Teamwork in Healthcare

Summary

This video explores the impact of teamwork in healthcare, particularly in stroke units across Canada. It features a dance class for stroke survivors and their carers, emphasizing the benefits of a collaborative approach among doctors, nurses, and other professionals. The video discusses the evidence for teamwork's positive effects on patient outcomes and safety, despite debates on the quality of such evidence. It also highlights the challenges of implementing teamwork, such as professional territoriality, and the need for rigorous evaluation to ensure effective and efficient healthcare delivery.

Takeaways

• 💃 Stroke survivors and their caregivers benefit from activities like dance classes, enhancing their quality of life.
• 🤔 The effectiveness of a teamwork approach in healthcare is being promoted in Canada, despite limited evidence of its impact on morbidity and mortality.
• 🏥 Canadian governments are investing heavily in promoting teamwork in healthcare, hoping it will benefit both patients and professionals.
• 🔄 The transformation from individual siloed professionals to integrated teams is seen as a positive change in healthcare delivery.
• 👥 Stroke care exemplifies the need for a multidisciplinary team approach, as no single professional can meet all patient needs alone.
• 🚸 Effective teams are characterized by clear purpose, good communication, conflict resolution mechanisms, and a patient-centered focus.
• 📈 A report suggests that coordinated and collaborative health professionals can improve patient care, safety, and reduce staff burnout.
• 👩‍⚕️ The interprofessional care model is being taught to students as a way to improve patient-centered care.
• 🗣️ There is a call for better communication and collaboration among different healthcare professionals to enhance patient recovery.
• 🧐 Critics argue that there is insufficient evidence to support the push for teamwork in healthcare and advocate for more rigorous evaluation.
• 🌟 Despite skepticism, there is optimism that teamwork can improve healthcare, and efforts are being made to integrate it into professional training.

Q & A

What is the primary benefit observed for stroke survivors and their carers from attending the Friday morning dance class?

The primary benefit is that it greatly enhances their quality of life and independence, as it helps them to dress and walk independently.

What is the debate surrounding the teamwork approach in stroke units across Canada?

The debate is whether the teamwork approach can improve patient outcomes in terms of morbidity and mortality, despite the lack of strong evidence supporting its effectiveness.

How does the Canadian government's investment in teamwork in healthcare align with the available evidence?

The Canadian government is investing tens of millions of dollars in promoting teamwork in healthcare with the hope of benefiting patients and professionals, despite the limited evidence of its effectiveness.

What is the significance of the Toronto Rehabilitation Institute's approach to stroke treatment?

The institute has developed a national reputation for working as an effective team, emphasizing that no single professional can meet the needs of a stroke patient alone.

What are the key characteristics of an effective team according to the Canadian Health Services Research Foundation's report?

An effective team has a clear purpose, good communication, mechanisms for conflict resolution, and places the patient at its central focus.

What is the role of interprofessional care in the context of the stroke team?

Interprofessional care, more formally known as teamwork, is a key approach being taught and modeled within the stroke team to improve patient-centered care.

What is the main challenge faced by Carol Lauren in her recovery from a stroke?

Carol faced a lack of teamwork and communication among different parts of the healthcare system, which she believes hindered her recovery.

What is the primary goal of the national push to bring teamwork into the healthcare system?

The primary goal is to improve patient care, enhance patient safety, and reduce staff burnout by promoting coordination and collaboration among health professionals.

What is the skepticism regarding the promotion of teamwork in healthcare based on?

The skepticism is based on the lack of research demonstrating improved outcomes for patients and staff as a result of improved teamwork.

What is the main argument of Dr. Merrick's team against the hasty implementation of teamwork in healthcare?

Dr. Merrick's team argues that there should be more evaluation and rigorous testing of different approaches to teamwork to ensure that investments are not wasted on ineffective methods.

What is the potential impact of teaching interprofessional teamwork to future healthcare practitioners?

Teaching interprofessional teamwork can prepare future healthcare practitioners to practice in a patient-centered manner, fostering better collaboration and potentially improving patient outcomes.

Outlines

00:00

💃 The Power of Teamwork in Stroke Recovery

This paragraph discusses the benefits of a Friday morning dance class for stroke survivors and their caregivers, emphasizing the positive impact of teamwork in a stroke unit across Canada. Despite the lack of strong evidence for teamwork's effectiveness, the Canadian government is investing in it with the hope of improving patient outcomes. The Toronto Rehabilitation Institute's team, comprising doctors, nurses, and physiotherapists, is highlighted as an example of effective teamwork in stroke care. The importance of a team having a clear purpose, good communication, and conflict resolution mechanisms is underscored. The patient-centered approach is also highlighted as crucial. The narrative includes a personal story of a stroke survivor, Helga Giannini, who has made a remarkable recovery. The report by Ivo Anderson suggests that coordinated health professionals can improve patient care, safety, and reduce staff burnout. The paragraph concludes with a special event where first-year health science students are encouraged to reflect on how teamwork can enhance patient care.

