Patient Safety: A Case Study in Team Building and Interdisciplinary Collaboration

Abstract

This case report presents specific steps taken to address potential patient safety problems, particularly those regarding collaboration between nurses and house staff at The George Washington University Hospital. Issues affecting patient care (e.g., lack of communication and teamwork) were identified through interviews, focus groups, and observations. The actions taken were team-building meetings that included a sensitivity session; coaching with nursing managers; and ground rules for nurse and physician collaboration. This report also describes the agenda for the team-building meetings, results, and lessons learned for implementation at other sites.

“What is Found There”1: Qualitative Analysis of Physician–Nurse Collaboration Stories

“…5,8,9 Patient safety experts also advocate optimizing the function of the nurse-physician unit to reduce error and harm. [10][11][12] Recognizing the centrality of effective physician-nurse relationships, the Accreditation Council for Graduate Medical Education designated team functioning as a competency area to be addressed by residency programs. 13 However, research addressing this relationship has appeared primarily in nursing journals, with occasional physician co-authors.…”

Examining communication and team performance during clinical handover in a complex environment: the private sector post‐anaesthetic care unit

“…Improvement strategies or tools developed in response to local issues are more likely to be accepted and used by clinicians. 32,33 • Familiarity of clinical staff with the local environment and their intimate understanding of common tasks, language and processes helps in interpretation of data and complements the perspectives of external project staff.…”

“…The engagement strategy proposed here was based on models of change management 31 . ‐ 33 Key elements of the strategy included promotion by influential role models, building capability of local staff through participation, promoting local ownership through ongoing involvement in data collection and solution development, and ensuring compatibility with local values and needs. The complexity of change can be minimised by identifying effective practices and involving clinicians in testing and modifying solutions.…”

“… It promotes local ownership of both the data and potential solutions. Improvement strategies or tools developed in response to local issues are more likely to be accepted and used by clinicians 32 , 33 Familiarity of clinical staff with the local environment and their intimate understanding of common tasks, language and processes helps in interpretation of data and complements the perspectives of external project staff. Engaging clinical staff to collect data through observation of interactions gives them a unique opportunity to gain new insights.…”

“…31 Promoting local ownership by those working in the clinical area and ensuring that tools and strategies are context-specific and endorsed by clinical leaders improves the uptake and sustainability of innovations. [32][33][34] The engagement strategy proposed here was based on models of change management. [31][32][33] Key elements of the strategy included promotion by influential role models, building capability of local…”