Week 4
Lecture
Why are teams in healthcare important:
- Synergy: 1 + 1 = 3
- Teamwork necessary to provide care: complex nature of medicine, increasing chronic diseases
and co-morbidity, specialization, combining technical and non-technical skills, 24h care.
- Teams are key players for optimization of time and resources
- Social appeal, desirable
West: medical errors, patient safety, reduced stress, job satisfaction, stay at work, cost-effective, patient
satisfaction
What is a team:
- Many definitions: limited group of people, common purpose, mutually accountable,
interdependence
- A team is a limited group of people, whose degree of interdependency varies in nature and
intensity, committed to shared and individual goals and mutually responsible for shared goals.
- A real team: clear team boundaries, team member stability, interdependency. However, a real
team is a context-based concept. Difficulties in defining team membership: multiple team
membership, inner and outer circle, patient as team member (patient participation).
- A team is not the cure to every organizational problem: is a team appropriate for the work being
one? Are tasks done better and more efficient by individuals? Is teamwork cost-effective? Take
context into account: do other systems support the team?
- Teams are changing
Characteristics of effective teamwork: Model of Lemieux-Charles
How to improve team performance:
- Overall belief that team interventions will improve team functioning, reduce adverse events,
increase performance outcomes. Most healthcare organizations are employing team
interventions. What are the evidence-based interventions?
o Training: crew resource management, teamSTEPPS (strategies and tools to enhance
performance and patient safety), simulation training (practice and reflection)
o Tools: structure teamwork with SBAR, (de)briefing checklists, rounds. Facilitate
teamwork through technology. Trigger teamwork through monitoring tools such as
(score) cards and dashboards.
o Organizational redesign: interventions that (re)design structures and processes
(pathways, schedules, relocate responsibilities and roles).
o Program: combination of interventions (training, tools and/or redesign)
, Literature
Lemieux-Charles, McGuire (2006). What do we know about health care team effectiveness? A review of
the literature. 263-300.
The use of teams in healthcare delivery continues to grow as the added pressure of restructuring,
reorganization, cost containment, and the increasing complexity of healthcare knowledge and work
have reinforced the need for them.
- A team is a multidimensional construct and team structures and processes can vary widely
according to membership, scope of work, tasks and interactions.
- Classification of outcomes that distinguishes between patient care, personnel or management.