What matters most and for whom? A cross-sectional study exploring goals of health professionals in German neonatal intensive care units

Abstract

Objectives: Quality of care largely depends on successful teamwork, which in turn needs effective communication between health professionals. To communicate successfully in a team, health professionals need to strive for the same goals. However, it has been left largely unaddressed which goals professionals consider to be important. In this study, we aim to identify these goals and analyse whether differences between (1) personal and organisational goals, (2) different professions and (3) hierarchical levels exist in neonatal intensive care units (NICUs).

Design: Goals were identified based on a literature review and a workshop with health professionals and tested in a pilot study. Subsequently, in the main study, a cross-sectional employee survey was undertaken.

Setting and participants: 1489 nurses and 537 physicians from 66 German NICUs completed the questionnaire regarding personal and organisational goal importance between May and July 2013. Answers were given based on a 7-point Likert scale varying between none and exceptionally high importance.

Results: Results show that the goals can be subdivided into three main goal dimensions: patients, parents and staff. Furthermore, our results reveal significant differences between different professions and different hierarchical level: physicians rated patient goals with a mean (95% CI) importance of 6.37 (3.32 to 6.43), which is significantly higher than nurses with a mean (95% CI) importance of 6.15 (6.12 to 6.19) (p<0.01). Otherwise, nurses classified parental goals as more important (p<0.01). Furthermore, professionals in leading positions rate patient goals significantly higher than professionals that are not in leading positions (6.36 (3.28 to 6.44) vs 6.19 (6.15 to 6.22), p<0.01).

Conclusions: Different employee goals need to be considered in decision-making processes to enhance employee motivation and the effectiveness of teamwork.

Trial registration number: DRKS00004589.

Keywords: intensive & critical care; neonatal intensive & critical care; neonatology.

Figure 1

Personal and perceived organisational goals. Please note that the dashed lines show the three goal dimensions (patient goals: reduction of mortality, reduction of morbidity, reduction of complication rate and improvement of patient’s long-term development; parental goals: increase of parental involvement, improvement of relationship of trust to parents, improvement of empathetic interest towards parental situation, more detailed and understandable parental information and improvement of parental satisfaction; staff goals: increase of time for team meetings, establishment or expansion of supervision, increase of emotional well-being of staff, increase of intellectual well-being of staff and increase of social well-being of staff).