Just a few short decades ago, the patient experience was quite different from how it is today. Patients would see different professionals for different needs, but those professionals didn’t interact much. Instead, they each focused on their individual specialties and left the patient to pull the advice from different physicians into an effective health plan. This worked on a basic level, but it did not optimize the care that patients received. It also didn’t maximize the therapeutic benefits of seeking treatment.
Modern healthcare no longer revolves around isolated treatments from different doctors and nurses. Instead, the field has evolved into team-based care. This means that patients have a care team who regularly interact with each other in order to optimize the treatment that patients receive. Someone with diabetes and heart disease might see two doctors, one who specializes in diabetes care and one who specializes in cardiac care. These physicians then compare notes and formulate a treatment plan that helps both health issues.
What else is important in collaborative care, and how do nurses form the backbone of the industry? This article examines team-based healthcare, why it matters, and how it can be done effectively.
Is collaborative care really that important?
While we’ve stressed the importance of team-based care, we haven’t examined the evidence for the effectiveness of this model of healthcare. Several studies have found that collaborative care positively impacts patients and helps to encourage good outcomes. One such study found that without teamwork, high-risk interactions between patients and caregivers were higher than they were when teams were involved. The research found that around 27% of treatment delays and inappropriate therapeutic treatment in the studied population were tied to breakdowns in communication between medical staff. Another found that team-based work was significantly tied to positive patient outcomes, especially when multiple teams (such as teams at different hospitals or different departments) were included.
In short, collaborative care really is that important. The information above is just a sampling of the research showing that care improves dramatically when professionals routinely collaborate with each other, regardless of specialty, role or location. Without collaborative teamwork, it is still possible for patients to receive good care. The difference here is between ‘good’ and ‘great’, however, with the latter being the outcome of a dedicated team with patient health in mind.
Why are nurses important in collaborative care?
Another reason why collaborative care is important concerns the number of healthcare professionals in the field. According to the World Health Organization (WHO), the global deficit of healthcare workers is more than four million. This deficit impacts all areas of the healthcare workforce, including nurses. In fact, the current shortage of nurses is a well-known problem. Healthcare ideally needs to add thousands of nurses to its ranks, but the progress is slow, and as older nurses retire, the problem will only get worse. As the number of nurses and other healthcare professionals decreases, the quality of care that patients receive could lower proportionately. Team-based care can help avoid this scenario.
Collaborative care recognizes the need to redistribute care in order to cover potential gaps in the workforce. There are two different levels where this happens. First, some non-clinical and clinical tasks can be reassigned to different professionals. As the number of physicians continues to decrease, for example, certain responsibilities can be shifted to nurses and other healthcare professionals who have not typically carried out those responsibilities. These other healthcare professionals can now add these tasks to their daily queue of work, including routine maintenance of chronic conditions, and enable physicians to focus on acute care cases and medical emergencies.
This redistribution of care presents problems for nurses, of course, as the workforce decreases. The answer here is also collaboration. Instead of one nurse handling all of the important decisions behind patient care, a team of nurses can more effectively administer treatment. This allows nurses to focus their attentions where they most need to be with the knowledge that the rest of the team will care for everyone else. As fewer nurses enter the field, the need for team-based care will only increase in the coming years.
Despite this rosy overview, team-based care is still a work in progress. There are some challenges that nurses must overcome in order to build strong and effective teams.
Barriers to collaborative care
Nurses must overcome several barriers to team-based care. These include:
- Staff turnover
- Patient attitude
These three barriers are not the only challenges that nurses face, but they are certainly some of the most difficult to face.
As you might expect, the nursing deficit is one of the main challenges faced by the healthcare industry as it shifts to collaborative care. The overall turnover of nurses has increased post-COVID-19. From poor working conditions to long shifts, many nurses burn out relatively quickly and leave to pursue other work, be it in the healthcare field or outside it. As staff turns over, the team structure begins to crack. Established nurses might question the ability of incoming nurses and be hesitant to hand over their patients to them. This naturally leads to a shift away from team-based care.
A rigorous and standardized training process can help to relieve some of this hesitation, but many healthcare systems are overcome with patients and lack the necessary resources to implement it. Luckily, nurse-led training can help ease this issue significantly. The importance of mentorship in nursing cannot be overstated. Learning from other nurses helps new nurses to better understand not only how to interact with patients, but also what they can expect with regard to scheduling and responsibilities.
It is important to note how completely nursing has evolved over the past several decades. What used to be primarily a physician’s assistant is now an independently qualified healthcare professional with specialized education. Nurses are now qualified to make certain medical decisions on their own. The problem is that while job focus has shifted, patient expectations often have not. When they are sick, patients expect to be treated by a doctor. This can make nurses’ jobs exponentially more difficult as they seek to educate patients about their own qualifications and experience.
Legislation and policy
The third challenge we’ll discuss is legislation and policy. The takeaway here is simple. Legislation is behind the times when it comes to nursing. We’ve discussed the new responsibilities that nurses must take on, but policy doesn’t yet acknowledge many of them. The legislative system has yet to fall in line with the healthcare system, making it more difficult for nurses to effectively treat patients.
