Key performance indicators that are used to establish concurrent validity while measuring team performance in hospital settings – A systematic review

Abstract Background Systematic studies on team performance have focused on subjective measurement approaches like survey instruments, focusing primarily on identifying the most robust and psychometrically valid surveys, and not on objective measures. One of the drawbacks of identifying improvements in team performance with surveys is that we may not be considering any secular trends that may be happening between the time points that the surveys are being administered . This review aims to establish a summary of the literature that has used key performance indicators -which are a set of quantifiable, measurable values - to concurrently validate their team performance surveys. Methods The research question “What are the key performance indicators that are used to concurrently validate team performance in hospitals?” was addressed through a systematic review. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviewing and Meta-Analysis (PRISMA) guidelines. The search was conducted using the “ECLIPSE” framework, The databases used to perform the search were PubMed, PsycINFO (Proquest), ABIInform (Global Proquest) and CINAHL. The search was limited to studies between 2009 and 2019 (10-year period). Results The total number of articles yielded by the search was 5973, of these there were 1736 duplicates. Of the 4237 articles shortlisted for title and abstract screening, 4189 were irrelevant and 48 articles were retained for full screening. Following full text screening 33 articles were excluded, leaving a total of 15 studies included in this review. The 15 included studies have KPIs and surveys that can be interpreted under the following common headings: Mortality, Incident Reports and Patient Safety Indicators, Absenteeism, Efficiency Metrics, and Financial Distress. The most common KPIs that the studies simultaneously assessed for impact were mortality (5) length of stay (3), patient safety indicators (3) absenteeism (2) , and financial distress (1), The most common concepts being measured by the surveys were Staff Satisfaction (5), Safety Culture (4), Patient Satisfaction (4), clinical governance (1), Support and Success (1) and Organizational Culture (1). Conclusions Patient safety managers and healthcare staff should consider exploring the use of tailored, meaningful objective metrics at the team level along with validated survey measures. Researchers could make a more meaningful contribution by conducting longitudinal studies that explore not only how these measures correlate but identifying the changes over time. However, repeated measurement and crude organizational level metrics, without more in-depth exploration and tailored interventions at the team level, cannot be expected to improve patient safety culture.