Building a teamwork model for uncertain times

The COVID-19 pandemic has put stress on the entire delivery system, including workforce relationships. But a teamwork model created by the University of Texas MD Anderson Cancer Center aims to improve clinical care and the effectiveness of staff even during uncertain times.

MD Anderson’s Leadership Institute Executive Director Courtney Holladay said a core piece of the model is making sure all team members know what their roles and responsibilities are, and establishing norms. This came in handy when, at the beginning of the pandemic, leaders had to delineate which employees would be moved to remote work and who would stay in their care facilities.

“You had teams working in a remote setting who had never worked remotely, or as a team,” Holladay said. Leaders had to establish what the new norms would be.

Most healthcare teamwork models, Holladay contended, are based on clinical teams, but this was applied to all levels of staff at MD Anderson, including executive leadership. MD Anderson also uses an interdisciplinary approach with staff across the scopes of practice weighing in, instead of traditional hierarchical models.

Historically healthcare workers like nurses aren’t empowered to speak up when their words could be perceived as questioning a high-level clinician’s—like a physician—knowledge or authority. But MD Anderson says teams operate best when everyone feels comfortable contributing, and mistakes are viewed as opportunities to improve processes and learn collectively.

Holladay said those more traditional models can lead to mistakes and complications that result from a team dysfunction.

“A lot of times a breakdown is the result of an assumption that somebody else had it covered, or not being comfortable to speak up because that other person (team member) is the expert,” Holladay said, adding that everyone on a team should have a role to play. “If you don’t help people work inclusively, you may not have the desired outcome.”