Teamwork in healthcare

Modern healthcare depends on teams. To provide high quality care, medical students and physicians must be prepared to collaborate with multiple other health professionals in both the hospital and clinic setting.

A team can be defined as “a small number of people with complementary skills who are committed to a common purpose, performance goals and approach for which they hold each other mutually accountable.” In the hospital, every patient has a team made up of at least physician and a nurse. Clinical pharmacists see patients for medication education and drug therapy issues. Physical therapists assist those with mobility limitations. Social workers or care managers may lead planning for post-discharge care.  And of course, patients and families are also key members of the team. If the information shared by team members is not timely and accurate, healthcare will at best feel disjointed and disorganized. At worst, it will lead to serious errors and dissatisfied patients – and teams.

Hospital teams are fluid – the roles to be filled are consistent but the people who fill each role change shift-to-shift and day-to-day. On fluid teams, effective teamwork is sustained by a shared set of team skills rather than permanent members. A clear understanding of each profession’s role, a standard approach to communication, and a shared set of goals and values support teamwork despite daily turnover.

In the clinic, the core team is traditionally made up of a provider (MD, ARNP, PA) and a medical assistant or a nurse.  More and more primary care practices are shifting to a team-based care model, encouraged by changes in reimbursement. These core teams often include a broader range of professions to better meet the needs of their patients.  Ideally, each element of care is provided by the most appropriate provider, each operating at ‘the top of the license’.  Clinic teams may be considered “stable” or “true” teams – a consistent set of members who can build relationships and trust.

Team responsibilities Teamwork skills & strategies
Identify goals and define plans to achieve them Develop a shared mental model by:

Communicate clearly Use closed loop communication
Engage all team members Elicit input from members who haven’t spoken
Understand and value each member’s contribution
Speak up about problems or concerns

There is a consistent relationship



The Foundations of Clinical Medicine Copyright © by Karen McDonough. All Rights Reserved.