Essays

Essays July 2015

What can healthcare providers learn from Pan Am Athletes? Team work!

Hsien Seow and Mila Ray-Daniels

The 2015 Pan American games have just ended representing the largest multi-sport event ever held in Canada. The 6,000 athletes from 41 nations (twice as many as the 2010 Vancouver Winter Olympics) competed intensely across 36 sports, such as basketball and soccer. Canada proudly finished second in the medal count, 217 medals in total, 78 of them gold. While the sports were exciting to watch, they can also teach healthcare providers about how to work effectively as a team.

Providers working in various organizations in the healthcare system can be as different from one another as the team sport of field hockey is to rowing. As in team sport, the individual “players” involved in providing patient care are each very dedicated, have their own speciality area and expertise, and need to play their position when delivering care; however, unlike in sports, the players in different healthcare organizations often have never met each other, let alone developed rapport or played as a team, and yet are working towards the same goal: high quality outcomes for patients. As healthcare providers enjoyed the thrill of the sports during the Pan Am Games, they could also make a study of teamwork to improve the performance of our healthcare system.

The care of patients with life-limiting illnesses is a good example. The healthcare providers are, without a doubt, very dedicated to their patients, families and their practice. Each player, be they a physician, nurse, personal support worker or others, is accomplished and practiced in their respective fields. They each tend to know how to play their position very well. In spite of this, the patient and family experience can be less than exemplary. If we look at key elements of the successful teams we’ll see at the Pan Am games, we may be able play better as a “healthcare team”, for example:

The Play Book.

Teams practice plays to succeed in situations they will encounter often. Soccer teams practice their formations during a corner kick and basketball teams practice set plays to score a buzzer-beating basket. The objective is that each player has to do their best as an individual and as part of a team, to ensure optimal performance in a complex play. In healthcare, while providers spend years honing their own clinical skills, we do not often practice “set plays” that recur often and involve multiple providers. For instance, even though a patient with end stage heart failure will most certainly require a family physician, cardiologist, and pharmacist, these three providers will likely never see each other face-to-face to discuss, let alone practice how to ensure there is continuity of information, care management and clear communication when a patient is transferred between providers.  Healthcare providers could benefit from practicing together (e.g. repeated mock drills of patient hand-offs until all players know their roles and the transition is smooth) and seeing their roles as part of an overarching “play book” that keeps patients and families at the fore.

Role clarity.

In team sports, players have particular roles to play on the team. One player may specialize in defence, while another plays offence. Even though one player may be capable of playing a different position, they build their own skills to play their position well and learn when to hand-off certain plays to teammates. They trust the teammates to play their position, knowing that one person cannot do everything – and it takes a team to win. In healthcare, there can be overlap and even duplication between individual players and between organizations. For instance, a patient receiving palliative and end-of-life care might have hospital discharge coordinator, a homecare care coordinator, a hospice coordinator, and a palliative care nurse, among others all of whom are coordinating care and providing services through their own perspective, rather than as a team. When individuals from different organizations with diverse skills work together, they should begin with agreeing to who will do what and support each other to play their respective position in order to provide optimal care to the patients they share.

Coaching.

Not only do team sports have a head coach, they often have additional coaches that specialize on specific areas such as offence and defense separately. The coaches work specifically with particular players training them to perform better and work on skills that need improving. Healthcare could adopt the concept of having coaches more pervasively. For instance, a coach can help a cardiologist use the best prognostication tools to identify patients earlier into palliative care, but also support the entire hospital team’s ability to have advanced care planning discussions that support patients and their families to make informed choices. Healthcare providers could benefit from coaching to support team performance as well as enhancing individual ability to strive for excellence.

Team mentality. Athletes’ have the mentality that “they win and lose as a team.” They are clear that their success is integrally related to their ability to play to each other’s strengths, they mitigate the other’s weakness and advance the winning spirit together. In after-game interviews, players rarely “throw their teammates under the bus” or single out a weak performer. Yet in healthcare, providers often operate in silos. When one provider lacks transparency, overpromises or fails to communicate effectively, it sets up the entire team for failure. When providers adopt a team mentality, they are much more likely to meet or even exceed the patient and family’s expectations by providing the kind of coordinated care patients deserve. This means that players adopt the attitude that everyone is responsible for good outcomes for the patient and family, not just when they are in your own setting, especially since patients and families often expect all healthcare players to work as one team anyway.

Interdisciplinary community-based palliative care teams are pioneering a different type of care delivery, by enabling healthcare providers from different organizations with different areas of expertise to work together to support patients and their families. By adopting practices from high-performing teams such as the Pan Am athletes, they may perfect teaming in healthcare and become role models for other health sector providers. By being deliberate about teaming, healthcare providers can achieve the ultimate goal of great patient care - which is the way that patients and families wish our healthcare system would be. 

About the Author

Dr. Hsien Seow (Associate Professor, Department of Oncology, McMaster University) and Mila Ray-Daniels (Director, Patient Experience & Collaborative Practice, Hamilton Niagara Haldimand Brant Community Care Access Centre)

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