Promoting Team Resilience within the Healthcare Setting: A Mixed Methods Approach to Develop & Test the Feasibility of an Online Team Reflective Journal Intervention

Healthcare teams face on-going challenges within the workplace giving rise to work-related stress. Responding to this, organisational stakeholders at a large NHS Trust identified the promotion of positive relationships within healthcare teams as a research priority. Promoting resilient team practices can reduce the impact of workplace pressures on wellbeing through positive team working relationships, thereby maximising team functioning during experienced adversity. Overall, the central question posed by this thesis is whether a feasible intervention can be developed to promote team resilience within healthcare teams. At present, no specific theory-driven interventions promote resilient team practices within the UK healthcare setting. To address this, a theoretical framework for promoting team resilience in the workplace was developed to underpin the approach of this thesis.

A multiphase mixed methods research study was designed to firstly develop an evidence-based intervention to promote resilient healthcare team practices, and secondly to evaluate intervention feasibility in practice. Recognising the challenges associated with developing and implementing an evidence-based real-world interventional research study, a strength-based approach to engaging with senior organisational leaders, team leaders, and team members at the research site was proactively pursued throughout the course of this project. The joint outcomes of a systematic review, interviews and surveys with healthcare staff conducted in the face of challenging workplace conditions, revealed important healthcare-specific resilient team practices, as well as identifying the need to further promote team resilience within the clinical context. Based on these initial findings, several recommendations for the design of an intervention to promote healthcare team resilience were put forward and informed the development of an evidence-based online team reflective journal intervention for use by teams experiencing challenging working conditions. Two ward teams were recruited to evaluate this work-based intervention over a four-week period, however within the real-world context of increasing workplace pressures the intervention had poor feasibility in practice. Despite contextually limiting factors, research outcomes highlighted the easy-to-use format, relevant content, and potential success of the online team reflective journal, alongside several solution-focussed recommendations to enhance user capability, opportunity, and motivation to engage with the intervention to help tackle work-related stress in healthcare teams. These recommendations further informed the developed theoretical framework for promoting team resilience in the workplace; thus, this thesis responds to real-world needs by making original contributions to both academic knowledge and occupational practice.