Talk about “teamwork” is easy in those places where this is a guideline, but tremendously complicated with whom has no clear the meaning.


Recently I read a post of the great Miguel Ángel Máñez (@manyez) where he said: “teamwork is one of the current mantra in health organizations. But actually “teams” that exist are really teams ? Or rather are pseudoteams based on the fallacy of the grouping? “.


More frequently than desired we confuse teams with teamwork. Joan Carles March (@joancmarch), in his book “Teams with emotion”, defines it as “a unit formed by two or more people with normally complementary skills who are committed to a common purpose and set objectives and expectations of performance.”[1]


Any person outside the health care system that we saw working might think we have common concerns and objectives and we work as a team to solve them.

But is this really true? I dare to say that not. Or, to be precise, not always. And those same people would be greatly surprised (and disappointed) to discover that actually people who attends them communicate among them far less than what is desirable and that many errors are caused by this lack of communication or transmission of information between the members of the so-called team.



Our system is excessively stratified and dispersed, living in all kinds of positions in this aspect, positioning that denote different conceptions of what collaboration means. I’m not the only one who thinks so, Leticia San Martín (@leticiasmartin) in another post, which I also recommend, she pointed out that this is mainly due to that “we haven´t been trained to do so, neither our professional system is governed by the logic of collaboration. We have a professional culture of differentiation, demarcation of territories, which is not consistent with the logic of teamwork.”


Historically raised discrepancies in this respect between doctors and nurses that seem that they conceived the issue differently, so some authors [2] claim that physicians show a less positive attitude toward teamwork, “probably related to the hierarchical position that this has kept and by the existing subordination by nurses”. In the attention to critical patients we share a goal, many objectives and we need to communicate, but that’s not enough. “It is not exchange information to take unilateral decisions”.


Nor it is a unique problem between doctors and nurses, giving frequent problems of communication between physicians and doctors and nurses with nurses [3]. Communication is essential to move forward in a collaborative environment. Experiences of improving communication among professionals have shown an impact on the quality of care and satisfaction of patients [4].

But teamwork is difficult. It requires training and development of skills in communication, on settlement of disputes as well as regular meetings between members of the same. Meetings in which objective information will be provided, sharing opinions, reaching  a consensus on objectives and integrating the perspectives of all.


On line with all the discussions that we have been holding on to integrate the family in the “team”, it is probably necessary to re – consider us as we work previously, re – structuring ourselves so that we could really give them welcome to “a team.”


References

[1] March Cerdá JC et al. Equipos con Emoción. Granada. Escuela Andaluza de Salud Pública. 2012 

[2] Del Barrio Linares M, Reverte Sánchez M. Evaluación del trabajo en equipo en seis unidades de cuidados intensivos de dos hospitales universitarios. Enferm Intensiva.2010;21(4):150–160 

[3] Chang LP, Harding HE, Tennant I, Soogrim D, Ehikhametalor K, James B, Frankson A, Gordon-Strachan GM. Interdisciplinary communication in the intensive care unit at the University Hospital of the West Indies. West Indian Med J. 2010 Dec;59(6):656-61. 

[4] Vazirani S, Hays RD, Shapiro MF, Cowan M. Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. Am J Crit Care. 2005 Jan;14(1):71-7.