05:01

🤔 Skepticism and the Need for Evidence in Teamwork

The second paragraph presents a contrasting view from a patient, Carol, who feels that the lack of teamwork hindered her recovery from a stroke. She emphasizes the need for better communication among various health professionals across different sectors. The paragraph also discusses the push for teamwork in Canadian healthcare, driven by politicians and policymakers who see it as a way to increase patient safety and satisfaction. However, the evidence for teamwork's effectiveness is questioned, with critics arguing that there is no research showing improved outcomes for patients or staff as a result of teamwork interventions. A skeptic, Dr. Merrick, calls for more rigorous evaluation and is conducting a randomized controlled trial to test a new communication approach among hospital professionals. The paragraph highlights the complexity of teamwork and the difficulty in conducting simple randomized control trials due to the many factors involved.

10:01

👥 Overcoming Skepticism and Embracing Teamwork

The final paragraph focuses on the challenges of implementing the teamwork approach in healthcare, such as professional territoriality. However, it suggests that change may be on the horizon, as evidenced by the positive reaction of a group of students to a teamwork event. The paragraph describes how students from different health science disciplines are encouraged to interact and understand the larger healthcare context in which they will work. The importance of teaching interprofessional, patient-centered care to future healthcare practitioners is emphasized. The narrative returns to the stroke team's dance class, where even Carol, the skeptic patient from the previous paragraph, visits and expresses a desire to dance again, hinting at the potential for teamwork to positively influence patient recovery and satisfaction.

Keywords

💡Teamwork

Teamwork refers to the collaborative effort of a group to achieve a common goal or to complete a task in the most effective and efficient way. In the context of the video, it is highlighted as a crucial approach in healthcare, particularly in stroke units across Canada, to improve patient outcomes. The script mentions that while the benefits of teamwork are being explored, it is already seen as transformative in healthcare delivery, moving from isolated professionals to an integrated team focused on patient-centered care.

💡Stroke

A stroke is a medical condition in which the blood supply to a part of the brain is interrupted or reduced, leading to brain cell death. The video discusses how stroke survivors benefit from various therapies and how a multidisciplinary team approach is essential for their recovery. The script features a patient, Helga Giannini, who has made a remarkable recovery from a stroke, illustrating the importance of teamwork in stroke recovery.

💡Morbidity

Morbidity refers to the state of being diseased, the incidence of a particular disease, or the degree of deviation from a state of physiological or physical well-being. In the video, it is mentioned that there is evidence suggesting teamwork can improve patient outcomes in terms of morbidity, implying that better coordinated care can lead to less severe disease conditions or complications.

💡Mortality

Mortality is the state of being subject to death, especially as a result of disease or illness. The script suggests that teamwork in healthcare settings could lead to improved patient outcomes in terms of mortality, meaning that patients are more likely to survive their illnesses when care is provided by a well-coordinated team.

💡Healthcare Professionals

Healthcare professionals encompass doctors, nurses, physiotherapists, and other specialists involved in providing medical care. The video emphasizes the importance of these professionals working together as a team to meet the complex needs of patients, especially those recovering from a stroke. It highlights how no single professional can address all the patient's needs alone.

💡Patient-Centered Care

Patient-centered care is an approach to healthcare that prioritizes the patient's values, needs, and preferences in all clinical decisions. The video underscores that an effective team has the patient as its central focus, which is exemplified by the stroke team's efforts to engage patients in activities like dance classes to promote recovery.

💡Interprofessional Care

Interprofessional care is a model of healthcare where multiple professions work together to provide comprehensive care to patients. The video discusses a national push to implement interprofessional care in healthcare systems, with the stroke team serving as a role model for how teamwork can positively impact patient-centered care.

💡Evidence-Based Medicine

Evidence-based medicine is an approach to medical practice intended to optimize patient care by using the best research evidence available. The script mentions a debate about the quality of evidence supporting teamwork in healthcare. Some experts, like Merrick's, argue for more rigorous evaluation through randomized controlled trials to ensure that the push for teamwork is justified.

💡Burnout

Burnout refers to physical and emotional exhaustion caused by prolonged stress or frustration. The video suggests that improved teamwork can reduce staff burnout, which is crucial for maintaining a motivated and effective healthcare workforce. The idea is that when professionals collaborate, the workload and stress can be more evenly distributed.

