• Chapter 7 concentrates on the need for continuity when patient care and other responsibilities are transferred from person to person and / or team to team.
1.02 Teams in healthcare
Teamwork has been the subject of increasing relevance to the world of healthcare over the past century. The caricature from the old movies of the authoritarian male doctor who expected his minions to follow his every bidding has its roots in the reality of the times. In that era this apparently lone-operator held his own personal records of every patient in a single notebook which he kept private. Fast forward to the current era and …
… a third of patients have at least ten specialist physicians actively involved in their care by the last year of life, and probably a score more personnel, ranging from nurse practitioners and physician assistants to pharmacists and home medical aides.
Atul Gwande
All are working with the intention of providing coordinated care. One significant shift in this respect is that the patient’ s record should, in theory, be one document which is available to and updated by any clinician involved in their care. Theory and reality are often difficult to align.
There are many others involved in patient care: administrators, technicians, opticians and dieticians to name a few. In addition, pastoral care can be of high importance to some patients and takes many forms for the culturally diverse patient population. There are separate wards and departments; separate buildings for hospitals, clinics and practices. There are people working in different health authorities and organisations. There are hierarchical teams within these specialties, disciplines and organisations. Then there are multidisciplinary teams. Some teams are formal and some informal. Some established with long-term intentions. Some are transient – lasting only as long as it takes to work together to manage an acute patient emergency.
In short, team interaction in healthcare is complex. And this complexity continues to
increase. In recent times in the UK, a concerted drive to fully integrate health and social
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