Contemporary, Effective Teamwork and Communication within Healthcare - Case Study Example

Contemporary, effective teamwork and communication within healthcare Student’s Name: Instructor’s Name: Course Code: Date of Submission: Contemporary, effective teamwork and communication within healthcare "Non Clinical research from commercial aviation, the defence forces, and rapid response teams within firefighting and police services reports that teams operating in high-risk and high-intensity work environments make fewer mistakes compared with individuals. These studies suggest there is a relationship between qualities such as flexibility, adaptability, resistance to stress, cohesion, retention and morale, with effective team performance." This statement can be argued from the point that when individuals work in isolation and faced with difficult situation which needs critical understanding and interpretation, they lack point of reference and the result is making decisions that may compromise quality and safety for the clients and more especially in the healthcare facilities. Despite operating in high-risk and high-intensity work environments, teams operating in defence forces, aviation and fire-fighting have been found to be more effective in the roles than when operating as individuals. This is because effectiveness as been attributed to high level and quality communication and workload management as well as task prioritization. A good example can be illustrated in the case of the U.S army during the 1980s when about 147 fatalities took place causing major worry about the safety of the aviation department within the military (Clancy and Tornberg, 2010). The failures were greatly attributed to errors in communication and management of workloads. This kind of situation led to introduction of the training and evaluation program that could save about 15 persons each year. In the case of the healthcare units according to findings of Christina Hunt into the effectiveness of teams in the state of Pennsylvania, various professionals working in healthcare are looking for tools that can be used to enhance the effectiveness of various teams and at the same time foster interaction among them with the aim of trying to advance quality and safety in their services to the patients (Joint Commission 2007). In some healthcare units according to Christina Hunt, training is given priority in trying to improve communication and liaison among teams working in healthcare facility. Like the case of aviation, military and firefighting departments, the healthcare sectors is equally faced with challenges related to quality and safety in operations. The failure in the U.S military in the 1980s leading to several cases of deaths and how they enacted the teamwork programs to recover from the same situation is something worthy to be imitated by teams working in the healthcare units. After the military failure for instance, the U.S Navy took an initiative to study into teamwork and various training interventions programs under Tactical Decision Making Stress (TADMUS). What this program did was to increase understanding of team knowledge, skills and attitude requirements, developing new training approaches to enhancing teamwork and providing reliable and effective measures to team processes and outcomes. Healthcare facilities have the opportunity to learn different lessons and procedures for using teamwork strategies (Mickan and Rodger 2003). As is the case of aviation, military and firefighting and all departments that are operating at high-risk contexts, teamwork is of great essence. However, teamwork is only possible in a healthcare unit where there is adequate communication. To illustrate, in the case of Pennsylvania, all the facilities are required to report all incidents and other serious events to the authority since 2004. In a review of 1,300 reports in 2009, it was found out that atleast each report had each of these of these sections: teamwork, communication, Situation, Background, Assessment and Recommendation (SBAR) and handoff communication (AHRQ, 2009). Each of these areas play an integral part to patient safety and quality of service delivered and are all included in teamwork training. Some of the comments that are also very conspicuous in these reports include the need to better communication among different departments (Smith 2005). Statistics have continued to show that teamwork can actually significantly improve quality of service and safety in patient care. It is estimated that one healthcare facility that had gone a step ahead to implement various teamwork initiatives, stood a better chance of reducing their clinical error rates from 30.9% to 4.4%. Another facility that practiced teamwork initiatives, had managed to reduce their adverse outcomes by 50%. The significant reduction in clinical errors is attributed to the effort made by the team to ensure that the competence of each and every member is enhanced through learning and interacting with the rest of the team members and more especially those that are more experienced and can be used as role models. In the recent past, many healthcare facilities, are considering using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), a program that is offered by AHRD and DoD which provide tools and various strategies that can be used to enhance communication and teamwork for the purpose of reducing errors and increasing safety while discharging care to the patients. According to Wake-Dyster (2001), the teamSTEPPS comprises both teachable and learnable skills which include leadership, mutual support, situation monitoring and communication. According to Clancy and Tornberg, 2010), the ratio of we’s to I’s is the most preferred indicator to developing an effective team. The team structure is particularly important and is an integral part to the teamwork systems and is what holds together an effective strategy to ensuring quality service and safety to the patients during medical attention. What the teamSTEPPS does in this case is to promote partnering with the patient so as to ensure that he is part of the team structure because the decisions made will affect him more than any other member of the team (Wake-Dyster 2001). In many different parts of the world, majority of healthcare facilities are using such tools as SBAR and handoff communication and check-backs in order to enhance effective communication among different teams and employees. However, there