The Assessment for Collaborative Environments (ACE-15) was developed to identify clinical training sites with a high level of “teamness” to ensure optimal learning environments for student training. The ACE-15 is suitable for a range of clinical settings and health professionals and allows for rapid assessment of a clinical practice’s teamwork qualities. The ACE-15 was used by stable members of the healthcare team who provide care and support in a particular context or for a particular panel of patients to assess teamness in clinical training sites that are settings for interprofessional learners. The ACE-15 may also be useful as a professional development and systems improvement tool. Additional research on the use of the ACE-15 with student, learner and healthcare teams that have changing members may be warranted.
The tool, in accordance with the Institute of Medicine report, Core Principles & Values of Effective Team-Based Health Care (Mitchell et al., 2012), defined effective teams as having core interrelated qualities that together embody “teamness.” These include shared goals that reflect patient/family priorities and that can be articulated, understood and supported by all team members:
- Clear roles, such that team members’ contributions optimize the team’s efficiency and ability to accomplish more than the sum of its parts
- Mutual trust that creates norms of reciprocity and greater opportunities for shared achievement
- Effective communication that is candid, complete and continuously refined
- Measurable processes and outcomes that are used to track and improve performance
- Organizational support at the system level to promote team success
Expert review and cognitive interviews allowed reduction of the initial 30-item tool to 15 items (the ACE-15). The psychometric properties of the ACE-15 were assessed using a convenience sample of 192 interprofessional clinicians (with a small subset of non-clinician administrative staff) in urban and rural areas who self-identified as working in stable teams. A majority of respondents were female and had been members of the same care team for one or more years. Seventeen separate health professions were represented, with the largest groups being physicians (17.2%), nurse practitioners (15.6%), dentists (11.5%) and staff RNs (8.9%). After a first wave of survey ofindividual clinicians sampling focused on clinical teams where individual respondents could be linked to their team (n=16). Teams consisted of three or more members from two or more professions. Team size ranged from 3 to 20 members. The majority of teams (n=12) were inurban settings (8 ambulatory and 4 hospital-based inpatient teams). Four teams, all ambulatory primary care, were in rural settings.
The authors conclude that the ACE-15 has acceptable psychometric properties and promising utility for assessing teamness in clinical training sites that are settings for interprofessional learners. In addition, the authors recommend additional research on the use of the ACE-15 as a professional development and systems improvement tool, use with rehab teams, and use with unstable teams.
Source: Development and psychometric properties of a measure of teamness: The ACE-15. In press, Journal of Interprofessional Care.Tilden, V; Eckstrom, E; Dieckmann, N.