Improving teamwork in hospitals is key to giving clinically excellent care to our patients.
While I was waiting in the pre-op area for a medical procedure, the anesthesiologist entered the room and introduced himself to me. After asking me about my surgical and anesthesiology history, he asked about my allergies. I reported my allergy to a blue food dye. He responded by checking my wristband to confirm it was listed and proceeded to enter my response into the computer he was charting on. Ten minutes later, a surgical nurse came to ask me a series of questions and started with my allergies. I responded the same way and held up my band. It may sound trivial and perhaps this was just routine protocol to verify, but it did leave me wondering … Did my nurse not speak to my anesthesiologist? What else did they not talk about routinely that they should?
While I was most certainly paying closer attention to these interactions than most, the truth is that all patients expect that their doctors, nurses, and other team members are on the same page about their care. They have good reason to demand this. Better interprofessional collaboration is associated with a myriad of positive health outcomes including reduced mortality, reduced length of stay and readmission rates, and higher patient experience ratings. Unfortunately, as I learned firsthand, this is not always the case. I am not alone. Data from Press Ganey patient experience surveys suggest that improving teamwork in hospitals is a key driver to improve patient satisfaction.
Why is it so hard to achieve interprofessional care? Unfortunately, there are many barriers to achieving this vision, including the disparate training and practice silos between physicians and other health professionals, disparate rules and regulations that apply to different professional roles, as well as institutional policies and routine procedures governing workflow that may prevent team-based care. To make matters worse, all of these barriers to interprofessional team-based care are even more acutely evident in academic teaching hospitals where clinical learning is happening alongside delivery of patient care. This makes achieving the vision of the interprofessional clinical learning environment put forth by the Josiah Macy Jr. Foundation and the Accreditation Council of Graduate Medical Education (ACGME), which articulates the need to deliver patient-centered care in a team-based fashion where everyone is learning and teaching together, a challenge.
As a Macy Faculty Scholar, and with a team of educational and health system leaders at University of Chicago Medicine via the ACGME Pursuing Excellence Initiative, I am implementing and evaluating IGNITE , to realize this vision. Through IGNITE, I have learned there are three basic things you can do to achieve this vision your practice:
1.) Ask other healthcare professional team members, in particular your patient’s nurse, about their impressions and concerns about your patient.
2.) Make sure that your patient’s nurse is aware of, and understands, the plans for the day and the overall direction that the care is heading.
3.) Clearly express to your patient and their family that you are part of a dedicated team who is collaborating to provide them the best possible care.
This piece originally appeared on themacyfoundation.org. Thank you to both the author and The Macy Foundation for the generous sharing of this piece for the benefit of all readers and learners!