U tests compared team citizenship behaviors between transformational and passive leadership groups, revealing significant differences. The results highlight the crucial relationship between team leader behavior and team citizenship behaviors. Transformational and transactional leadership are positively associated with team citizenship behaviors; transformational leadership inspires and motivates team members, while transactional leadership sets clear expectations and maintains accountability. In contrast, passive leadership is negatively associated with team citizenship behaviors. These results underscore the need for targeted leadership training and mentorship programs, particularly in teaching environments. Notably, the study also revealed a statistically significant association between cooperation and increased 30-day mortality rates, highlighting the importance of cooperation in enhancing team performance and patient outcomes. Further research should explore additional variables and aspects of team leadership to better understand their relationship with patient outcomes, particularly mortality rates. This comprehensive approach enhances team performance, improves patient care, and achieves better outcomes in trauma settings.

Name thesis:degree_name

Ed.D.

Level thesis:degree_level

Doctoral

Grantor

Baylor University.

Year dc:date.issued

2024

Author dc:creator

• Holroyd, Ashley, 1972-

Advisor dc:contributor.advisor

• Vaughn, Shelby Duncan.

• Transformational leadership.
• Passive leadership.
• Team citizenship behaviors.
• Speaking up.
• Cooperation.
• Knowledge sharing.
• Trauma care teams.
• Leadership in healthcare.

Statement dc:rights

• Baylor University works are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. Contact libraryquestions@baylor.edu for inquiries about permission.

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/2104/13578

OAI identifier oai:identifier

oai:baylor-ir.tdl.org:2104/13578