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Improving patient care and reducing diagnostic errors has been a hot topic since the Institute of Medicine (IOM) released To Err is Human1 and Crossing the Quality Chasm2 in 2000 and 2001 respectively.  Then in 2002, the IOM convened the Health Professionals Education Summit to determine the core competencies needed for all healthcare providers and practitioners to improve the health and safety of our patients.  One of the five core competencies agreed upon was the use of interdisciplinary teams.3.4 The reason interdisciplinary teams became a core competency is due to the fact that 70-80% of serious medical errors were a result of teamwork failures.5

Interdisciplinary teams consist of team members from all areas of healthcare including, but not limited to, the provider, patient, care giver(s), nursing, pharmacy, occupational therapy, speech therapy, physical therapy and laboratory.  It is the collective intelligence of interdisciplinary teams that make them integral to improving patient outcomes, by reducing medical errors and increasing quality of care.5,6

In order for interdisciplinary teams to be successful, teams must exhibit the following characteristics7:

  1. Leadership and Management-A successful interdisciplinary team has a clear appointed team leader who gives clear direction and management along with sharing the power with fellow team members.7 The leader’s job is to encourage and support team members.7
  2. Communication-Team members should have developed communication skills and the means to properly communicate within the team.7
  3. Personal Rewards, Training and Development– Team members should have access to career development, learning and training opportunities on interdisciplinary teams, along with ways to promote moral and motivation in the team.7
  4. Appropriate Resources and Procedures-A team should have structure (team meetings, working from same location, team organizational support). It is also vital that the structure is appropriate for the group and is enforced.7
  5. Appropriate Skill Mix– Team members of the group should represent a wide array of skills and personalities so that the team can utilize each member to their fullest ability.5 In order to keep an appropriate skill mix, proper replacement for empty or absent positions is critical.7
  6. Climate– The culture of the environment is key to the success of interdisciplinary teams. The culture should be trusting, respectful, empowering and concentual.7 Hierarches should be demolished.6
  7. Individual Characteristics– Respect of each person’s individual characteristics makes a team strong.7 Utilizing listening skills, reflective practice, and knowing strengths and weaknesses are ways to recognize and respect individual characteristics.7
  8. Clarity of Vision-A team should have a clear vision and set of values to drive the purpose of the team.7 Having a charter or another form of a working document helps groups develop a clear vision and expectations to which team members are held.
  9. Quality and Outcomes of Care-The main goal of the team is to provide exceptional care of the patient. This means that all care decisions should be patient-centered.7 The group should encourage feedback, capture and record evidence of effective care, and then use it to provide feedback and improve. 7
  10. Respecting and Understanding Roles-A team should be sharing power and work together.7

In the clinical laboratory, there are many opportunities for interdisciplinary teamwork. Some examples include reducing specimen rejection rates (both with nursing and phlebotomy), decreasing turnaround time, improving utilization of laboratory testing, and collaborating on appropriate use of blood products. When a patient issue arises in the clinical laboratory, it is likely to also be affecting other departments and personnel. Examples include unnecessary phlebotomy procedures or delaying treatment or diagnosis due to inappropriate testing. Interdisciplinary teams can help address these issues in a timely manner and on a regular basis when a medical laboratory professional is included on the team.  We have the expertise in the laboratory to help improve the safety and quality of healthcare around laboratory testing and utilization. Therefore we must be the ones to share this knowledge and get out of our silos.

Resources:

  1. Committee on Quality of Health Care in America. Institute of Medicine, Kohn L, Corrigan J, Donaldson M., eds. To err is human: building a safer health system. Washington DC: National Academy Press; 2000.
  2. Committee on Quality of Health Care in America. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.
  3. Committee on the Health Professions Education Summit, National Academies Press.Greiner AC, Knebel E. eds. Health Professions Education: A Bridge to Quality. Washington DC: National Academies Press; 2003.
  4. Morris, S, Otto, C, and Golemboski, K. Improving Patient Safety and Healthcare Quality in the 21st Century – Competencies Required of Future Medical Laboratory Science Practitioners. Clinical Laboratory Science 2013; 26(4) 200-204.
  5. Mayo, A. T., & Williams Woolley, A. (2016). Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication. AMA Journal of Ethics, 933-940.
  6. Smith, M. E., Wells, E. E., Friese, C. R., Krein, S. L., & Ghaferi, A. A. (2018, November). Interpersonal and Organizational Dynamics Are Key Drivers of Failure to Rescue. Retrieved from Health Affairs: https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0704
  7. Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten Principles of Good Interdisciplinary Team Work. Human Resources for Health, 1-11.

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