Variation in caregiver perceptions of teamwork climate in labor and delivery units

J. B. Sexton, C. G. Holzmueller, P. J. Pronovost, E. J. Thomas, S. McFerran, J. Nunes, D. A. Thompson, A. P. Knight, D. H. Penning, H. E. Fox

Research output: Contribution to journalArticlepeer-review


Objective: To test the psychometric soundness of a teamwork climate survey in labor and delivery, examine differences in perceptions of teamwork, and provide benchmarking data. Design: Cross-sectional survey of labor and delivery caregivers in 44 hospitals in diverse regions of the US, using the Safety Attitudes Questionnaire teamwork climate scale. Results: The response rate was 72% (3382 of 4700). The teamwork climate scale had good internal reliability (overall α0.78). Teamwork climate scale factor structure was confirmed using multilevel confirmatory factor analyses (CFI=0.95, TLI=0.92, RMSEA=0.12, SRMRwithin=0.04, SRMRbetween=0.09). Aggregation of individual-level responses to the L&D unit-level was supported by ICC (1)=0.06 (P<0.001), ICC (2)=0.83 and mean rwg(j)=0.83. ANOVA demonstrated differences between caregivers F (7, 3013)=10.30, P<0.001 and labor and delivery units, F (43, 1022)=3.49, P<0.001. Convergent validity of the scale scores was measured by correlations with external teamwork-related items: collaborative decision making (r=0.780, P<0.001), use of briefings (r=0.496, P<0.001) and perceived adequacy of staffing levels (r=0.593, P<0.001). Conclusion: We demonstrate a psychometrically sound teamwork climate scale, correlate it to external teamwork-related items, and provide labor and delivery teamwork benchmarks. Further teamwork climate research should explore the links to clinical and operational outcomes.

Original languageEnglish (US)
Pages (from-to)463-470
Number of pages8
JournalJournal of Perinatology
Issue number8
StatePublished - Aug 2006


  • Climate collaboration
  • Culture
  • Psychometrics
  • Scale
  • Teamwork

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


Dive into the research topics of 'Variation in caregiver perceptions of teamwork climate in labor and delivery units'. Together they form a unique fingerprint.

Cite this