Collaborating with health care teams is a crucial component of residency training, but working with consults to treat patients may require special teambuilding strategies. How can residents better collaborate with their peers in other specialties? Resident authors of a recent perspective piece in the Journal of Graduate Medical Education illuminates some possibilities. This intraprofessional solution could be coming to a program near you.
“The frustration from poor consults, and the need for consult courtesy, has been well documented,” authors of the perspective wrote. “As communication and teamwork break down, we take on tribal identities: The belief that they are different from us. And by different, we mean inferior. Other services don’t work as hard or understand the patient the way we do. This lack of partnership and respect can lead to delays in providing care, an inefficient system, and more concerning, suboptimal patient care.”
To address this issue, the authors propose that programs consider developing intraprofessional teams that foster streamlined communication and care among residents across specialties. For instance, structured programming—such as shared intern rotations and collaborative research opportunities—can help build trust among residents and improve quality and safety in training.
“Teamwork training as a strategy for improving quality has been associated with substantially improved outcomes,” the perspective authors wrote, citing instances in which institutions like the Veterans Health Administration saw an 18 percent reduction in patient mortality after implementing “a formalized medical team training program for personnel in the surgical operating room.” The program called for effective collaboration between health care staff, anesthesiologists and surgeons.
Authors of the perspective encouraged residency programs to look to other programs that have successfully established intraprofessional teams. Examples they cite include:
- University of California—San Francisco’s hospitalist-neurosurgery team-based approach
- University of Chicago’s comanagement model of chronic liver disease for hospitalists and hepatologists
- Mayo Clinic’s medical and surgical comanagement after elective hip surgery and knee arthroplasty in Rochester, Minn.
These intraprofessional efforts can be particularly helpful as residents confront rapid changes in health care delivery systems that shift “toward new collaborative payment models, such as bundled payment models and accountable care organizations.” In these models, “specialties will no longer be stand-alone silos,” according to the article.
“In an era where the medical education community, including the Accreditation Council for Graduate Medical Education, strives to meaningfully engage trainees to lead change in quality and safety, substantive intraprofessional training may provide a compelling solution,” the authors said.
Tell us: Do agree? Do you think working with residents in other specialties would help advance your training? Share your thoughts on the AMA’s Residents and Fellows Facebook page or in comments below.
For more residency program solutions
- Explore this new method one residency program devised to get rid of miserable schedules.
- Learn about this residency program intervention that improved documentation timeliness and decreased stress.
- Check out Stanford University School of Medicine’s successful wellness program, and learn why taking time for fun (and the occasional sailing lesson) can improve resiliency in training.
