Working in effective teams improves clinical outcomes, increases professional satisfaction and provides crucial peer support. However, teamwork as a core value is often missing in health care, limiting the benefits we achieve.
A single health care encounter can involve interactions with several health care professionals in various clinical settings. Recognizing that high-quality care necessitates careful coordination and collaboration has fueled numerous initiatives aimed at improving clinical teamwork.
I had the opportunity to perform research on interprofessional teamwork in health care as a Josiah Macy Faculty Scholar. We developed training and educational programs to help improve team skills, including communication, situational awareness and performance assessment. However, we discovered that one of the most critical aspects of strengthening clinical teams is often overlooked.
Teamwork requires more than just communication skills, coordination or even mutual goals. As a guiding principle, effective teamwork requires a collaborative mindset that recognizes the inherent value of the team model and a commitment to building effective relationships.
Adopting a collaborative mindset leads to greater respect for our coworkers and their unique contributions to patient care. In addition, this mindset causes us to become more aware of how our actions affect those of our teammates and ultimately influences clinical outcomes.
With a collaborative mindset in place, teams become natural opportunities for integration, innovation and quality improvement. However, when teamwork is not a core value, we go through the motions but lack the underlying conviction necessary for effective collaboration.
The "Us vs. Them" Pitfall
Unfortunately, one of the barriers to developing this mental framework is human nature. In the absence of context, we often default to making negative assumptions about other people's motives. Whenever there is a disconnect between someone's actions and our desired outcome, we tend to fill that gap with suspicion and assume malicious intent.
Perhaps this was an evolutionary trait important to our survival in the ancient past. It may have been advantageous to assume that the unknown posed a threat, whether in the form of rustling grass or strangers from another tribe.
This trait, however, does not serve us well in the modern context with our health care colleagues. It frequently leads to an "us versus them" mentality. "They" are either lazy, uncommitted or ignorant. We attribute perceived shortcomings in others to a character flaw. We do not give them the same room for extenuating circumstances that we do for ourselves or other members of our group. This reaction, in turn, creates division, factionalism and distrust.
When operating with a collaborative mindset, we approach conflict by assuming that everyone is trying to do the best they can and giving others the benefit of the doubt. Before reaching a negative conclusion, we withhold judgment and ask clarifying questions. Inquiry is a powerful tool that can curb negative biases, prevent misunderstanding and preserve relationships.
Using this approach will also enable us to intervene if a colleague makes a negative assumption about another team member. Speaking poorly about others not only fractures collegiality but also erodes trust across the entire health care team. When we gently correct people who unfairly disparage others, we demonstrate true leadership.
Value Team Integration
According to research, team-based care can improve the safety, efficiency and quality of health care. Leveraging the unique skill set and perspective that each member brings to the team enables us to meet patients' needs and advance the health of populations.
Effective teams have a clear, common understanding of each other's roles and responsibilities, which allows them to act appropriately and work together effectively. This concept is embraced in other fields, including aerospace, military, software development and music performance. It's not enough for everyone to perform their part; we also must think about how our part fits into what other team members are doing. This integration is what interdisciplinary care is all about.
Creating opportunities to observe others in their clinical settings is one method for achieving this perspective. We can learn how to interact more effectively by walking a mile in each other's shoes. Team huddles and multidisciplinary meetings are other ways of accomplishing this goal. Role clarity and mutual understanding help avoid the "us versus them" mentality.
Create Psychological Safety
A collaborative mindset is also essential for forming inclusive, psychologically safe teams. Harvard Professor Amy Edmonson coined the term "psychological safety" to describe an environment in which people feel comfortable, can be curious, are empowered to participate and are permitted to be vulnerable.
Psychological safety is an important differentiator in creating learning organizations where people can grow and contribute to improving performance. Professional satisfaction and fulfillment are also abundant in this type of environment.
Health care leaders and individual team members alike share the responsibility for instilling and spreading psychological safety in their organizations.
Adopting a collaborative mindset helps to create effective team-based health care. Every member of the clinical team can contribute to a stronger emphasis on interdependence by embracing teamwork as a core value. This approach has the potential to change the way we interact with each other in clinical settings and ultimately transform the health care environment.
- Rosen MA, DiazGranados D, Dietz AS, Benishek LE, Thompson D, Pronovost PJ, Weaver SJ. Teamwork in healthcare: Key discoveries enabling safer, high-quality care. Am Psychol. 2018 May-Jun;73(4):433-450. doi: 10.1037/amp0000298. PMID: 29792459; PMCID: PMC6361117.
- Havyer RD, Nelson DR, Wingo MT, Comfere NI, Halvorsen AJ, McDonald FS, Reed DA. Addressing the Interprofessional Collaboration Competencies of the Association of American Medical Colleges: A Systematic Review of Assessment Instruments in Undergraduate Medical Education. Acad Med. 2016 Jun;91(6):865-88. doi: 10.1097/ACM.0000000000001053. PMID: 26703415.
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