Testing of the Patients' Insights and Views of Teamwork (PIVOT) survey: A validity study

Objective: To explore patient observations of teamwork-related behaviors such as inter-team communication through a newly designed survey. Methods: In this cross-sectional study, 101 patients (N= 86) and caregivers (N= 15) recruited from the emergency department (ED) of an urban, academic medical center (>85,000 visits/year) completed the 16-item Patients' Insights and Views Observing Teams (PIVOT) Survey. We evaluated validity evidence through descriptive statistics and analysis including a Many-facet Rasch model to determine associations between questionnaire items and sociodemographic characteristics. Results: Participant responses provided evidence survey items performed well and reflected patients' awareness of team behaviors such as inter-team communication, coordination, and keeping teammates informed. Also, participants responded about the consistency of information from team members and knowing what people's jobs were on the team. Rasch analysis largely supported that the PIVOT items reflected the intended content area and adequacy of ratings scales supporting evidence of response processes. High internal consistency (Cronbach alpha, r= .87) supported evidence of internal structure. As expected, response patterns differed by ED visit acuity level and length of stay. Conclusions: The PIVOT survey offered a means to collect patient and caregiver observations of health care teams. Practice implications: PIVOT survey responses may contribute to evaluation of teamwork behaviors.