💡Siloed Professionals

Siloed professionals are those who work independently and do not collaborate with others. The video contrasts this with the integrated team approach, suggesting that moving away from siloed work towards a team-based model can transform healthcare delivery by fostering better communication, shared goals, and a more comprehensive approach to patient care.

💡Randomized Controlled Trial

A randomized controlled trial is a type of scientific experiment that is often used to test the effectiveness of medical interventions. The video mentions that there is a lack of such trials to demonstrate the benefits of teamwork in healthcare. Merrick's and his colleagues are conducting one to test a new approach to communication among healthcare professionals, aiming to improve teamwork and patient outcomes.

Highlights

Stroke survivors and their carers benefit greatly from Friday morning dance classes.

Teamwork approach is being championed in stroke units across Canada.

Evidence suggests teamwork can improve patient outcomes in terms of morbidity and mortality.

Canadian governments are investing in teamwork in healthcare despite limited evidence.

Transformative potential of moving from siloed professionals to integrated teams in healthcare delivery.

Stroke requires the involvement of many different healthcare professionals.

Teamwork is essential for meeting the needs of stroke patients.

Patient-centered care is a key component of effective teams.

Teamwork can improve patient care, safety, and reduce staff burnout.

Interprofessional care is being promoted as a formal approach to healthcare.

Healthcare professionals need to communicate more effectively for better patient recovery.

The healthcare system does not sufficiently support communication among different health professionals.

Politicians are convinced of the benefits of teamwork in healthcare.

Teamwork is believed to increase patient safety and satisfaction.

There is a need for more rigorous evaluation of teamwork interventions.

The complexity of teamwork makes it difficult to conduct simple randomized control trials.

Critics argue that different sorts of teamwork must be tested to ensure effective use of resources.

Students are embracing the idea of interprofessional teamwork in healthcare.

Teaching interprofessional patient-centered care is essential for future healthcare practitioners.

The stroke team's dance class is an example of teamwork in action.

Transcripts

[Music]

it seems clear that these stroke

survivors and their carers benefit

greatly from their Friday morning dance

class what's less clear is whether the

teamwork approach being championed in

this stroke unit and now right across

Canada is also beneficial there is

mounting evidence that teamwork can

improve patient outcomes in terms of

morbidity and mortality at the moment

there's very little evidence for the

effects of teamwork if teamwork was a

drug that would not be licensed in any

country despite debate about the quality

of evidence Canadian governments are now

spending tens of millions of dollars

promoting teamwork in health care with

the hope that patients and professionals

will be the winners I think this is

fundamentally transformative I think

when you can truly move from a series of

siloed professionals working in parallel

towards a common or an uncommon goal to

an integrated functional team you will

change the nature of health care

delivery in a very positive way able to

dress ourselves independently these

doctors nurses physiotherapists and

others based out of the Toronto

Rehabilitation Institute have developed

a national reputation for working as an

effective team stroke is a condition

that really requires many different

people to be involved it's absolutely

clear to all of us that no one of us

could meet the needs of the patient

alone so it requires our engagement

together and otherwise she's back to

being independent walking outdoors and

indoors it's completely normalized

according to a recent report

commissioned by the Canadian Health

Services Research Foundation an

effective team has a clear purpose good

communication and mechanisms for

conflict resolution a good team also has

the patient as its central focus today

that's Helga Giannini who's made a

remarkable recovery from a stroke just a

few short weeks ago

I really like to walk because I always

walk I don't have a God for one thing

yes she will go within a few weeks to

her family dr. Cynthia Whitehead has

been part of this team for more than

seven years there is a sense of trust

that has really developed amongst people

and we just expected people that people

will be engaged will be involved will be

a part of of the group effort I think

there's a real dedication to the

patients as well you know and focusing

on the patient really helps helps people

realize our commonality and focus our

different perspectives summarizing the

relevant research the report suggests

that when health professionals

coordinate and collaborate they can

improve patient care enhance patient

safety and reduce staff burnout first

author of the report Ivo Anderson is

helping lead a national push to bring

teamwork into the health care system an

approach known more formally as

interprofessional care the stroke team

that you witnessed today is one of the

places where we actually send our

students to actually learn about

interprofessional care and it is a role

model from which we can we can actually

have our students understand and see how

teamwork can impact positively on

patient-centered care

we want to help you to reflect upon when

to collaborate more than a thousand

first-year students studying medicine

occupational therapy and other health

sciences have come to this special event

to learn how 10 work can improve patient

care we want you to reflect upon how to

collaborate one of the special guests

today is ivy sister-in-law Carol Lauren

two years ago Carol had a stroke and her

life changed so we'll help me welcome

Carol Lauren good afternoon it is a

privilege to be here today

while carol is grateful for much of the

good care she received in Winnipeg she

feels that a lack of teamwork did not

help her recovery from stroke different

parts of the system need to talk to one

another more the hospital system and the

primary care doctors the inpatient

programs and the outpatient programs the

physiotherapist and the occupational

therapists the doctors the chiropractors

acupuncturists and social workers if I

was a patient that had a chronic illness

that had a whole host of health

professionals from different contexts

some in the hospital some in the

community sector some in a rehab sector

I would expect that those health

professionals regardless of location

would actually be talking to each other

our system health care system does not

actually support that component of

communication amongst Health Professions

regardless of context

[Music]

