At my current place of work, teamwork and collaboration have become a significant problem at the health care center that needs to be addressed. The health care hospital does not meet the necessary guidelines by the World Health Organization in regard to teamwork and collaboration. At its core teamwork and collaboration is regarded as a very critical issue because it has an influence on the quality of care delivered to patients (Morley & Cashell, 2017). The various health professionals at the hospital do not work as an interdisciplinary team in the development of individualized plans for its patients. Recently a diabetic patient had to be re-admitted at the facility. Her initial care was characterized by a lack of collaboration and communication between the doctor, laboratory personnel, the dietician, and pharmacist. Because of the nature of the process of treating patients, as well as that of some illnesses, team work and collaboration, is important for quality patient care. Delivery of quality care cannot be compromised in the health care industry. Our organization will, therefore, improve the situation through training on teamwork and collaboration.
Quality Improvement Model (PDSA)
Based on the problem process at hand, the chosen model for quality improvement will be Plan-Do-Study-Act (PDSA). At its core PDSA provides a framework for development, testing, and implementation of changes within the health care industry that can lead to improvement (Kroning, Yezzo, Dimenico & Hesse, 2019). PDSA is based on a scientific method and moderates the rate at which immediate action is taken through the wisdom of carefully studying the problem. Usually, the results of a cycle inform the next step in the PDSA cycle.
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In the first step, a plan for what will change will be made. For this problem, the plan is to make plans within the hospital schedules to ensure that all health professionals are trained on the importance of teamwork and collaboration. Some of the steps to be taken include the decision on which patients will be involved. Our health center will use diabetic inpatients. In the second cycle, teamwork and collaboration between the patients and health professionals will be done for a short period. In the third step, a study will be conducted to see whether teamwork and collaboration have improved. The measure for improvement will be based on the number of readmissions of diabetic patients. If the readmissions of diabetic patients in the facility decrease, the PDSA model will have been successful at improving the quality of teamwork and collaboration within the organization. The final step, which is Act, depends on the results of the entire plan. If it did work for diabetic patients, the scope should be increased across all departments of the health care center.
For the implementation of the plan to be successful, particular persons have to be involved. These include nurses, pharmacists, diabetic physician specialties, doctors, and dieticians. This group has to illustrate teamwork and collaboration in the flow of information to ensure diabetic patients are accorded quality care at the organization.
Literature Review for Evidence-based Practice
Teamwork and collaboration offer the potential to achieve more than when working as a single person. Particularly, in health care that spans professional boundaries at times, it is important to capitalize on skills, knowledge, and abilities available. Mao & Woolley (2016) reveal that there is a reliance on teams in modern health care unlike the traditional health care industry where a health professional would deal with a patient single-handedly. Yet in the United States of America, medical errors account for a third of deaths. Problems in teamwork and collaboration, particularly in communication account for 70-80% of medical errors. Due to the high number of medical errors, there is a critical need for professionals in the health care industry, particularly those in leadership to consider improving teamwork and collaboration which will consequently improve the quality of care.
According to Mao & Woolley, research and practice indicate that teamwork is best when a team has the best and smartest members (2018). The study investigated the possibility of a collective intelligence factor, one that describes the general ability of a team to engage and complete various tasks. The results of the study indicated that a team’s performance on a single type of task is closely related to all other tasks they perform in the health facility. (Mao & Woolley, 2018) Besides collective intelligence, teams must also share relevant knowledge about the task at hand. One of the ways for expertize use is through speaking up. The challenge of efficient communication begins with the decision of who should be on the team. For teamwork to be effective, a team has to have members that are aware of boundaries and with whom they can share relevant information about patients. Besides knowing members, each team member should be aware that their information is worth sharing and necessary for patient care. The challenge is that many health professionals do not realize they have important information at their disposal. Capitalizing on expertise will be important to help avoid errors that arise from a lack of teamwork in health care.
In another study, Rosen et al, (2018) acknowledge that harms in hospitals such as hazard-acquired infections, patient falls, diagnostic errors, and surgical errors manifest through a lack of teamwork and collaboration among health professionals. According to the authors, the problem of teamwork and collaboration usually arises during transition care or shift changes for health care professionals. During this time, a communication breakdown occurs, exposing patients to potential harm. In the study, poor communication of the name of the medication, dosage, and means of delivery, and the timing of administration by either the nurse, physician, pharmacist, or patient has been the number one cause of medical errors. The teamwork and collaboration challenges manifest the problem of compromised delivery of quality care in health organizations.
Implementation of Plan and Measurement of Improvement
Both practical and well-evaluated plans for implementing teamwork are rare. In this case, however, individual and group training programs to enhance teamwork will be implemented. The plan will be carried out on a departmental basis. Besides training, other decision aids such as checklists and communication protocols will be used. Communication protocol, for instance, will involve making phone calls to ensure a patient has been attended to by the necessary team members. The plan to do it on a departmental basis is based on the fact that trained professionals can influence others on the importance of teamwork and collaboration for quality patient care. The measurement of improvement will be done through counterchecking of checklists to ensure that each team member deals with the patient in the process of receiving treatment. Additionally, a reduction in medical errors, readmissions, and mortality will be an indication of improved teamwork and collaboration.
In conclusion, the delivery of quality patient care is subject to focused and collaborative teams. Therefore, health care organizations should aim at providing quality care through teamwork across all professionals. This should be done through the adoption of team-based culture that has values and principles instilled through training and shared among team members including patients who should be at the heart of the care. An organization can use the PDSA model as described above to improve the quality of teamwork and measure improvement with tools such as checklists and reduced mortality rates and readmissions. Teamwork and collaboration reduce medical errors, communicates effectively and sequentially improves the quality of health care.
References
Kroning, M., Yezzo, P., Dimenico, L., & Hesse, H. (2019). Teamwork and rounding for improved infection rates. Nursing2019 , 49 (11), 60-63.
Mao, A. T., & Woolley, A. W. (2016). Teamwork in health care: maximizing collective intelligence via inclusive collaboration and open communication. AMA journal of ethics , 18 (9), 933-940.
Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of medical imaging and radiation sciences , 48 (2), 207-216.
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist , 73 (4), 433.
