The Spirited Multidisciplinary Healthcare Team
Healthcare is a high stress work setting where professional burn out is common. Burnt out physicians and healthcare workers lose focus on tasks at hand and withdraw from engagement with others; they project their frustration and anger on their colleagues. The result is relationships that lack professionalism and divide the healthcare team. The focus becomes personal conflict instead of professional goals for the patient’s best health. When communication breaks down errors occur.
In a healthy professional setting each member of a team should have a common focus – the health and well-being of each patient, each team member, and the delivery of high quality, compassionate, error-free, cost-effective care. To maintain professionalism each member of the team must hold other team members accountable for retaining focus on their common goal. Tension between team members is a signal the team needs to meet as a group to clarify goals, re-establish the roles of each team member, and to work on team process and problem solving.
The longer a group of healthcare professionals work together towards a common goal of patient care health and excellence, the more united they become behind that goal. Working together then becomes fluid and effortless.
Although “teamwork” and “healthcare team” are often cited in healthcare organizations’ policies and values, the reality is that most health networks are vertical organizations. Each discipline reports through separate discipline-specific hierarchies. In such a situation, when the doctor comes to make rounds, the nurses, social worker, residents, and others who follow him/her around are often referred to as “the multidisciplinary team.” However, because primary communication and accountability remains discipline-specific and vertical this is NOT the healthcare team to which I am referring.
Organizations that are splintered by discipline create problems. Messages to frontline caregivers are mixed and often do not consider the needs of other frontline disciplines. When problems arise there is a tendency to assign blame to other professional disciplines. Tension develops between disciplines and little direct conversation about patients occurs. Frontline workers are not engaged with one another and, therefore, not able or empowered to problem solve at their level. Instead, all problems are addressed, often in a punitive way, by managers who are remote and unaware of the frontline realities faced by the team and the patients it serves.
Most doctors and nurses work in a highly stressful situation that often leads to burnout. The Joint Commission notes that 60% of medication errors in the healthcare setting can be attributed to impaired communication between doctors, nurses, pharmacists, and other frontline professionals. The interpersonal withdrawal that results from burnout further decreases communication between disciplines. Frustrations can seem overwhelming and the tendency for interdisciplinary irritability and blame is high. This is a perfect breeding ground for disruptive behavior and medical errors.
The absence of open conversation, shared information and teamwork creates an opening for feelings of helplessness, false assumptions, disruptive behavior and medical errors.
Therefore, success strategies are those that encourage and empower the frontline multidisciplinary team to gain the knowledge, skills and confidence to work together as a cohesive entity supported by the institutional structure around them. With this direct and open sharing of information amongst all disciplines involved with a given patient, as well as the common goal of outstanding service to patients and one another, the seemingly miraculous happens. Patients heal, staff and patient satisfaction soars, and medical error and disruptive are a thing of the past. ,
My next post will give the reader a brief look at the team process that makes this positive change possible
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