Plenary Session IV - Inter-professional Collaboration

Doctors need to be personally competent but most doctors today work in teams, certainly in hospital care, and what patients really need is not just competent doctors but well-functioning teams. This can be a challenge for doctors who, historically, have often been selected on attributes which reflect single mindedness, perfectionism and personal achievement, often in competition with others. Indeed, during undergraduate medical education, students are often encouraged to directly compete with their peers and after medical school, obtaining the best posts and passing postgraduate exams is perceived as more about personal endeavour than teamwork.
Teamwork is more than technical ability – this is a necessary but not a sufficient condition. For example, an operating theatre team need to be as efficient and competent as the team who refuel a Ferrari in Formula 1 but in medicine it is also about broader capabilities such as empathy and compassion. 
Why does this matter so much? Evidence shows that the public want caring and listening teams despite the pressures, demands, expectations and lack of time of a busy service. The Francis report into the excess number of deaths of elderly patients at Mid Staffordshire Hospital emphasised that because we all work in teams, we cannot practise in ‘silos’ – we cannot walk past a patient in distress with the attitude that this is not my patient or their basic needs are the responsibility of other team members. Teams need good leaders who lead by example – in most healthcare systems, doctors still provide the bulk of clinical leadership if not managerial leadership.
Just as in sports, in healthcare “teams that work together must train together” so interprofessional learning is important, for example in simulations. Good teams train together to be competent but also to observe the four C’s of excellent care: candour, compassion, communication and the team respects confidentiality, sharing information on a ‘need to know basis’.
This plenary will explore these concepts and there will be an opportunity for questions.
 

Many challenges have evolved in the health care system that support the need for interprofessional collaboration. Over time, separate specialties and professions have been created to focus on specific aspects of patients’ health and care such that a single profession today cannot adequately meet all the complex needs of patients. To keep patients safe, health care professionals are tasked to work together as a team; however, it is clear through medical error rates, root cause analyses, and patient outcome research that breaches in quality health care are often due to poor communication within health care professional teams. Just as the significance of interprofessional practice has become apparent, the evidence that health care teams generally cannot figure out how to effectively work together has emerged as a major issue. Teamwork failures stem from a variety of systemic gaps in our health care processes as well as fundamental human factors.   Health care simulation is increasingly recognized as one potential vehicle for teaching interprofessional collaboration.