the Porsche in Canada to get health

professionals playing as part of a team

has taken off here because politicians

have been convinced there's strong

evidence to support their use we know

that they increased patient safety

increases patient satisfaction and if

you do it right

it increases provider satisfaction which

leads to better recruitment and better

retention and all all parts of those are

critical for the health care system a

practicing physician and assistant

deputy minister Joshua tempeh is one of

a growing number of teamwork converts

more and more policymakers are trying to

turn them towards evidence for any

decision they make and as the evidence

became clear and not just anecdotal it

really provided a strong impetus for

policymakers to feel comfortable making

the investment putting the energy into

creating interprofessional or team-based

care models in the healthcare system and

a variety of settings but how strong is

the evidence the teamwork can make team

members happier and patients safer

there's enough mounting evidence that we

should be moving in this direction

cautiously rigorously evaluating every

intervention that we're doing while

upbeat about the benefits of teamwork

the report authors acknowledge

significant weaknesses in the literature

because there are so many different

theories and methods used to study

teamwork but for others those weaknesses

are even more significant

there is no research to date which

demonstrates that once you've done

something to improve the teamwork the

outcomes improve not for the patients

and not for the stuff there are no such

studies a skeptic steeped in the ways of

evidence-based medicine

Merrick's warrants team believes Canada

is being too hasty pushing teamwork and

he wants to see much more evaluation

with colleagues he's running a

randomized controlled trial of a new

approach to communication within

hospitals the plan is to get

professionals talking to each other in a

more thoughtful way when they meet

informally in hospital corridors and

nurses stations the aim ultimately is

better understanding of what others do

and what the patient needs we've done a

systematic review of this and the only

studies that we could find about

improving interprofessional

collaboration are not good randomised

trials and don't explicitly focus on

trying to improve teamwork they're in

the area of things like stroke care and

some other kinds of care organization

the complexity of teamwork is immense

therefore to do a simple randomized

control trial is almost impossible

because of all the many factors that

come into place related to teamwork

[Music]

the studio crew at CBC's national a-one

sort of team all based in the same room

but in health care often members may

never even meet for critics different

sorts of team work must be rigorously

tested in order to make sure money is

not being wasted on the wrong approach

I think we're naturally optimistic as a

species if we weren't we would have

given up long ago and in settings as

complex as health care I think the

people who work in them want to believe

that there are simple solutions there

are but many of the simple solutions are

going to be wrong and the trick is to

find the solutions that are correct I

don't believe we're being hasty in this

case I think the evidence is there and I

think there's a pressing need to move in

this direction

at the big teamwork event things are

moving towards a conclusion as you

embark on your training I hope you will

continually ask yourself what is right

for the patient thank you for the

opportunity to speak with you this

afternoon and to share my story

[Applause]

one of the biggest challenges to the

teamwork approach is the ongoing turf

war between professionals trying to

protect their patch but if the reaction

of this group of students is any guide

change may be on the way social work in

the pharmacy all have to do in the

health care at first when we came here

like we can't sit with our friends but

then that wouldn't have served the

purpose I'm trying to get to know others

so I thought that that was a good

opportunity to meet people that you

wouldn't meet in class because we are

segregated so you know I see the same

people every day every class and so you

get so you know ingrained in your own

feel that you don't really understand

that you're working at a larger context

you are working in a larger healthcare

setting so I think for me really helped

break that isolation and allowed this

sort of icebreaker as to when you go out

into the actual profession and you are

gonna be working at you you know you can

interact with the other healthcare

professionals and it's not I can talk to

other people that aren't nurses like the

first year students at the University of

Toronto are across the health science

and Social Work faculties are the future

they're the future healthcare

practitioners for us here in Canada if

we expect them to practice in a

different way if we expect them to

practice in a interprofessional

patient-centered manner we actually have

to teach this

[Music]

back at the stroke teams dance class

everyone's moving now

and even carol has dropped in on her way

to the airport and home to Winnipeg I

try to dance and I'm very uncomfortable

and awkward and I don't want to do it

but I would love to get out there and

dance again in fact I'm thinking of

going back to Winnipeg and requesting

that someone somewhere out there provide

that kind of service

[Music]

[Music]

you