The Executive Suite: Five strategies for building a better medical team

Medicine is a team sport—the collective is often much greater than the individual when it comes to patient care, innovative ideas, productivity, and efficiencies. Even more important is that effective teamwork leads to fewer medical errors.1

It’s helpful to think about team tasks rather than individual ones because within a team there exists a diversity of skills, experience, talent, and perspective, allowing members to take on more complex and involved work than individuals. The science of teamwork has made significant advances, such that we can now draw upon evidence-based practices to guide us in forming and maintaining higher function teams.2

Teams come together for a variety of purposes, for different time spans, and with differing skills sets and background. Some teams are highly interdependent (they need each other to accomplish tasks), while others work together more independently, seeking advice or guidance from team members when needed. For example, in physician practices, you are likely to have highly interdependent teams—such as the team focused on direct patient care and one that is focused on administrative responsibilities. Depending on the size and complexity of the practice, one team may be focused on both “front” and “back” office responsibilities.

Despite the differences in team purpose, composition, structure, and inter-relatedness, there are several factors common to all teams. The most important one being a concept of “psychological safety”— where team members believe that it is “safe” to share their thoughts, ideas, and experiences (even mistakes) without fear of judgment or retribution.3 Bearing in mind that not all teams are created equal, below are some strategies worth considering to get the most from your team.

1. Develop a team mission – your purpose for being. When people all agree on a common purpose and feel that they are all working towards that purpose, there is a greater sense of camaraderie and teamwork. Reminding people of that common purpose (i.e. patient care and comfort) helps them feel a sense of meaning and significance and helps break down and/or avoid silos. It is critical for teams to understand that success is best defined by achieving your purpose In other words, it is more about team success than individual success.

2. Develop team agreements. One of the most common traits of successful teams, is that they have established norms by which they agree to operate under.4 Here are some questions I typically use when helping teams develop their agreements:

a. What are the behaviors we need from each other to develop greater trust?

b. How do we want to make team decisions?

c. How do we ensure that everyone’s voice is heard?

d. When we have an issue to address with one of our team members, are we willing to go directly to the person (and not talk behind their backs). This last one is critical. I often help teams learn how to have difficult conversations in an effective and productive way. Team members need to not participate in talking about others and instead, encourage their colleagues to go directly to each other.

3. Clarify team roles (what is expected of each other individually and of the team collectively) and create team goals. When team members clearly understand each other’s roles and responsibilities, they can then find opportunities to help each other out. I often ask healthcare teams how they define success at the end of their day. My objective is for them to see that their work is all about the best interest of patient care, and that includes helping out our colleagues when needed. Establishing a common set of metrics helps to define success and ensure that the team is able to measure their progress. The ability to achieve goals not only boosts team morale and reinforces the team mission, it also helps the team to identify factors that contributed to their success. When goals are not achieved, it allows the team to discuss strategies that might be more effective.

4. Learn from mistakes and failures. Teams that learn together, bond together. It is critical, especially in a health-care setting, that mistakes are seen as an opportunity to learn and improve, versus an opportunity to shame and blame. The team agreements should address this issue. You want people to openly discuss errors and near misses so that they can continually improve patient care and safety. A culture of continuous improvement among a team means that everyone knows that mistakes are bound to happen and that the best thing that can come from them is learning.

5. Provide opportunities for the team to get to know each other on a more personal level. One great way to do this is through a personality workshop (see my previous article on the NeuroColor personality assessment). It is a perfect opportunity to learn about people’s different styles, preferences, communication behaviors, and ways they might be misunderstood. It can lay the foundation for ongoing sharing, a key element for teams to develop psychological safety.

References:

Edmondson, A. The kinds of teams health care needs. Harvard Business Review, December 16, 2015.
Salas, E., Reyes, D. and McDaniel, S. The science of teamwork: progress, reflections, and the road ahead., The American Psychologist, 2018, Vol. 73, No. 4, 593-600.

Edmondson, A and Zhike, L.. Psychological safety: the history, renaissance, and future of an interpersonal construct. Annual Review of Organizational Psychology and Organizational Behavior. 2014, Vol. 1: 23-43

Duhigg, Charles. What Google learned from its quest to build the perfect team. The New York Times Magazine, Feb. 25, 2016.