Quality Health Care Is a Team Effort

Added on Jan 19, 2017

Quality Health Care Is a Team Effort
By Diana Mahoney
Industry Edge January 2017

Teamwork is the heart of health care—a reality that was especially striking to the group of reviewers charged with selecting the winner of the 2016 Press Ganey Team of the Year Award.

While one team—Duke Women’s Cancer Care Raleigh—received the inaugural award during the 2016 Press Ganey National Client Conference, the many entries from health systems around the country served as a clear indication that teamwork is highly valued by organizations striving to move the needle on their delivery of safe, effective, quality care.

Among the submissions, summaries of which are published on the Institute for Innovation website, the team from Duke stood out for its steadfast commitment to the shared purpose of delivering compassionate, connected care to women with cancer, and for sustaining that commitment during a challenging organizational transition.

In 2015, the leadership at Duke Raleigh Hospital made the decision to dedicate one of its three cancer centers to the care of women’s cancers, placing every service these cancer patients might need under one roof. Bringing the new facility to fruition required merging several teams—cancer center staff, breast surgeons in independent practice, hospital radiology staff, radiation oncologists and support services—and the clinic remained open during the transition.

The 35,000-square-foot clinic officially opened on July 11, 2016, with a multidisciplinary team of 14 physicians and 65 staff. In addition to physicians, surgeons, nurses and ancillary caregivers being together in one location, clinical social workers, dietitians and other specialists are also on-site to provide services that include genetic testing and counseling, clinical research assessment, nutritional and financial counseling, and fittings for bras and breast forms.

According to hospital president Dr. David Zaas, “The team was engaged throughout the process, and showed professionalism and optimism, despite the demands of caring for patients on a daily basis throughout months of construction and structural changes.” Every team member became a true champion of the project, he said, “because of the benefits they knew it would bring to patients.”

During the transition, the various team members were in multiple locations, but they were unified in making sure patients felt they were seamlessly connected. They also used the transition period as an opportunity to talk to the patients about the changes and to listen to their concerns. Partnering with patients in this way helped put them at ease and improved their experience.

The team’s performance on clinical and patient experience measures, accessed through a balanced scorecard and the Press Ganey Improvement Portal, was shared during monthly meetings and consistently indicated that their efforts were paying off. Notably, the team achieved an overall mean score for patient experience of 95.2, which was higher than the mean score of 90.7 for all of the hospital facilities combined, and a mean score for the “Staff worked together to care for you” item of 96.7, which was also higher than the all-facilities mean score of 93.2.

Perhaps the greatest nod to the power of teamwork, however, has been the continuously high level of engagement reported by the team members themselves. In an organizational engagement survey conducted just before the new center opened—arguably the most stressful time frame of the project—the staff scored a Tier 1 for its level of engagement, the highest rating possible.

These outcomes are consistent with the growing body of literature confirming the value of teamwork in health care. Multiple studies have indicated that patients are safer and receive higher-quality care when their providers work as a coordinated team.

Further, patients who perceive that their care team is working together to meet their needs rate their experience of care higher than those who don’t. In fact, as can be seen in this interactive set of findings regarding patient perception of care coordination, patients who give an optimal response (i.e., top-box rating) to the patient experience survey measure regarding staff working well together are more likely to rate the hospital as a 9 or a 10 and to indicate that they are certain they would recommend the hospital.

And, according to these data from the Agency for Healthcare Research and Quality, providers who feel they are part of a highly effective care team are more engaged in and experience more reward from their work.

What Makes a Great Team

Highly effective health care teams share certain characteristics. Specifically, according to a definition used by the World Health Organization, such teams comprise members who do the following:

  • Possess specialized and complementary knowledge and skills
  • Know their role and the roles of others in the team(s) and interact with one another to achieve a common goal
  • Act as a collective unit, as a result of the interdependency of the tasks performed by team members

In addition, “high-performing caregiving teams must be organized around the patients’ needs and diagnoses, not around convenience of the caregivers or the organization,” said Christina Dempsey, Press Ganey chief nursing officer. “Superior coordination, information sharing and collaboration across disciplines are required if value and outcomes are to improve.”