Healthcare Team Communication: What Can We Learn from Pit Crews and Special Ops Forces?

Group of medical professionals discussing medical case.

Communication is one of the most critical tools we have for ensuring great patient care and improving key outcomes from safety to patient (and employee) satisfaction. Influencers, like Atul Gawande, have compared healthcare team communication to that of racing pit crews and Special Operations Forces who work seamlessly with precise roles and expectations, and quickly make decisions in controlled chaos [1]. The consequences of poor communication are significant, including reduced quality of care, lower HCAHPS scores, increased rate of readmission, or worse. Indeed, according to a recent article from Becker’s Hospital Review [2]: “…more than a quarter of hospital readmissions could be avoided with better communication among healthcare teams.”

Whether a hospital, senior care community, or urgent care, wellness hinges on teams of professionals working in concert to deliver healing care and a patient experience that builds patient commitment to continued care.  This requires coordinated teams of people throughout the healing process: from doctors and nurses to housekeeping and dietary teams sharing information as well as building productive working relationships. With so many professionals from diverse occupational backgrounds involved, it is critical to understand not only how communication can go wrong, but also what it takes for it to be most effective.   The quality of communication is affected by both what employees bring to the care team as well as the culture of the healthcare organization.

Communication and Who You Hire

Communication is complex because it is affected by our personality and past experiences.  Imagine a nurse who previously worked in an environment with a strict chain of command within nursing where open and transparent communication and voicing her ideas and opinions was discouraged.  Now, she works for an organization where everyone on the care team is expected to offer their input on care plans and transparency is the norm.  By understanding how a candidate or new hire’s experience and expectations influences their work style, you can identify gaps between their preferences and what your team needs for success as well as make the best choices about who to hire.

In addition to experience, personality traits affect communication preferences.  There is a spectrum of personality characteristics that influence performance depending on the demands of the position and the organization’s model for care.  Two qualities that consistently influence the ability of care teams to communicate are locus of control and emotional intelligence.  Healthcare team members with a greater locus of control, or belief they can influence events and their outcomes, are more likely to initiate communication with others, especially those team members outside of their professional domain.

Emotional intelligence is also linked to improved team performance.  Healthcare professionals with greater emotional intelligence are better equipped to regulate their emotions in stressful situations and are more adept at reading and responding to the emotions and behaviors of others.  Patient safety is linked to situational awareness, or the team’s ability to understand a patient’s condition not only clinically, but also ensure others on the team share the same awareness and understanding.  Knowing how personality influences day-to-day behaviors that affect patient care is valuable because then we can begin to build more effective care teams through hiring the right people and building on their strengths through training and development.

Breaking Silos with Culture

In addition to hiring, your organization’s culture and model for care can foster or inhibit effective communication.  In any work environment, people are more likely to share information and resources where they feel respected and understood.  Unfortunately, this often means people communicate most comfortably within their professional group at the exclusion of others.  Healthcare research seeking to understand social networks and communication patterns found nurses are most likely to communicate with other nurses, while physicians and allied health professionals, like dietitians and social workers, have the strongest ties and most frequent interactions across professional groups [3].

Silos within professional groups or among people who are most comfortable communicating with each other can jeopardize patient safety by compromising situational awareness.  One way to overcome this is to build a strong culture of shared beliefs about how teams should work together and provide care. Such a culture has the transformative power to break silos and build teamwork. In fact, healthcare organizations with shared beliefs about what it means to be an effective team not only achieve greater patient outcomes but also report higher job satisfaction [4]. Building a culture for patient care and safety requires setting clear standards for communication and behavior while also hiring for the qualities essential for living your cultural values.

Next Steps

Racing teams and Special Operations Forces are extraordinarily selective because they know that one bad team member can bring down the team. This same evaluation of the personality, experience, and values of a new nurse, medical assistant, or allied health professional should be the norm in health for the same reason. For care teams to operate seamlessly while optimizing safety, quality care, speed, and the cost of care, leaders must consider both the qualities needed in employees as well as how the organization’s values and beliefs can positive influence these goals.  Pre-employment assessments are tools to help you understand and measure the qualities you need for performance – whether for physicians, nurses, or frontline staff.  Learn how assessments can be used across positions to help provide a patient experience that builds continuity of care in our blog: The Untouchables: Personality Assessments for Reducing Cost and Improving the Patient Experience.

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Resources

[1] Cowboys and Pit Crews.  By Atul Gawande.  The New Yorker.  May 26, 2011. https://www.newyorker.com/news/news-desk/cowboys-and-pit-crews

[2] The chronic problem of communication: Why it’s a patient safety issue, and how hospitals can address it.  Becker’s Hospital Review.  March, 21, 2016. http://www.beckershospitalreview.com/quality/the-chronic-problem-of-communication-why-it-s-a-patient-safety-issue-and-how-hospitals-can-address-it.html

[3] The Social Network of a Burn Unit Team.  Journal of Burn Care Research.  September, 2015. https://www.ncbi.nlm.nih.gov/pubmed/25501788

[4] Relationship of Organizational Culture, Teamwork and Job Satisfaction in Inter-professional Teams.  BMC Health Services Research.  2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477418/

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