T E AC H Chapter 4
Making Teams Work in Your Setting
I
started the book with a description of what I call a bad team in a large teaching hospital. I propose that this type of team is bad because it is ineffective and in many cases leads to increased frustration and fatigue for providers. While there are many bodies to assist, there is only one person capable of effectively guiding the team, thus carrying all the weight. There are many healthcare delivery settings besides an academic hospital, so in this section, I will describe my experiences in other settings so we can explore how effective teaming could work in each one.
Community Hospitals In contrast to a large teaching hospital, community hospitals in my experience are more likely to foster an effective team model. I have had the opportunity to work in varied hospitals with as few as twenty beds to as many as six hundred. Some have been located in rural towns and some in large cities; some were for-profit, some not-for-profit, and some publicly run. Let’s imagine a scenario where I am the staff hospitalist physician at a community hospital. The team there is smaller, yes, but I have found that to be beneficial, in part because everyone understands their role, and their responsibility is clear. In addition to me, there are perhaps an advanced practitioner (physician assistant or nurse practitioner), the nurses, aides, the social worker and case managers, and the unit clerk. I may even have a scribe to assist with recording in the EHR. 57
