Interprofessional collaboration can have a direct influence on the improvement of patient care because teamwork facilitates the sharing of experiences and perspectives on the most appropriate treatment. Each healthcare provider involved in a collaborative relationship has unique skills, knowledge, and professional identity for enhancing care, yet there are still limitations that prevent team-based systems from being successful. Such limitations include the lack of collaborative competence, differences in perceived power, and profession-oriented care models. In the case of conducting surgeries, collaboration is especially needed because it guarantees the immaculate implementation of procedures at all levels – interventional radiology, scheduling appointments, managing wards and ICUs, and coordinating surgeries.
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Need for Enhancing Collaboration
The need for enhancing collaboration within an interprofessional team is associated with the occurrence of medical errors that take place due to the lack of communication. As mentioned by O’Daniel and Rosenstein (2008), medical errors can lead to serious injuries and even unexpected patient deaths, as mentioned by O’Daniel and Rosenstein. The failure to communicate effectively is a pervasive issue that any healthcare organization can encounter. It is the leading cause not only for medication errors but also delays in patients’ treatment, surgeries done at wrong sites. Also, it can be the second leading reason for high rates of both operative and postoperative complications as well as falls resulting in fatal injuries (O’Daniel & Rosenstein, 2008). The problem’s impact is so wide that if errors linked to the poor management of medical procedures were in the list of top ten causes of death in the United States, “they could rank number five, higher than car accidents, diabetes, AIDS, breast cancer, and gunshot wounds” (O’Daniel & Rosenstein, 2008, p. 271). Given the high financial cost of increased mortality due to medical errors, the inability of interprofessional teams to collaborate can be classified as an urgent and widespread problem of public health (Kohn, Corrigan, & Donaldson, 2000). Therefore, the main objective in the case of interprofessional collaboration is improving the existing patterns of communication and identifying steps that should be taken for overcoming the issue of medical errors and even mortality.
The Three-Tier Program
The implementation of the STEPPS initiative will fit the project of improving collaboration within an interprofessional team that deals with surgeries. This is so because it implied the shift toward the safety culture by using strategies and tools that help teams go through a three-tier program and achieve actual results (“TeamSTEPPS instructor manual,” 2014). The first tier should deal with the assessment of the situation in an organization for determining whether the responsible team members are ready to undertake a change in their collaborative patterns and enhance communication. During this stage, a team of interprofessional leaders should be formed to conduct a climate evaluation and assessment and determine how well team members communicate. The climate that should be considered conducive to change implies both leaders and team members are committed to change their processes and avoid errors.
The second tier is concerned with planning, training, and the implementation of the plan for collaboration improvement. The leading team will develop a plan and implement it with regards to such issues as poor communication between interventional radiology doctors, inefficient appointment scheduling and ICU/ward management, and the inadequate coordination of patients’ surgeries. Recommendations to improve collaboration include:
- Integrating simulations whenever possible to train professionals and enhance problem-solving and crisis management;
- Encouraging the team-wide reporting of errors and dangerous conditions to facilitate situations of shared authority and collaborative problem-solving.
The third tier supported by the TeamSTEPPS program is linked to sustainment – monitoring, coaching and integrating new solutions for improving collaboration. The main goal of the last tier is making sure that the interprofessional team maintains the new procedures on a long-term basis and makes “health care a team sport,” as mentioned by Eric Dishman in his TED-Intel talk (TED, 2013). Normal daily routines should be supported by team training and the newly-developed processes that open new opportunities for improvement and spread positive changes. For instance, interventional radiology doctors can negotiate a common schedule that considers both planned and emergency procedures. Being on the same page in terms of workload planning will allow interventional radiologists to be more prepared for unexpected procedures and avoid medical errors while also serving patients whose appointments were pre-planned.
Overall, improving collaboration within an interprofessional team that deals with patient surgeries can be done by following a cohesive three-tier plan that takes into account assessment, implementation, and sustainment. The participation of as many team members as possible is the key to success because the sharing of knowledge, expertise, and unique professional perspectives will allow the plan to consider all problems that the practice setting has encountered previously. The successful implementation of the plan will rely on team members integrating such procedures as simulations and error reporting to learn from their mistakes and facilitate the environment in which relying on each other will be welcomed and celebrated. Overcoming medical errors is a complex task, but improving collaboration and communicative patterns between professionals that have a mutual goal can be instrumental in helping to reach that objective.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.
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O’Daniel, M., & Rosenstein, A. H. (2008). Professional communication and team collaboration. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (pp. 271-284). Rockville, MD: Agency for Healthcare Research and Quality.
TeamSTEPPS instructor manual. (2014). Web.
TED. (2013). Eric Dishman: Health care should be a team sport [Video file]. Web.