As anyone who has been a member of a healthcare team knows, a hospital, department or medical practice is only as strong, smart and efficient as the team of people who comprise it.
This might seem like an obvious statement, especially since everybody wants to work with the best individuals. According to research from Harris Interactive and Tact Knowledge Systems, 67 percent of employees believe colleagues are critical to effective job performance.1
Talent and intelligence are important baselines, but the ability to work well as part of a team can be a deciding factor in whether or not someone will succeed in a job. In the case of surgical teams, while each surgeon brings his or her own talents to the patient journey, it is necessary for all team members to work collectively toward a shared vision of delivering a superior experience.
Patient-centric care should be a team's unifying factor as it epitomizes modern medicine in the 21st century and has the ability to empower our organizations to deliver the highest quality care.
Starting from the ground up
The ideal surgical team isn't just a collection of surgeons, but a group of constantly collaborating professionals – from the scrub nurse to the medical assistant to the perfusionist using the heart-lung machine – who maintain compassion for the patient as a primary focus.
For the patients I see every day, experiencing a cardiovascular problem – like almost every medical issue – can be life-altering and cause immeasurable amount of stress. It is for this reason that patients need to experience compassion from the time they call to make their first appointment until the patient is fully recovered, which can be months – even years – down the line.
Research has proven that patient satisfaction is linked to the cohesiveness of your team.2 Therefore, it is important for every member of the team to communicate with one another – and, possibly more importantly, feel comfortable communicating with each other – or it impacts the entire team's ability to function.
Three essential traits
In my experience, there are three key traits that every team member must have to foster a team-based environment:
1. ACTIVE LEARNING: On my team, every member participates in regular trainings to ensure we're on the same page with both new and tried-and-true technologies, practices and procedures.
We also hold monthly conferences where, in addition to establishing team goals, we discuss new technology, such as the MitraClip device being used for transcatheter mitral valve repair, and how it can benefit our patients. In fact, we encourage our surgeons to learn new tools and techniques; after all, the effectiveness of advanced medical technology is contingent upon the expertise of the surgical team. Providing education, training and tools is a central tenet – along with setting clear expectations and encouraging accountability – of the culture of safety established at Main Line Health.
2. EMOTIONAL INTELLIGENCE: Intelligence and skill are, of course, crucial. However, research suggests that being physically and mentally present with each patient, as well as being able to offer comfort and the precise information he or she needs, is key to developing patient trust.3
In all patient communications, team members must be calm and direct, yet compassionate. A surgeon is a human first and a surgeon second. Therefore, one must connect with his or her patients with this in mind, or that trust will never be established. Even a "minor" heart issue can be life-altering for the patient; therefore, everyone on the staff must be willing to treat each and every patient with their unique emotions in mind.
3. RESPECT: Collaboration often requires a bit of modesty and realism. Each one of our surgeons is capable of performing the most complex cardiac procedures. However, our surgeons must be willing to admit that a fellow surgeon may be better-suited to provide a patient with the specific treatment and care he or she needs, such as a minimally invasive aortic valve replacement. With Gallup research on employee efficiency finding that people who use their strengths every day are six times more likely to be engaged, allowing individual team members to focus on their areas of expertise is an obvious choice that benefits our patients first and allows our surgeons to refine their talents.
A key factor in determining how a surgeon will fit on your team is by the way he or she manages the operating room during surgery. You learn a lot about surgeons' skills when a procedure goes as planned. However, you learn even more – and truly separate the elite doctors from the very good ones – by how they handle themselves in the face of unforeseen complications.
On our team, we aim to treat our operating staff as valuable partners in care. If a surgeon is not able to do this, he or she will never be able to treat the patient with the necessary levels of equality and compassion. The need to communicate openly and comfortably with each other, as previously mentioned, is not just important for efficiency and accuracy, but essential for enabling collaboration.
Of course, none of these traits can replace or compensate for the exceptional level of physical skill and mental fortitude required for surgeons to successfully perform complicated procedures. No matter how skilled a surgeon is, great interpersonal skills and a teamwork-focused approach are essential to earning – and maintaining – a spot on our team.
Success of this approach in cardiovascular surgery
Since I arrived at Main Line Health's Lankenau Heart Institute nearly three years ago, building a team with these characteristics has been my uncompromising focus.
When patients come to my practice, they see specific cardiac surgeons based on their individual needs, not necessarily based on the internal structure or any sort of political hierarchy within the practice. Therefore, it's important for a cardiovascular surgical team to be built around a wide breadth of individuals with varying expertise. Our team features experts who focus on serving a broad range of our patients' cardiovascular needs, including aortic aneurysm surgery, aortic valve repair and replacement, mitral valve repair and replacement, coronary artery bypass and robotic surgery, trans-catheter valve replacement surgery and heart failure surgery.
On top of that, each of our surgeons specializes in minimally invasive techniques, which require an added level of expertise and have been proven to result in increased safety, decreased scarring, faster recovery and decreased length of hospital stay.4 The success of our program is evident from our volume of work, with nearly a thousand minimally invasive operations in 2015.
In sports terms, our team is made up of multiple Michael Jordans, superstars through their individual skills and experience. When you combine that with their ability to collaborate, communicate, respect each other and prioritize patient needs, they form an impressive dream team. This provides the continuum of care our patients need for a successful outcome.
Having a high-quality staff that feeds off of collaboration and support for each other and our patients, allows us to push boundaries. For example, we're able to perform about 80 percent 79.5% of our coronary artery bypass surgeries off-pump, compared to the nationwide average of 13% percent. Additionally, our 2015 mortality rate for both minimally invasive aortic and mitral valve surgery was zero percent.
In addition to improving patient care and making it easier to recruit quality experts, assembling and maintaining a top-notch team focused on interpersonal relationships, communication, learning and honesty will inspire other members to keep improving and contribute to the greater goals of the team.
Medical advancements and patient expectations are continually evolving. But if you assemble an incredible team based on the tenets outlined above, you will be one step ahead in keeping up with those changes and providing the personalized, safe and high quality to the patients you serve.
1 “Recruiting Social Media”: https://books.google.com/books?id=B4JrTBZy-hwC&pg=PT39&lpg=PT39&dq=harris+interactive+tact+knowledge+systems+67%25+colleagues&source=bl&ots=Z67pF8lI1M&sig=9zwnCx4I2OZCS7VrOPnTbC9rUaI&hl=en&sa=X&ved=0ahUKEwjBq5-fxPHNAhVJ1R4KHZi7DcoQ6AEIHDAA#v=onepage&q=harris%20interactive%20tact%20knowledge%20systems%2067%25%20colleagues&f=false
2 Journal of Services Marketing: http://www.emeraldinsight.com/doi/abs/10.1108/08876040310501232
3 Ethics and Information Technology: http://link.springer.com/article/10.1007/s10676-004-4591-7
4 American Institute of Minimally Invasive Surgery: https://www.aimis.org/benefits-of-minimally-invasive-surgery
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