CHSRF Knowledge Transfer: Teamwork in Healthcare: Pulling It All Together
In Canada, the Health Council of Canada has identified improving teamwork as a critical component to both accelerating system change, as well as improving human resource management (Health Council of Canada 2005). There have been a number of research grants to study the problem, as well as federal and provincial efforts to enhance teamwork, such as the 2004 Health Canada Initiative on Interprofessional Education for Collaborative Patient-Centred Practice, which developed an evolving framework to help accomplish the task.
For its part, the Canadian Health Services Research Foundation (CHSRF) commissioned a team of researchers to pull together the growing knowledge about the characteristics of effective teams, the degree to which teamwork has already been enhanced in Canadian healthcare settings and what can be learned from successful interventions both in Canada and abroad.
Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada (Oandassan et al. 2006) outlines the need for changes to support effective teamwork at not only the practice level, but also the management and policy levels. CHSRF is hopeful that this policy synthesis and recommendations will contribute to the formal process of establishing effective teamwork in Canada.
Key messages from the policy synthesis include the following points:
- A healthcare system that supports effective teamwork can improve the quality of patient care, enhance patient safety and reduce workload issues that cause burnout among healthcare professionals.
- Teams work most effectively when they have a clear purpose; good communication; coordination; protocols and procedures; and effective mechanisms to resolve conflict when it arises. The active participation of all members is another key feature.
- Successful teams recognize the professional and personal contributions of all members; promote individual development and team interdependence; recognize the benefits of working together; and see accountability as a collective responsibility.
- The make-up and functioning of teams varies depending on the needs of the patient. The complexity of the health issue defines the task. The more interdependency needed to serve the patient, the greater the need for collaboration among team members.
- Patients and their families are important team members with an important role in decision-making. To enable patients to participate effectively, they need to learn about how to participate in the team; how to obtain information about their condition; and how each healthcare professional will contribute to their care.
- Teams function differently depending on where they operate. Teams in hospitals have clearly defined protocols and procedures, professional hierarchies and shared institutional goals, while teams in community-based primary care practices face challenges related to the role-blurring in community settings. This wide variety of settings and tasks means that transferability of processes is not always straightforward. It also highlights the need for a common definition of "team."
- Teamwork is influenced by organizational culture. A clear organizational philosophy on the importance of teamwork can promote collaboration by encouraging new ways of working together; the development of common goals; and mechanisms to overcome resistance to change and turf wars about scopes of practice. Teams need training to learn how to work together and understand the professional role/responsibility of each member. They also require an effective administrative structure and leadership.
- The larger policy context can promote teamwork by providing consistent government policies and approaches; health human resource planning; legislative frameworks to break down silos; and models of funding/remuneration that encourage collaboration. Successful team interventions are often embedded in initiatives working to improve quality of care through better coordination of healthcare services and the effective utilization of health resources with a focus on the determinants of health.
Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada can be found on CHSRF's website: https://www.chsrf.ca/research_themes/workplace_e.php.
About the Author(s)
Dave Clements is a senior program officer in CHSRF's Knowledge Transfer and Exchange branch.
Janet Helmer is currently acting as CHSRF's senior program officer for the management of the healthcare workplace research theme.
Health Council of Canada. 2005. Health Care Renewal in Canada: Accelerating Change.
Health Council of Canada. 2005. Modernizing the Management of Health Human Resources in Canada: Identifying Areas for Accelerated Change. Report from a National Summit.
Oandasan, I., G.R. Baker, K. Barker, C. Bosco, D. D'Amour, L. Jones, S. Kimpton, L. Lemieux-Charles, L. Nasmith, L. San Martin Rodriguez, J. Tepper and D. Way. 2006. Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada. Canadian Health Services Research Foundation.
Ovretweit, J., P. Bate, P. Cleary, S. Cretin, D. Gustafon, K. McInnes, McLeod, T. Molfenter, P. Plsek, G. Robert, S. Shortell and T. Wilson. 2002. "Quality Collaboratives: Lessons from Research (Organizational Matters)." Quality and Safety in Health Care 11(4): 345-51.
Plsek, P. and T. Wilson. 2001 (September 29). "Complexity, Leadership, and Management in Healthcare Organizations." British Medical Journal 323: 746-49.
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