Teamworking in clinical practice
Most doctors today practise in medical and clinical teams,
increasingly of an inter-disciplinary nature. As well as being personally
responsible for their own performance, doctors share the responsibility for the
quality of care provided by their team, which may include colleagues from other
health professions. However, doctors remain individually accountable for their
professional conduct and the care they provide.
Medical teams are usually organised around clinical
directorates in hospitals and partnerships in general practice. Single-handed
general practitioners may work in clinical teams when other health professionals
are involved in the care of their patients.
To be effective, medical and clinical teams must be well
led and managed. They must:
 | have a positive attitude to patients and listen to their wishes and needs
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| make sure that patients and colleagues understand the roles and
responsibilities of team members, their professional status and specialty
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| make themselves aware of what patients think about the quality of their
service; and
|
| have a clear understanding of their professional values, standards and
purpose. |
The team leader should:
| take responsibility for ensuring that the team provides care which is
safe, effective and efficient
|
| make sure, as far as possible, that the whole team understands the need to
- provide a polite, responsive and accessible service - treat patient
information as confidential
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| if necessary work to improve his/her skills as a team leader. |
Team members should:
| be willing to learn
|
| be committed to providing good-quality service and effective clinical
practice
|
| respect the skills and contributions of colleagues; and
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| be open and honest about professional performance, both together and
separately
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| try to persuade other team members to change their minds when they believe
a decision would harm a patient, failing which they should tell someone who
can take action. As a last resort they should take action themselves to
protect the patient's safety or health. |
To help maintain quality, clinical teams will normally use:
| an active and supportive approach to the professional development of each
member
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| the standards set by professional organisations
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| recommended clinical guidelines
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| detailed performance records
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| internal and external medical and clinical audit
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| regular review of individual members' performance and
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| suitable procedures for looking into complaints and avoiding unnecessary
risk. |
Effective clinical teams should be prepared to test
themselves against others providing similar care, to see where they stand and to
learn from this. This testing can be quite informal - for example, through
visits, discussions, and comparing results with colleagues. There may also be a
more formal audit, involving an external review leading to accreditation for
training.
An effective team will show:
| purpose and values - for example, evidence of well-defined values,
standards, functions and responsibilities, and strategic direction
|
| performance - which will involve evidence of leadership, competent
management, good systems, good performance records and effective internal
performance monitoring and feedback
|
| consistency - including evidence of thoroughness and a systematic approach
to providing patient care
|
| effectiveness and efficiency - evidence that amongst other things, they
are assessing the care they provide, and its clinical results
|
| a chain of responsibility - demonstrating that responsibilities are well
defined and understood
|
| openness - for example, willingness to let others see in, and evidence of
performance presented in ways that people outside the team can understand and
|
| overall acceptability - including evidence that the performance and
results achieved by the team inspire the trust and confidence of patients,
employers, and professional colleagues. |
Effective clinical teams will need the time, skills and
other resources to maintain, and show that they maintain, a consistently good
standard of patient care. This means having committed and supportive management
in NHS trusts, health authorities and boards, and their associated primary care
groups. It is the management's responsibility to create the conditions under
which good practice can be achieved.
Source: Charles George, GMC
http://www.gmc-uk.org/med_ed/teamwork.htm
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