Healthcare teams. Teams in healthcare. Does this notion correspond with today’s reality, or are we still stuck in a cycle of independence and lack of coordination?
Let me elaborate. Doctors are independent workers who all have a common goal, save lives the best way they know how. Everybody studies the same basics, some branch out, some specialize, but in the end, they mostly work for themselves whether it be in a clinic, hospital or other.
If a patient comes into an emergency department with varying symptoms, they could be treated by one specialty and then passed on to another. They could be prescribed something based on a set of symptoms, while still being on other medication that treats another problem but linked to the issue at hand.
A more accurate representation of this problem is seen in farms and can be used as a comparative example. Silos represent the structures used by farmers to store various crops separately. When it comes to healthcare in the United States, it can be said that clinical care is a mixture of many silos.
In the Breaking Down Clinical Silos: Enhancing Care Coordination by the Frontiers of Health Services Management edition, this exact concept of healthcare silos is explored:
[silos] when applied to healthcare delivery, conjures up a picture of each clinical department, each specialty, and each service department standing alone, doing what they do expertly: diagnosing and treating the unique symptoms of patients entering the silo in search of the specialty service performed there. As implied by the analogy, these silos of care do not support or encourage the involvement of other specialties to address the patient’s comorbidities; the whole patient; […].
This concept, however, is not only at the human level. Clinicians use the technology available to them. Healthcare silos essentially start in the IT department, which in turn, transcends to healthcare professionals.
In a VertitechIT post, the concept of healthcare silos is explored through the various levels of IT teams in hospitals and the evolving technology being implemented. Storage managers don’t necessarily coordinate with network managers, or server managers, or application managers or even operations managers. Without the presence of cross-functional teams to work together towards enabling technologies that promote accessibility, security and availability to its users, in turn, these users, healthcare professionals in this case, can’t function as cross-functional teams themselves. They are needed at every level of the healthcare industry.
Through the example of Eric Dishman’s case, let me explain the importance of healthcare professionals working as teams. In his TED Talk, he introduces the concept of Care Networking by giving a personal example:
We have got to go beyond this paradigm of isolated specialists doing parts care to multidisciplinary teams doing person care. Uncoordinated care today is expensive at best, and it is deadly at worst. Eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members. I had my own heart scare years ago in graduate school, when we’re under treatment for the kidney, and suddenly, they’re like, “Oh, we think you have a heart problem.” And I have these palpitations that are showing up. They put me through five weeks of tests – very expensive, very scary – before the nurse finally notices the piece of paper, my meds list that I’ve been carrying to every single appointment, and says, “Oh my gosh.” Three different specialists had prescribed three different versions of the same drug to me. I did not have a heart problem. I had an overdose problem. I had a care coordination problem.
By building multidisciplinary teams, we go beyond the healthcare silos that have been festering and weakening healthcare technology, clinicians and processes. The past provider-centric focus is being replaced by patient-centric care where organizational structures form around the patient, not the department. This will lead to team members relying on the expertise of their coworkers, knowing their role within the team and benefiting from streamlined communication. Through cross-functional teams, clinicians coordinate better at every level and augment the potential for increased positive outcomes.
