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HCA 822 TOPIC 5 Discussion Question One

HCA 822 TOPIC 5 Discussion Question One


Does a collaborative culture necessarily equate to a sustainable health care organization? Why or why not?

Research on teams and teamwork processes within health care is important for two main reasons. First, the quality of teamwork is associated with the quality and safety of care delivery systems. This represents an opportunity for team researchers to contribute to solving large societal challenges. Second, the health care industry provides the means to develop and test theories on a large scale, across a wide range of team types. Each of these opportunities is elaborated on in the following two sections.

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The Importance of Teamwork to the Quality and Safety of Care Delivery
Academics, policymakers, and the public are increasingly aware of the magnitude of preventable patient harm in U.S. health care, which may exceed 250,000 deaths per year (Makary & Daniel, 2016). These harms include hospital-acquired infections (Klevens et al., 2007), patient falls (Miake-Lye, Hempel, Ganz, & Shekelle, 2013), diagnostic errors (Newman-Toker & Pronovost, 2009), and surgical errors (Howell, Panesar, Burns, Donaldson, & Darzi, 2014), among others (Pham et al., 2012). Each manifests through complex interactions in the sociotechnical care delivery system.

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Communication failures are both an independent cause of preventable patient harm and a cross-cutting contributing factor underlying other harms. Transitions of care (i.e., between care areas or shift changes) in acute care settings are leading opportunities for communication failures directly causing patient harm. They are high-risk interactions in which critical information about the patient’s status and plan of care can be miscommunicated, leading to delays in treatment or inappropriate therapies. These transitions are

HCA 822 TOPIC 5 Discussion Question One

HCA 822 TOPIC 5 Discussion Question One

associated with approximately 28% of surgical adverse events (Gawande, Zinner, Studdert, & Brennan, 2003). Additionally, care team member interactions contribute to specific clinical harms. Poor communication of medication name, dose, route of delivery, and timing of administration between physicians, pharmacists, nurses, and patients can lead to medication errors (Keers, Williams, Cooke, & Ashcroft, 2013). Hierarchy (e.g., between professional roles, and over occupational tenure) can inhibit the assertive communication necessary for effective recovery from error (Sutcliffe, Lewton, & Rosenthal, 2004) such as violation of evidence-based treatment protocols.

The teamwork and communication challenges in health care manifest the problem of coordination neglect in organizational systems (Heath & Staudenmayer, 2000). Managing complex work usually involves breaking it into tasks and delegating components of the work. However, across industries, there is a strong tendency to emphasize the division of labor and ignore mechanisms of coordination and integration (Heath & Staudenmayer, 2000). Health care delivery is inherently interdependent and increasingly complex. No one individual can assure a patient receives the highest standard of care, nor can he or she protect the patient from all potential harms stemming from increasingly complex and powerful therapies. However, despite high levels of interdependence, health care has underinvested in structured and evidence-based practices for managing teams and coordinating care.

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