are a few which have chose to adopt the TeamSTEPPS to facilitate communication and teamwork in their healthcare facilities so as to enhance the quality of their services and reduce errors that occur in the process of attending patients. One such hospital that has been spotted and that has incorporated the TeamSTEPPS program is Wayneshoro Hospital. Waynesboro Hospital is a non-profit community hospital with a capacity of 64 beds which deals with acute care in South Central Pennsylvania. The health facility after looking into different teamwork training programs, it came into a conclusion that TeamSTEPP is the most comprehensive teamwork training program. The program was expected to take one year approximately to complete and what was considered very fundamental, is the support of the nurses and administration (AHRQ, 2009). This is especially important in ensuring that the nurses are empowered to use such phrases as “I need clarity” so as to get proper communication and also acquire important tools that can be used to enhance their proficiency in their daily practice. Many of the nurses came to see this initiative as something full of fun and helpful in their daily endeavors (Clancy and Tornberg, 2010). What is important and need to be understood here, is that teamwork in healthcare is one important means for facilitating high level quality services and facilitate safety in daily operations through minimization of errors. This goes further, to improve both process and client outcomes and increase both customer and staff satisfaction. This is because the patients will feel appreciated and an important part of teamwork whereas the staff will have the opportunity to enhance their skills (Mann et al. 2006). A well performing team is characterized by its ability to interact dynamically and interdependently as well as adapting to a common and valued goal. Further, shared vision and clear roles and duties and having a common purpose as well as strong leadership that can manage and maximize performance outcomes are also characteristics a well-performing team (Wallick and Stager 2002). This can be demonstrated in the case of Waynesboro Hospital which has managed to significantly improve on its performance and safety. This is because with shared goals and objectives, the nurses and administrators working in the health facility feel part of the whole team (Frankel et al. 2003). In healthcare facilities like is the case of the military department, firefighting sector and aviation, teamwork is very fundamental. However, the effectiveness of teamwork in ensuring quality services and safety when administering medical care to the patients is depended on how effective communication is. According to Morey et al. (2002), communication is preferred because of its role in facilitating the process of sharing information among the team members and among different teams. The finding by Joint Commission’s Sentinel Event Data, lack of proper communication is the root cause of major failures in the healthcare as there is failed system of delivering any message between the sender and the receiver. Effective communication is only possible if the message that is being delivered is effective is complete, precise, clear and timely. According to Weick and Sutcliffe (2007), communication in the team can be improved by use of different approaches namely SBAR which is a standard method of communicating about the patient’s condition; call-out which is to communicate critical information on an emergent issue; check-back which is used set the limit of communication and verify the already exchanged information and lastly handoff which allows exchange of information to take place when transition occurs in healthcare (Shortell 2003). In conclusion, there is direct relation between different qualities such as flexibility, adaptability, resistance to stress cohesion, retention and morale and effective team performance and in particular, those departments that operate under high-intensity risks such as military, aviation, firefighting and police services. This is because teamwork is associated with learning of skills that are important in performing different tasks (Shortell, 2003). This is also true with the case of healthcare facilities where quality service and safety is supposed to be maintained when handling patients. However, effectiveness of teamwork is depended on how adequate communication is done as it facilitates the delivering of information in a team. Reference Agency for Healthcare Research and Quality (AHRQ) (2009). TeamSTEPPS: national implementation. retrieved on 23rd October 2012, Available at: http://teamstepps.ahrq.gov/index.htm. Clancy, C.M., and Tornberg, D.N. (2010). TeamSTEPPS: integrating teamwork principles into healthcare practice. Patient Safety Quality Healthcare. retrieved on 23rd October 2012. Available at: http://www.psqh.com/novdec06/ahrq.html. Frankel, A, Gandhi, T.K, and Bates, D.W. (2003). Improving patient safety across a large integrated health care delivery system. International Journal of Quality HealthCare, 15 (1), p. 31-40. Joint Commission (2007). Improving America’s hospitals: the Joint Commission’s annual report on quality and safety. Retrieved on 23rd October 2012, Available at: http://www.jointcommission.org/NR/rdonlyres/658A9BB9-3485-4ACB-91BF- FCDCA73E4F30/0/2007_Annual_Report.pdf. Mann, S., Marcus, R., and Sachs, B. (2006). Lessons from the cockpit: how team training can reduce errors on L&D. Contemp OB/GYN, 51, p. 34-45. Mickan, S., and Rodger, S. (2003). Characteristics of effective teams: a literature review. Australian Health Review; 23, p. 201–208. Morey, J.C., Simon, R., and Jay, G.D., et al. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Service Reserved; 37(6), p. 1553-81. Weick, K.E., and Sutcliffe, K.M. (2007). Managing the unexpected: resilient performance in an age of uncertainty. 2nd ed. San Francisco: Jossey-Bass. Shortell, S.M. (2003). Developing individual leaders is not enough. Journal of Health Services Research and Policy; 7, p. 193–194. Smith, E.A. (2005). Communities of competence. The Journal of Workplace Learning, 17, p. 7– 23. Wake-Dyster, W. (2001). Designing teams that work. Australian Health Review. 24, p. 34-56. Wallick, W.G., and Stager, K.J. (2002). Healthcare managers' roles, competencies and outputs in organisational performance improvement/practitioner response. Journal of Healthcare Management, 47, p. 390–402. Read More