Could the future of interprofessional clinical care teams be germinating in colleges around the U.S.?
As hospitals and other healthcare organizations continue to strive for the “triple aim” of improved population health, lower costs and improved patient experiences, many organizations are turning to interdepartmental care as one solution.
But implementing team-based care is a challenge. Ongoing silos. Old clinical and personal habits. Turf wars. These roadblocks and others often prevent fast adoption.
Where healthcare sees roadblocks, though, colleges (including medical schools) see opportunity and are now implementing semester-long programs specifically designed to teach clinical teamwork skills and provide an atmosphere where future providers learn about the different roles each profession plays on the team.
TEAM-BASED CLINICAL DECISION MAKING
Perhaps the best example is at the University of Michigan, where the course – Team-Based Clinical Decision Making (TBCM) enrolls students in dentistry, pharmacy, social work, medicine and nursing. In fact, it’s a required course for all third year Doctor of Pharmacy and Doctor of Dental Surgery students.
To build teamwork skills and awareness, each student is assigned to groups of six to eight people which have all four disciplines represented. Using exercises, case studies, discussion and both self and group-evaluation, the students work towards competency in understanding different roles and responsibilities and working effectively as diverse teams.
What has been the outcome? Student feedback has been positive and has focused on new insights. “I don’t need to be an expert in all areas,” one student remarked. “I need to be an expert in my field and understand how to work with other disciplines on the team.”
The course has also shown students the downside to teamwork as well as some teams noticed a decrease in team functioning over time, often the result of a disengaged or overpowering team member.
As more younger professionals enter the clinical environment, the drive towards interdepartmental teams may be a natural extension of what they have already learned in school, resulting in an acceleration of adoption in healthcare communities across the U.S.
For some, it can’t come soon enough.
Improved healthcare collaboration has often been cited in studies as a key strategy for healthcare reform. Collaboration has been shown to improve patient outcomes, such as reducing preventable adverse drug reactions, decreasing morbidity and mortality rates, as well as optimizing medication dosages1. Teamwork has also been demonstrated to provide benefits to healthcare providers, including reducing extra work and increasing job satisfaction.2
COMMON BARRIERS TO INTERPROFESSIONAL TEAMWORK
Some of the common barriers preventing interdepartmental healthcare teamwork include:
- Organizational barriers (financial and regulatory constraints, lack of knowledge and appreciation of the roles of other health professionals, etc.)
- Barriers at the team level (lack of a clearly stated an measurable purpose, role and leadership ambiguity, etc.)
- Barriers faced by individual team members (split loyalties, competition, gender, race or class-based prejudice, etc.)
- Barriers for independent providers (unease with allowing others to be involved in clinical decision making, accustomed to assuming total responsibility, etc.)
OVERCOMING INTERPROFESSIONAL HEALTHCARE BARRIERS
What are some ways to overcome these barriers? Here are several suggestions:
- Agree on a unifying philosophy centered on primary care of the patient and the community.
- Develop a commitment to the common goal of collaboration.
- Learn about other professions.
- Respect others’ skills and knowledge.
- Establish positive attitudes about your own profession.
- Develop trust between members.
- Be willing to share responsibility for patient care.
- Establish a mechanism for negotiation and re-negotiation of goals and roles over time.
- Establish a method for resolving conflicts between team members.
- Be willing to work continuously on overcoming barriers.
1 Romanow RJ. Building on values: the future of health care in Canada. Ottawa (ON): Canada, Commission on the Future of Health Care in Canada; 2002. Available: http://publications.gc.ca/collections/Collection/CP32-85-2002E.pdf (accessed March 4, 2015).
2 Oandasan I, Baker RG, Barker K, et al. Teamwork in healthcare: promoting effective teamwork in healthcare in Canada. Canadian Health Services Research Foundation; June 2006. Available: www.cfhi-fcass.ca/Migrated/PDF/teamwork-synthesis-report_e.pdf (accessed March 4, 2015).
3 Grant RW, Finnocchio LJ, and the California Primary Care Consortium Subcommittee on Interdisciplinary Collaboration. (1995). Interdisciplinary Collaborative Teams in Primary Care: A Model Curriculum and Resource Guide. San Francisco, CA: Pew Health Professions Commission, 1995.
MedAptus works to improve interdepartmental healthcare teamwork and collaboration by developing patient assignment software products for physicians, nurses, case managers, therapists and admitters — allowing providers to coordinate care and seamlessly view each team member’s assignments. For more information for our vision of collaborative care, click here.
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