Is Your Team Helping or Hurting Your Patients? 3 Keys to Effective Teamwork
I used to work at a small community hospital and spent a lot of time in the radiology department, conducting modified barium swallow studies. I had a great team, except for one person who was arrogant, impatient, and rude. He never listened to anyone, which inevitably caused issues for me, him, and the entire team. For example, once, we had a very ill patient come down for a swallow study, but there was an issue with the machine recording. Several of us tried to tell this team member about the problem, but he ignored us and insisted we continue the study despite the issues. It turned out that nothing was recorded, and we lost the entire study. As a result, the patient had to be rescheduled later in the day, causing a delay in care and disrupting the schedule for the entire day.
How Group Decisions Can Hurt
The truth is that working in groups does not automatically guarantee success. Numerous examples of group decisions ending up in terrible outcomes exist, such as the escalation of the Vietnam War, the US military defeat at the Bay of Pigs, and NASA's Challenger explosion.
So when do group errors occur? Oftentimes individuals may defer to others with power, whether from their position (like a medical director or an executive) or their personality (such as someone who speaks loudly or assertively). It's important to consider racial and gender issues in these dynamics as well. But it’s clear that this person with power may not be the one who is always capable of making the best decision.
This is an example of a phenomenon known as groupthink. Bringing all team members into a room to discuss care plans might seem like a good idea, but the person with the most power or status (or even just the one with the loudest voice) often ends up with the final say. We don't even realize we are doing this most of the time. Imagine having six highly skilled and experienced individuals in a room, all with valuable contributions to make. However, all that value is disregarded when a dominant director takes over. It's like trying to whisper a secret at a rock concert – the message from those great minds is completely lost and all we ended up hearing is the noise.
It's crucial to remember that, as social beings, we tend to avoid disagreement. The well-known Asch Conformity Experiment demonstrated this phenomenon. Participants were asked to identify which two out of the four lines presented were the same size. Sounds like a pretty simple task right? Hard to get wrong even? And yes, in the control group, most participants correctly answered this simple question. However, when an actor was hired to choose an incorrect answer first, the participants were three times as likely to select the SAME wrong answer. If this can happen with something as straightforward as matching lines, consider the potential impact on the complex array of information involved in medical care.
How Group Decisions Can Help
We need each other. We are not sole survivors. Throughout history, humans have collaborated in hunting, gathering, and socializing. The notion of the solitary hero is a fictional concept popularized by Hollywood and has very few examples of actually working in reality.
Working in groups is like having a superpower. It gives us different perspectives to fully understand the problem. Groups provide access to a wider range of information, improve communication by allowing us to make multiple connections, and can help moderate extreme views.
Oliver Sibony, in his excellent book on decision-making, shared research findings that team discussions provide SIX TIMES the value of gathering and analyzing information. This suggests that conducting testing, assessment, and chart reviews is like driving on the highway at 10 MPH, but bringing this information to the team for discussion rockets you up to speed at 60 MPH. Gathering and analyzing information, such as through an instrumental swallowing evaluation, is important. However, it's crucial to remember that this information only becomes useful and meaningful when discussed with the team and, most importantly, with the patient. We must understand what this information means for the patient and why it is important for their care.
A strong team is like a jigsaw puzzle where each member fills in the missing pieces to fit into a cohesive whole. Similar to a smartphone, car, or airplane, the team becomes much more valuable than the sum of its parts. Dr. Patrick Laughlin and his colleagues at the University of Illinois studied the impact of groups on complex problem-solving. They found that groups of at least three people outperform the highest-performing individuals. In other words, if you compare a group of 3 average individuals to a single genius, the group of 3 will outperform the genius no matter how smart they are. Let’s talk about three simple ways we can improve our own team, capitalize on their benefits, and minimize their potential shortfalls.