One example here is drug administration. Some states and hospitals restrict what nurses are able to administer. Some even go so far as to limit this to over-the-counter medication only. Due to the physician shortage we mentioned above, patients must often wait to receive the drugs they need to function and recover. This, in turn, makes collaborative care more difficult as nurses are not able to effectively work alongside doctors to uphold an effective treatment plan. This is not a problem that all nurses face, but many of them are caught in this legislative inconvenience and struggle to provide optimal care to patients as a result.
Note that when nurses are unable to administer certain medications, this only reinforces the patient attitudes we discussed above. They often see nurses as mere ‘assistants’ unable to actually treat them.
Benefits of collaborative care
We have touched on some of the broad benefits of collaborative care but have yet to explore the specific advantages that this kind of care offers patients. We examine some of these in more detail below.
Fewer medical errors
Communication difficulties in healthcare can have dire consequences for patients. From missing symptoms to misdiagnosing patients entirely, busy physicians sometimes overlook important information. Nurses serve as the first line of defense between medical errors and patient health. They collaborate closely with doctors in order to note any additional symptoms to those recorded by the physician, as well as any side effects from medication. Nurses might also adjust the dose of in-hospital medication during recovery as they see the need arise. This flexibility further reduces medical errors by responding to patients’ individual needs.
Interprofessional communication has been shown to significantly reduce adverse drug reactions, overlooked symptoms and mortality rates in particular.
One of the most frustrating aspects of modern healthcare from a patient perspective is the delay in starting treatment. They often have to wait for consultations and lab results before their physician can treat them effectively. Because the number of physicians in the field is steadily decreasing, this issue will likely only grow in the future. Team-based healthcare can also help here. Collaborative care encourages quick and comprehensive communication between physicians as well as between physicians and nurses, ensuring that patients do not have to wait with worsening symptoms before they are treated.
Lower healthcare costs
In addition to the waiting described above, the cost of healthcare in the US can be incredibly prohibitive. For example, according to the US Centers for Medicare & Medicaid Services, the average cost of a three-day hospital stay is $30,000. This doesn’t even touch on the expense of comprehensive cancer care, which can cost many hundreds of thousands of dollars, and the treatment of other health problems. Anything that can lower the steep price of healthcare for US patients is an incredibly worthwhile pursuit. Team-based care is often the answer here.
According to a study conducted by the Robert Wood Johnson Foundation, collaboration between nurses and physicians can have a significant impact on patient care. This translates to shorter hospital stays, an increased bed turnover, and an increase in before-noon discharges. All of this lowers the cost of medical care for patients as well as for the hospitals in question.
Increased job satisfaction
As mentioned earlier, one of the main problems fueling nurse shortages is low job satisfaction. This issue often stems from a lack of communication between nurses as well as between physicians and nurses. Every profession comes with its own philosophy, knowledge base and subculture, and collaborative care helps to cut through these issues by placing the patient above internal conflict.
As the playing field is leveled via team-based care, and everyone on the team is given vital roles, morale improves along with job satisfaction.
How to make collaborative care work for your team
Now that we’ve explored the barriers to entry as well as the benefits to patients that team-based care provides, let’s discuss some techniques to make collaboration easier.
The first step to building an effective team of nurses and physicians is to assign clear roles. It is absolutely crucial that everyone involved understands the part they play in effective patient care. This not only helps to ensure that everyone is on the same page, but it also limits potential infighting. Everyone has a role, and everyone must fill that role by placing the patient first. Assigning roles is what makes or breaks a team. If you are hoping for a close-knit team of reliable nurses and physicians, then you must be willing to give everyone clear responsibilities to fulfill.
Set team goals
Another way to ensure that teams work effectively is to set team goals. These might include reducing response time, decreasing waste and improving patient care. By setting these goals, team members have a shared objective to meet and are more likely to unite under the shared objective. This further encourages collaboration and communication as members seek to streamline and optimize their care process for the patient’s benefit.
Encourage open communication
Nurses interact with a wide variety of people throughout the day. From patients to physicians and everything in between, they must be able to listen not only to what is said, but also to what they are expected to do to address the issue. Sometimes nurses are given direct feedback, questions or suggestions, or have their own for other members of the team. It is essential that everyone is able to communicate clearly and effectively.
Breakdowns in healthcare are often the result of a lack of communication. This lack of communication typically stems from concerns about explaining or expressing things to the rest of the group. Teams that encourage open communication and acknowledge good communication efforts are more likely to have solid working relationships that keep patients safe throughout departments and treatments.
Because the members of the team span different departments and specialties, it is important that respect is given to all. All members of the team are critical to success. Failure to respectfully acknowledge all members can quickly lead to defensive professionals less willing to interact with the rest of the group. This, in turn, can lead to the breakdowns in care we mentioned in the section above.
Set the expectation for mutual respect early. Demand that everyone treat each other respectfully regardless of their personal feelings. The patient is the most important person in the room, and everyone else should be committed to providing them with optimal care. This includes being kind and polite to the whole team, even when struggling with communication or even personal differences.
Collaborative work between healthcare professionals is critical to patient care. Dedicated teams with the patient’s health in mind are more likely to provide excellent care than professionals without a team structure. Effective communication between all professionals treating the patient is vital so that they have the information they need to optimize treatment.
Are you interested in learning more about nursing and how team-based care is revolutionizing the industry? If so, keep the information above in mind as you search for a great university and prepare to begin your journey toward a long and satisfying career.