CHSRF Knowledge Transfer Dave Clements and Janet Helmer

Teamwork in Healthcare: Pulling It All Together

elping health professionals work together better

H may seem like the holy grail of Canadian health-

care renewal; the solution is as elusive as the
quest is lengthy.
Indeed, the literature is chock-full of different characteriza-
tions of the problem and ways to fix it. Whether it’s the “total
quality management” of the 1980s or the more recently
fashionable approaches of “quality collaboratives” or “complex
adaptive systems,” the challenge remains the same from the
system perspective: How do we get health professionals to
collaborate in meeting shared objectives that improve care for
the patient? (Ovretweit et al. 2002; Plsek and Wilson 2001).
In Canada, the Health Council of Canada has identified
improving teamwork as a critical component to both accel-
erating system change, as well as improving human resource
management (Health Council of Canada 2005). There have
been a number of research grants to study the problem, as
well as federal and provincial efforts to enhance teamwork,
such as the 2004 Health Canada Initiative on Interprofessional
Education for Collaborative Patient-Centred Practice, which
developed an evolving framework to help accomplish the task.
For its part, the Canadian Health Services Research
Foundation (CHSRF) commissioned a team of researchers to
pull together the growing knowledge about the characteristics
of effective teams, the degree to which teamwork has already
been enhanced in Canadian healthcare settings and what can
be learned from successful interventions both in Canada and
abroad.
Teamwork in Healthcare: Promoting Effective
Teamwork in Healthcare in Canada (Oandassan
Improving teamwork in healthcare settings is a
et al. 2006) outlines the need for changes to current and long-standing concern across Canada’s
support effective teamwork at not only the healthcare systems.
practice level, but also the management and
policy levels. CHSRF is hopeful that this policy
synthesis and recommendations will contribute • Successful teams recognize the professional and personal
to the formal process of establishing effective teamwork in contributions of all members; promote individual develop-
Canada. ment and team interdependence; recognize the benefits
Key messages from the policy synthesis include the of working together; and see accountability as a collective
following points: responsibility.
• A healthcare system that supports effective teamwork can • The make-up and functioning of teams varies depending on
improve the quality of patient care, enhance patient safety the needs of the patient. The complexity of the health issue
and reduce workload issues that cause burnout among defines the task. The more interdependency needed to serve
healthcare professionals. the patient, the greater the need for collaboration among
• Teams work most effectively when they have a clear purpose; team members.
Illustration by Eric Hart.

good communication; coordination; protocols and proce- • Patients and their families are important team members with
dures; and effective mechanisms to resolve conflict when it an important role in decision-making. To enable patients
arises. The active participation of all members is another key to participate effectively, they need to learn about how to
feature. participate in the team; how to obtain information about

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 CHSRF Knowledge Transfer

their condition; and how each healthcare professional will

contribute to their care. Teamwork in Healthcare: Promoting
• Teams function differently depending on where they operate. Effective Teamwork in Healthcare in Canada
Teams in hospitals have clearly defined protocols and proce- can be found on CHSRF’s website: http://www.
dures, professional hierarchies and shared institutional goals, chsrf.ca/research_themes/workplace_e.php.
while teams in community-based primary care practices face
challenges related to the role-blurring in community settings. References
Health Council of Canada. 2005. Health Care Renewal in Canada:
This wide variety of settings and tasks means that transfer- Accelerating Change.
ability of processes is not always straightforward. It also Health Council of Canada. 2005. Modernizing the Management of
highlights the need for a common definition of “team.” Health Human Resources in Canada: Identifying Areas for Accelerated
• Teamwork is influenced by organizational culture. A clear Change. Report from a National Summit.
organizational philosophy on the importance of teamwork Oandasan, I., G.R. Baker, K. Barker, C. Bosco, D. D’Amour, L. Jones, S.
Kimpton, L. Lemieux-Charles, L. Nasmith, L. San Martin Rodriguez, J.
can promote collaboration by encouraging new ways of Tepper and D. Way. 2006. Teamwork in Healthcare: Promoting Effective
working together; the development of common goals; and Teamwork in Healthcare in Canada. Canadian Health Services Research
mechanisms to overcome resistance to change and turf Foundation.
wars about scopes of practice. Teams need training to learn Ovretweit, J., P. Bate, P. Cleary, S. Cretin, D. Gustafon, K. McInnes,
McLeod, T. Molfenter, P. Plsek, G. Robert, S. Shortell and T. Wilson.
how to work together and understand the professional role/
2002. “Quality Collaboratives: Lessons from Research (Organizational
responsibility of each member. They also require an effective Matters).” Quality and Safety in Health Care 11(4): 345–51.
administrative structure and leadership. Plsek, P. and T. Wilson. 2001 (September 29). “Complexity, Leadership,
• The larger policy context can promote teamwork by and Management in Healthcare Organizations.” British Medical Journal
323: 746–49.
providing consistent government policies and approaches;
health human resource planning; legislative frameworks to
break down silos; and models of funding/remuneration that About the Authors
Dave Clements is a senior program officer in CHSRF’s
encourage collaboration. Successful team interventions are
Knowledge Transfer and Exchange branch.
often embedded in initiatives working to improve quality of
care through better coordination of healthcare services and Janet Helmer is currently acting as CHSRF’s senior program
officer for the management of the healthcare workplace
the effective utilization of health resources with a focus on
research theme.
the determinants of health.

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