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Had Enough of Teamwork? A Recent Hospital Experience (Part Nine in a Series)

March 12, 2010

habit 2

Consider this a bonus (9th) post. While I was putting up the previous eight posts over three weeks, my 90 year-old mom was admitted to a hospital in Ottawa, Ontario. I won’t go into any details, but my reason for writing this post is because of something one of the nurses said to me when Mom was admitted: “We practice team-based medicine.” Well, with those words I was all ears and eyes to how my mom was going to be treated.

Mom will finally be discharged today after an 18 day stay, although the first 10 days were waiting for surgery. Her ordeal was something I hope to never experience. I’ve restrained myself not to rail about Canada’s healthcare system, which does vary across the ten provinces. In Eastern Ontario we have our issues and challenges. Wait times for surgery, shortages of specialists, a lack of hospital beds, and most recently the laying-off of nurses and other hospital staff when hospitals are over 100 percent capacity stretches logic to the max. Budgets are blown (an understatement).

But I digress.

I’ve had plenty of experiences with this particular hospital in the past with both my mom (two knee replacement surgeries) and my dad (who died there four years ago in the Intensive Care Unit). The level of care in the various units was actually quite good and compassionate. But this recent 18 day experience was quite jarring.

Think about it for a moment. You enter a hospital (or in this case an aging, frail parent) and you have a set of expectations, e.g., attention to detail (no mistakes), empathy, efficiency in having tests, etc. administered efficiently, respect from hospital staff, maintaining your dignity, and (if necessary) access to skilled surgeons.

My mom’s experience was not something out of a Stephen King movie. But my wife, Sue, and I were there daily, helping mom go for walks, humoring her, following up with the nurses, waiting with her for tests, and consulting with the surgeons. All the while I was also observing.

Unfortunately, a number of balls were dropped over the two and a half weeks Mom was in the hospital. Communication was clearly lacking–the most important ingredient of effective teamwork. New developments were not always shared with us (the family) unless I went hunting for answers. The level of ambivalence among some of the medical staff in the unit (namely some of the nurses and admin staff) was clearly some cause for alarm. Some nurses actually seemed to care and assisted, while others early on gave the attitude that they were being bothered. My Mom went through several female roommates during her stay, and the others suffered the same indignities.

It became clearly evident to me that that there was a lack of a shared vision and mission among the staff of the unit. There’s a saying that a team is only as strong as its weakest link. In a healthcare setting where lives are often at stake then EVERYONE must be on the same page and working in concert towards the same purpose. If some staff are not as committed as others, then this is a recipe for bad morale, poor performance, inefficiency, turnover, and undesirable outcomes for patients. It makes it especially frustrating for highly committed staff whose efforts get undermined by the less committed.

Remember the two necessary conditions for effective teamwork:

• Shared common purpose for the team
• Interdependency of work among the members

Unless both these conditions are present, you don’t have a team. And as I’ve mentioned previously, other critical elements of teamwork include effective communication, shared performance goals, respect, mutual accountability, passion for client service, and celebrating accomplishments.

We all grow old and die one day, and unfortunately many of us will do so in an institutional setting, especially with a burgeoning Baby Boomer population. As much as I hope to “go” while playing the piano, the odds are that it won’t happen that way. However, I just hope to leave this planet with my dignity intact.

Next week: Are YOU a Manager or a Leader? Making Sense of It with Henry Mintzberg’s Help

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4 Comments leave one →
  1. March 14, 2010 2:21 am

    Jim,

    That was a fascinating account of leadership principles as applied to real life. It’s clear that your mother’s care was certainly less than ideal because of the lack of unity and communication at her hospital. Thankfully, you and Sue were there to help keep her best interests a priority.

    I had never thought of medical care as the ultimate example of teamwork, or lack thereof. Thank you for an enlightening post. And best wishes for your mom’s good health.

    • March 14, 2010 3:23 am

      Thanks Susan for your comments and for your wishes for my mom. There are few better examples of where teamwork is vital than in a hospital, except for perhaps other demanding professions such as police tactical teams, the Armed Forces, and firefighters. There’s usually not a lot of room for error. We can get away with it in government and corporate bureaucracies most of the time, but when the health and lives of people are at stake–and frequently under personal stressful conditions–then it’s that much more critical to ensure that everyone is on the same page and pulling together towards the same pupose.

  2. March 12, 2010 12:24 pm

    I dealt with two surgical teams, since there was a later change. They were excellent, as were the young resident physicians, who were quite compassionate with my mom.

  3. Mary Mimouna permalink
    March 12, 2010 11:39 am

    I sent your post on to a doctor friend of mine in the U.S. Very interesting.

    Mary

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