Dr. Lorelei Lingard - Collective Competence, TEDxBayfield

Summary

In this talk, a communications researcher explores the complexities of healthcare team dynamics, focusing on how competent individuals sometimes fail to deliver competent team care. Using a case study of a patient, Joe, the speaker illustrates how fragmented communication across healthcare providers leads to errors despite individual expertise. The presentation argues for the need to adapt healthcare systems to foster collective competence, rather than just individual competence. This includes technological advancements, structural changes like family health teams, and initiatives to improve team communication, especially in high-stakes environments like operating rooms. The call to action is for a shift in both healthcare education and practice to achieve more effective, collaborative care.

Takeaways

• 😀 Individual competence is essential in healthcare, but it is not enough on its own to ensure effective patient care.
• 😀 Healthcare professionals, despite their individual expertise, can form incompetent teams due to poor communication and coordination.
• 😀 The story of Joe, a 75-year-old patient, highlights the consequences of fragmented care and lack of communication across healthcare providers.
• 😀 Scientific reductionism, specialization, and the focus on individual competence create barriers to achieving collective competence in healthcare teams.
• 😀 Scientific reductionism treats patient conditions in isolation, failing to address the interconnected nature of healthcare problems.
• 😀 Specialization divides healthcare into distinct areas, which can lead to fragmented care if professionals don’t communicate across fields.
• 😀 The traditional focus on individual competence in medical education overlooks the importance of teamwork and collaboration in healthcare settings.
• 😀 Collective competence is the ability of a healthcare team to communicate effectively and coordinate care, improving patient outcomes.
• 😀 Technological advancements like electronic health records are crucial for improving communication and preventing fragmented care in healthcare teams.
• 😀 Family health teams, which bring together multiple healthcare professionals under one roof, are a promising model for improving collective competence and care coordination.
• 😀 Initiatives like the WHO’s Safe Surgery Saves Lives checklist show the value of structured communication in improving team performance in high-risk situations like surgeries.

Q & A

What is the main focus of the speaker's research?

The speaker focuses on studying healthcare teams, examining how they communicate, how their communication impacts patient care, and how medical education can improve communication for better team functioning.

What is the primary issue with healthcare teams, according to the speaker?

The primary issue is that healthcare professionals, despite being individually competent, often fail to work cohesively as a team, leading to fragmented and sometimes incompetent care for patients.

Can you explain the story of Joe and how it highlights the issue of fragmented care?

Joe's story illustrates how competent individual care from doctors, specialists, and pharmacists can still lead to poor outcomes due to lack of communication. For instance, Joe restarts a medication that was stopped in the hospital, and his kidney issues weren't communicated, leading to a dangerous prescription from a specialist.

What are the three barriers to collective competence in healthcare teams?

The three barriers are scientific reductionism, specialization, and the concept of individual competence. These barriers cause healthcare providers to work in isolation, focusing on separate issues without coordinating as a team.

How does scientific reductionism affect healthcare communication?

Scientific reductionism leads to healthcare issues being tackled in isolation (e.g., treating heart disease, diabetes, and kidney issues separately), which results in fragmented communication and care, rather than considering the patient as a whole.

Why is specialization in medicine both necessary and problematic?

Specialization allows deep expertise in specific areas of medicine, but it creates fragmentation. For patients with multiple conditions, specialists often work in isolation, leading to a lack of communication and integrated care.

What is the traditional approach to medical education and why is it problematic in modern healthcare?

Traditional medical education focuses on individual competence, teaching students to excel in their specialized fields. However, this approach does not prepare healthcare professionals to work together as cohesive teams, which is essential in modern, complex healthcare settings.

What is meant by collective competence in healthcare?

Collective competence refers to the capacity of a healthcare team to function effectively as a whole, where each member’s expertise is leveraged for the benefit of the patient, and the team works in concert to deliver the best care.

How can healthcare systems adapt to improve collective competence?

Healthcare systems can adapt by shifting focus from individual competence to collective competence, fostering better team communication, and implementing technologies like electronic health records to improve information sharing.

What role do Family Health Teams play in improving collective competence?

Family Health Teams bring together primary care physicians, nurses, and other healthcare professionals under one roof, facilitating better coordination and communication among the team. This model helps address the problem of fragmented care and promotes collective competence.

What is the 'Safe Surgery Saves Lives' initiative, and how does it relate to collective competence?

The 'Safe Surgery Saves Lives' initiative is a protocol introduced by the World Health Organization to improve communication in surgical teams. It requires team members to share critical information before and during surgery, which has been shown to improve safety and teamwork, demonstrating the importance of collective competence in high-stakes environments.