Teamwork is an important factor in patient safety and healthcare management. Researchers have observed that healthcare workers such as doctors, nurses, and pharmacists tend to work in groups rather than as effective teams due to hierarchical structures. True teamwork is needed in healthcare as it involves multiple professionals like physicians, nurses, and pharmacists working interdependently to heal patients. Effective teamwork is fostered when there are clear goals, stable core teams, adequate resources and administrative support, and feedback and evaluation of performance.

1. Teamwork
An important factor in Patient
Safety and Healthcare Management
Dr. Taher Y. Kagalwala. M. D. (Paediatrics)
Specialist Paediatrician and Director, Patient Safety,
Al Muwayh General Hospital, Al Muwayh, Ta’if, K. S. A.

2. What have researchers observed in the
past?
 Researchers have observed that healthcare workers, viz. doctors, nurses,
pharmacists, case managers and residents tend to work as GROUPS and not as
TEAMS.
 One of the main reasons for this is the hierarchical structure of health
workers. A consultant is above the specialist, who is above the senior
registrar, and so on. This prevents a team from forming and working together
as equals.
 One on one conversations are more common and not discussions
 Nurses rarely speak as advocates for the patient or to push correct procedure.
 Pharmacists, even when present, never speak unless specifically spoken to.
 The patient is never involved in his/her own care.
drtyk/ps/teamwork 15-10-2014 2

3. NONE OF US IS AS
SMART AS ALL OF US
drtyk/ps/teamwork 15-10-2014 3

4. What is a Team? What are its chief
characteristics
 A team is a group of people coming together for a specific purpose.
They usually share the following characteristics:
 SOCIAL INTERACTION
 STABILITY
 COMMON GOALS AND INTERESTS
 RECOGNITION WITHIN THE ORGANISATION AS BEING A PURPOSEFUL
GROUP
In healthcare settings, we can have a CLINICAL TEAM, a CODE BLUE
TEAM, a DISASTER MANAGEMENT TEAM, a QUALITY CONTROL TEAM, an
INFECTION CONTROL TEAM, etc.
drtyk/ps/teamwork 15-10-2014 4

5. Why is Teamwork poor?
 Firstly, Physicians are never taught the value of team work
in medical college. The emphasis is always on individual
excellence, individual effort and individual advancement
in a competitive format.
 Often, in a multi-disciplinary discussion, experts come
from different services, rarely if ever meet the general
physician, often visit the patient at different times, and
forget that their common goal is to heal THIS patient.
 Distrust and
 Disrespectful communication is often also involved.
drtyk/ps/teamwork 15-10-2014 5

6. What are the features of a successful
team?
• Team members speak freely
• Support each other
• Effectively solve problems collaboratively
• Have a clear sense of direction
• Have adequate information
• Have adequate resources
• Trust each other
• Accomplish their goals
drtyk/ps/teamwork 15-10-2014 6

7. Hierarchical set-up of Healthcare workers
Sr.
Physician
Jr.
Physician
Resident
Dr.
Case
Manager
Jr.
Physician
asst.
Pharmacist
Nurses Nursing
Assistant
Medical
drtyk/ps/teamwork Student 15-10-2014 7

8. Is Teamwork needed in healthcare?
 Teamwork is needed wherever multiple individuals with multiple skills
are required to work INTERDEPENDENTLY to achieve a favourable
outcome.
 This means that teamwork is absolutely critical in the management of
sick patients.
 Healthcare is a complex activity which needs many different kinds of
professionals such as physicians, nurses, case managers, pharmacists,
surgeons, physiotherapists, nutritionists, etc.
 One individual working ALONE cannot achieve the target of healing a
patient.
 A team is therefore absolutely necessary.
drtyk/ps/teamwork 15-10-2014 8

9. What conditions foster effective
teamwork?
drtyk/ps/teamwork 15-10-2014 9

10. 1. Goals
 The basic goal is to improve the health and
well-being of every patient
 Problems and distractions occur due to:
- Increase in billing (costs)
- Increased patient volumes and overload
- Burnout
drtyk/ps/teamwork 15-10-2014 10

11. 2. Real Team
 Ideally teams should be bounded
 The core team is usually fixed – e.g. in code blue situations.
 The team members need to stay together for a longer time so
that they understand each others’ strengths and weaknesses,
understand each others’ body language, understand non-verbal
signals, gel with each other and work better together.
 The teamwork then tends to continually improve over time.
 Team workers need to be active, enthusiastic, industrious, and
open-minded to be effective. Also, they need to be lateral
thinkers, innovative and ADAPTIVE.
drtyk/ps/teamwork 15-10-2014 11

12. How many members in a team?
Ideally 5 – 7 members should be part of the
core-team.
drtyk/ps/teamwork 15-10-2014 12

13. 3. Resources: What will encourage the
team to perform better and better
 REWARDS – MAY BE IN THE FORM OF PROMOTION, CASH, ETC.
 ADMINISTRATIVE SUPPORT – THEY SHOULD LISTEN TO THE TEAM AND
PROVIDE WHAT THEY NEED
 COACHING AND TRAINING – SHOULD BE SPONSORED BY ADMINISTRATION
 FEEDBACK AND AUDIT OF PERFORMANCE – VERY CRITICAL FOR THE CORE
MEMBERS.
 To which I may add: LEAVE, DAYS OFF, OTHER SIMILAR INCENTIVES
drtyk/ps/teamwork 15-10-2014 13

14. Summary
 The secret of the care of a patient is caring for
the patient
- Dr. Francis Peabody,
Boston City Hospital, 1925
 In today’s time:
The real secret of the care of a patient is TEAMWORK.
drtyk/ps/teamwork 15-10-2014 14

15. Electric Blue lion fish
drtyk/ps/teamwork 15-10-2014 15