Dr. Felice Tilin
The healthcare industry no stranger to teamwork and has increasingly utilized inter-professional teams comprised of a diverse group of experts. Inter-professional teamwork is not limited to healthcare; interesting experiments can be found using inter-professional teams in other industries in their effort to bring higher quality results to projects. To understand some of the challenges these teams face illustra.tv approached Dr. Felice Tilin.
An Organizational Development professional, Author and Educator, Dr. Felice Tilin advises executives and executive teams in the areas of culture change, team effectiveness and leadership. Her recent work has been with the dynamics of inter-professional teamwork in healthcare and she carries many interesting insights for high performing team development. Her most recent publication is The Interprofessional Health Care Team: Leadership and Development (2013). We spoke with Dr. Tilin about inter-professional teams and some of her findings.
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i.tv: How are you defining inter-professional teams?
FT: Every professional group has a different name for these teams. They are commonly referred to as inter-professional, multi-disciplinary, inter-disciplinary teams. This is a concept that has been around for years. Simply stated an inter-professional team is a group of people trained in different professional disciplines that need to work together on one team.
In the nineties we saw members of various disciplines coming together with IT in order to create user friendly IT solutions. In the IT world it’s one thing to get a bunch of technology people together to solve a problem, but if you’re in a bank or an insurance company you’ve got to talk to the tellers and all the other people that are going to use the software on your team. How do you get the various teams, such as IT, Marketing, Research, etc. to be more functional as a team? They’re not even speaking the same language. These are diverse, heterogeneous teams. Less diverse, homogeneous teams form faster and get results faster however research shows that although heterogeneous teams take longer to form they produce more innovative and higher quality results.
The use of inter-professional teams has become really important in healthcare. If you need a team of people working together, good inter-professional teamwork can assure that a patient gets taken care of properly and safely. These teams are usually comprised of a physician, a nurse, marketing people, finance people, occupational therapists, social workers and so on. It can be quite a big mix of people, not only from different kinds of education but even different levels of education. So it’s challenging.
i.tv: Tell me more about the learning challenges these teams face.
FT: Our research has shown us that one of the biggest problems with these teams is that people are used to being experts in their own field. When you are used to being the expert you get used to people taking direction from you. Experts need to learn to become more open to learning, creating a learning environment and enabling members of a team to feel safe. When everyone is seen as an expert, team leadership can be likened to herding cats. Another challenge is that people on the team just aren’t speaking the same language, and I’m not talking English versus Italian, but the language as they apply it in their field. A social worker is talking about something in one way and the doctor is talking about the same thing in another.
I was just reading an article yesterday about how physicians talk about the same thing that a nurse will talk about, but they use different language. For instance, a physician says a patient is “hypoxic” while many new nurses learn to say “the patient has altered tissue perfusion.” (REFERENCE: What can nurses learn from doctors? By MEAGHAN O’KEEFFE, RN, MARCH 1, 2013).
Just the the fact that they come in using a different language tends to intimidate. As I was saying, it’s not a safe environment for people to learn in. After all, you’re supposed to be an expert, so you’re not really supposed to be asking a question. Quite often the environments for these teams aren’t set up so that there’s a culture of clarifying or ensuring understanding. These teams move very fast and everything needs to happen quickly. So agreeing on a common language is critical for team functioning. Just imagine that if you have five or ten people on the team, you’ve got five or ten different ways of saying the exact same thing in a way that is not understandable to some team members. Yet, very often team members are not comfortable asking each other questions because of this expert identity. People are coming in with their egos and being moved by their own biases.
i.tv: So when a team is formed, what kind of team training or preparation do they get to create a highly functioning team?
FT: The interesting thing is that they rarely get any team training. The need for this is one of the things that came out of our findings. There’s definitely a need for people to develop as leaders and to work in a diverse teams. They need to understand about power differentials and how to make a team a safe and functional unit. A lot of times people who traditionally see themselves as the leaders, like the physician, the executive, the Chief Nursing Office (CNO), do want to create the highly functioning team, yet team members and leaders need the skills to make the team an effective and safe learning environment. A good example of this comes from an interview we did with one CNO for our book.
He’s said, that in his entire 20+ year career he never knew the difference between a physical therapist and an occupational therapist, yet he’s been on multiple teams functioning with them. Finally, one day, he realized this when taking care of patients with this team. So he decided to make the move and ask. He found it so enlightening he couldn’t believe he’d spent 20 years not asking for a clear definition from the people he worked with. Imagine the amount of miscommunications result when we do not know the fundamentals of our team mate’s job functions!
This CNO didn’t leave the issue there. Realizing how important it was to make sure there was proper language understanding he got the entire team to agree on creating a glossary. In the process they were to ask each other what many different terms meant; this became part of their team building. From this they learned each other’s languages and agreed on how to talk about things.
In a more homogeneous situation where just about everyone is trained as an MBA for example, and there’s a common language throughout the organisation even for those without MBAs, then that’s the language everybody uses and understands. If you come in as an outsider you’ve got to learn it.
If you want to collaborate across disciplines, to create incredible things, you’ve got to be able to create a common language. It sounds so simple, but it really can have a big impact. Healthcare is a and industry embroiled a radical change process and effective healthcare teams are essential to the health and well being of our society. Shifting from an expert to a learning culture is really necessary. It’s a huge shift.