How YOU Can Improve Your Team's Effectiveness
The Three Cs of Teamwork:
Connect
Connect before your redirect
Communicate
Make sure your message resonates
Collaborate
Work together seamlessly
Connection
The key to connecting with your colleagues is to establish trust, and the best way to achieve this is by increasing opportunities for interaction. It's a cycle where spending more time together leads to more chances to connect and build trust. Consequently, the more time we invest in these relationships, the more we desire to spend time together and strengthen our connections.
This extends beyond the workplace. Instead of watching YouTube videos alone, join your colleagues for lunch. Attend company-sponsored events, participate in continuing education programs, and socialize with your colleagues after work. This is how trust is fostered. It's as easy and as hard as that, but regardless it’s an essential step in creating a cohesive and a successful team.
Trust is not just some woo woo quality. It has a real impact on various aspects of work life. According to research from the Harvard Business Review, higher levels of trust in the workplace lead to significant improvements in stress, burnout, energy levels, productivity, engagement, job satisfaction, and even ends up in reduced sick days. The study found that energy levels improved by over 100%. This means that a person without trust might feel exhausted by noon, while someone in a trusting work environment could breeze through their entire shift and still have energy to spare for their family at night.
Communicate:
Our next "C" is communication, which is the foundation. First, be concise. Use terminology that the person is familiar with. Not everyone knows the jargon you're used to. For example, talking about oropharyngoesophageal dysphagia with globus sensation below the cricopharyngeal segment and above the lower esophageal sphincter might be interesting for a speech-language pathologist, but if you bring this up to someone from a different field, they might look at you like you have a butterflies flying out of your mouth. In short, break it down and speak on their level.
Next, be concise. Don't launch into an endless pros and cons list with the doctor who has 27 seconds in between patients. Give the most essential information and then deliver the message or question you are trying to communicate.
Lastly, keep things safe. We want to create an environment where others feel safe and secure speaking up to raise issues that must be corrected. It's never worth thoughtlessly criticizing, dismissing, or berating to make your point. Knocking down others for disagreeing with you is like rubbing your hands with Vaseline before a basketball game; nobody is going to want to throw you the ball.
Collaboration
And finally, collaboration. Collaboration brings everything together. It means approaching the table with an open, curious mind. It involves shifting our mindset from fear-based practices to one that examines our decision-making, learns from our mistakes, and embraces change. Once we adopt this mindset, we can welcome disagreement as an opportunity to learn, grow, and provide the best possible care for our patients. Instead of asking if your care plan is right or acceptable, ask how it might be improved and what changes can be made to enhance it. Invite others to poke holes in your plan so you can fill them up with cement and make your plan that much stronger.
I recently heard someone say that we should think about life like a game of Mario. When I was a kid, the original Nintendo was all the rage (I know, I’m aging myself with that one!). In the original Mario, you had a certain number of lives; when you lost, you had a chance to start over and try again. You didn't get upset when you died in Mario. Instead, you saw it as an opportunity to start from the beginning, learn from your mistakes, re-conquer your castle, and rescue the princess. Real life can be like this, too, and thinking this way makes us much more open to constructive criticism. Make a mistake, learn from it, and grow.
We want to create a culture that facilitates experimentation, trial, and error to help each other recognize those errors so we can engage in constant improvement. Because often there are no right or wrong answers, there are only unbeaten paths that need to be explored to determine which is the best for each specific patient. Remember, your intuition is inherently flawed. You are biased. You are the hammer, and, to you, this problem is just another nail. You need your teammates to help you see through multiple frames to view the whole picture. Without proper collaboration, this is simply impossible.
Conclusion
In conclusion, the Three Cs of Teamwork - Connect, Communicate, and Collaborate - form the backbone of successful teamwork. By placing emphasis on fostering genuine connections, promoting clear and considerate communication, and encouraging open-minded collaboration, teams can elevate their productivity, engagement, and overall success. Embracing these principles creates a work environment where individuals feel empowered to contribute their best efforts and collectively work towards common goals. By incorporating these principles into our daily interactions, we can create a dynamic and thriving team culture that propels us towards greater achievements for ourselves, and most importantly, for our patients.
