Comprehensive Healthcare Simulation: Mastery Learning in Health Professions Education by William C. McGaghie & Jeffrey H. Barsuk & Diane B. Wayne

Author:William C. McGaghie & Jeffrey H. Barsuk & Diane B. Wayne
Language: eng
Format: epub
ISBN: 9783030348113
Publisher: Springer International Publishing

Effective Healthcare Teams

Definition

Modern healthcare teams vary in many ways. Healthcare teams may be hierarchical like a surgeon leading a clinical team on morning rounds with military efficiency [22] or egalitarian such as primary care teamlet “huddles” where doctors, nurses, pharmacists, social workers, and many other professionals talk frequently during the day about patient care details [23]. Healthcare teams can be small, nimble, and stable over time like an emergency medical service (EMS) crew or have a large pool of individuals that turn over frequently as in a medical intensive care unit (MICU) [24]. Healthcare teams also vary by purpose. Some teams are defined by disease, such as a cystic fibrosis care team that manages patients in the clinic or when they are admitted to the hospital. Continuity and expertise define such a team’s success. Other healthcare teams are shaped by emergency situations such as cardiac arrest and trauma where speed and technical skills are crucial.

There are also less acute team structures in healthcare. In teaching hospitals, for example, a general medicine inpatient team usually makes rounds every morning, 7 days/week. The general medicine team has senior and junior physicians and students and frequently includes nurses, pharmacists, and social workers. Outpatient clinical settings across specialties, from pediatrics to surgery, often have well-defined team structures where individual team members are rarely in the same physical space. Physicians appear at the front line with clinic patients, a triage nurse handles phone calls and emails using patient charts, and team members communicate closely with social workers and clinic schedulers. Teams are now dominant in healthcare because no one works alone any more.

Team research psychologist Eduardo Salas and his colleagues define a team as “… a distinguishable set of two or more people who interact, dynamically, interdependently, and adaptively toward a common and valued goal/objective/mission, who have each been assigned specific roles or functions to perform, and who have a limited life-span of membership” [25]. Salas and colleagues amplify the team definition by pointing out that “… task completion requires: (a) a dynamic exchange of information and resources among team members, (b) coordination of task activities (e.g., active communication, back-up behaviors), (c) constant adjustments to task demands, and (d) some organizational structuring of members” [25].

There is wide diversity among healthcare teams, yet there are fundamental team elements that distinguish thriving teams versus teams that struggle. Effective teams have clear goals, structure, measurement, feedback, and accountability. Goals govern the team and each team member. Structure comes from leadership and team communication. Salas and colleagues state elsewhere that “… teams have meaningful task interdependencies, hold shared and valued objectives, use multiple information sources, possess adaptive mechanisms, and perform through intensive communication processes. The key characteristic of a team is task interdependency. The team members must not only communicate but they must also coordinate actions and cooperate so that they can accomplish a task” [26].

The fundamental metrics for a healthcare team are always patient focused. Process measures of patient care practices can vary from team adherence to an

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