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Posted September 2016


A newly minted physician was serving in the military in Afghanistan soon after completing his residency in Family Practice. He assigned to a clinic to treat the locals a number of miles outside of the protected “green zone”. He was given all of the usual safety warnings. He was told that he would potentially be a target because the enemy didn’t approve of these clinics. Furthermore, he was an officer and that would make him a more likely target. He was given a small caliber side-arm and a security team for the trip.
He was loaded into an armored vehicle along with a group of regular soldiers who were heavily armed. Several similar vehicles accompanied them when the motorcade left the green zone. As they put more distance between themselves and the safety of the base, he could feel his anxiety level increasing.

When the motorcade reached the intended village, a number of children flooded into the street and surrounded them. He had been told to expect this. The soldiers had often given them candy on previous trips to reassure them that they were there with good intentions. Still, the crowd slowed their progress and left him feeling vulnerable. This feeling only increased as he stepped out of the vehicle at his destination in the center of the village. The children all rushed in around him and sense of claustrophobia hit him. He could see the other soldiers diligently scanning the rooftops and deploying themselves to strategic positions and constantly communicating over radios. Almost instinctively, he slid his hand over and gripped his side-arm feeling a nebulous sense of danger. Standing right beside him was the security team leader. He saw the apprehension on the young physician’s face and said, “Hey Doc…We’ve got this.”
It was a pivotal moment early in the physician’s career. In that instant he realized that he was surrounded by trained professionals who were well equipped and prepared to do their job. He could leave the security to the professionals while he gave candy to children and focused on treating patients as he was trained to do.
In the grand scheme of things, the physician and the security team where there to accomplish the same goal. The soldiers had been trained in basic first-response, but weren’t great at diagnosing and treating illness. The physician had some basic weapons training and was issued the side-arm, but he knew well that he was not likely to manage any threat that had breached his well-armed security team. In spite of the overlap, they were each reliant on the other to do their job well so the mission would be successful.
Of course, this type of teamwork translates well into almost every other aspect of life and business. However, it is probably most poignant in the healthcare setting. Why? Lives are at stake.

A number of studies have shown that multidisciplinary collaboration and teamwork have been shown to reduce hospital admissions, length of stay and costs. More importantly, it has been shown to improve quality, reduce errors and yield better outcomes for patients. Just as in the military example, the more intense the situation, the more important the teamwork. In the Emergency Department, the Cath Lab or the ICU, teamwork and communication simply saves lives.

Historically, healthcare providers have been trained in silo’s. Rarely do nursing students, medical students, pharmacy students, radiology tech students, or any other kind of students come together for educational purposes in the course of their education. They are trained to be independent rather than inter-dependent. The challenge that healthcare organizations face is creating the sense of teamwork and collaboration.

In the world of electronic health records, it is more possible than ever for each member of the care team to interact only with a computer. More deliberate attempts at interaction have been devised to overcome this issue. The multi-disciplinary huddle is one example. Mock codes and disaster drills are other examples of times when the team can come together.
What should not be overlooked, however, is the need to bring the various team members together over larger issues. Education and governance are likely some of the better opportunities to do this. Many times, new initiatives or in-services are given at shift change to catch the nurses and at noon or after five to catch the physicians. Leadership meetings for the hospital staff and medical staff meetings almost never overlap. Rarely do all of the members of the team get in one room at one time to learn, discuss, solve or simply interact as a team over larger or broader issues. When it does occur, this type of interaction brings value to each of the team members and creates phenomenal results.
Hospital and healthcare organization leaders must recognize that the current system of training for all healthcare providers is evolving, but is not as team oriented as it should be yet. They must find ways to cultivate the culture of valuing each member of the team, instilling that value in the other team members and creating confidence in the team that allows each to trust the others as true partners in patient care.