Abstract
BACKGROUND: Effective teamwork is essential for patient safety and quality of care in intensive care units (ICUs), where complexity, high cognitive demands, and multidisciplinary collaboration prevail. Despite its critical role, there is a lack of validated instruments specifically designed to assess teamwork effectiveness in ICUs. This study aimed to develop and validate a context-specific tool-the Teamwork Effectiveness Scale in Intensive Care Units (TES-ICU). METHODS: The study was conducted in two phases. In Study 1, a comprehensive item pool was generated through literature review and expert evaluation. Items were tested for clarity and distributional properties, and an exploratory factor analysis (EFA) was used to refine the pool. In Study 2, the psychometric properties of the resulting 30-item TES-ICU were evaluated using a nationwide sample of ICU professionals in Türkiye (N = 716). Validity was assessed by examining associations with job satisfaction, organizational commitment, burnout, and turnover intention. Reliability was evaluated using Cronbach's alpha. RESULTS: EFA revealed a three-factor structure explaining 56.76% of the variance: (1) Teamwork Effectiveness (16 items), (2) Effective Communication and Error Management (11 items), and (3) Effective Leadership (3 items). All subscales demonstrated high internal consistency (α > 0.85). The TES-ICU showed strong construct validity; it was positively associated with job satisfaction and commitment and negatively associated with burnout and turnover intention. CONCLUSIONS: The TES-ICU is a reliable and valid tool to assess teamwork effectiveness in ICU settings. It can guide interventions aimed at improving team dynamics, enhancing staff well-being, and ultimately contributing to better patient outcomes. The 16-item core scale may be used as a shorter form for research or quality improvement efforts.