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The article, titled “Importance of Good Teamwork in Urgent Care Services”, makes reference to a case study to investigate the topics of teamwork and communication in a London emergency department (ED) resuscitation unit, and also to draw conclusions regarding the factors that might inhibit and encourage effective communication, leadership, interaction and collaboration among team members (Meier, 2014).
As demonstrated in this paper, the article provides valuable insights into how teams in the healthcare setting operate, the common types of communication failures among team members, as well as how frequent communication failures within an organization impede performance and lead to poor quality of patient care.
Purpose/Type of Team
The team discussed in the article is an ED resuscitation unit consisting of “a senior medical consultant, an anesthetist, a junior doctor, a band five nurse, two nursing students and a healthcare assistant (HCA)” (Meier, 2014, p. 33). The purpose of the team, it seems from the case scenario, is to share complementary skills and work collaboratively with the view to addressing emergency medical cases at the ED resuscitation unit.
In the case study, this team is charged with the responsibility of providing care to a 67-year old man suffering from cardiac arrest. The word “team” is described in the literature as “a distinguishable set of two or more people who interact dynamically, interdependently and adaptively toward a common and valued goal, objective or mission, and who have each been assigned specific roles or functions to perform” (Meier, 2014, p. 32).
The reviewed article is definite that effective and efficient teams are essential, particularly within high-pressure environments such as EDs, as patients’ care and treatment outcomes are sorely dependent on actions are taken in minutes or even seconds.
The article is also definite that effective teams not only lead to high patient satisfaction and enhanced staff innovation but also minimize stress levels and facilitate communication among members within the healthcare setting (Meier, 2014). This view is reinforced in the literature by Hunt (2014), who acknowledges that effective teamwork in practice teams aids performance, productivity, work satisfaction as well as superior patient care and treatment outcomes.
The article discusses at length the importance of communication as the gel that holds effective teams together in the healthcare setting. Indeed, the author is clear that members of a resuscitation team must develop the capacity to communicate openly about their actions, findings and concerns about clinical or safety issues, not mentioning that they must have the competency to give feedback and review whether they have accomplished their objective regularly (Meier, 2014).
Feedback and review can only be necessitated through effective communication (Hunt, 2014), hence its importance. The article is definite that feedback through effective communication improves members’ self-awareness, encourages the more dominant members to listen more and the quieter members to become more vocal, and also opens avenues to the team members with concealed abilities whose opinions may otherwise remain unexpressed (Meier, 2014).
The article investigates and analyses several instances where communication failures were experienced amongst members of the ED resuscitation unit as they attempted to address the patient’s care concerns. Their first communication failure revolved around the inability of team members to open up and state their interests and perceived contributions.
It is reported that “although the first nursing student in the case study observed the patient’s warming therapy from start to finish, he was reluctant to bring it to the attention of the team leader” (Meier, 2014, p. 34). As a direct consequence of this communication failure, initiation of mild therapeutic hypothermia, the universally agreed-upon standard in the circumstances highlighted in the case study, was ultimately delayed.
According to Hunt (2014), such a communication failure is caused by a perception that some members of the team are more qualified than others, hence the fear to voice persistent concerns. Available literature demonstrates that effective communication within a group is adversely affected when members form sub-units or sub-groups and communicate along with these units instead of engaging the team (Hunt, 2014).
In the reviewed article, it is evident that “the second nursing student and a healthcare assistant (HCA) formed a sub-unit in the team that was not verbally accountable to the team for their actions” (Meier, 2014, p. 34). The evolution of sub-units within the team represents the second communication failure, as it created a communication breakdown that saw the two members failing to voice their intention to warm the patient, an obsolete medical procedure that could have had an adverse consequence on the patient’s neurological outcome.
Communication challenges in the article are also represented by the failure of senior members of the team to offer direction and expert knowledge to the junior members. In the case study, it is reported that “the anesthetist had expert knowledge but provided little direction for other team members, who acted on their initiative” (Meier, 2014, p. 35).
Failure to provide direction using effective communication strategies creates knowledge gaps amongst team members, which in turn lead to ineffective treatment and time-wasting. Another communication failure reflected in the article revolves around lack of verbal acknowledgment amongst team members on their aims and objectives, leading to disharmony in the processes and procedures that could have been used to ensure the patient received quality care (Meier, 2014).
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Indeed, the case study is precise that the resuscitation team members should have verbally acknowledged that their aims were to prepare the patient for care in an intensive care unit (ICU), ensure he was sedated and had central venous access, and induce in him a therapeutic temperature of between 32°C and 34°C. This way, the team members attending to the patient could have saved critical time, employed minimal hospital resources as well as put the patient at less risk, particularly in terms of dealing with associated complications (Hunt, 2014; Meier, 2014).
Consequences of Communication Failure
Drawing from the above elaboration, it is evident that the effects of communication failure are many and varied. The author of the article is clear that “lapses in teamwork and poor communication can result in adverse events ranging from retained foreign objects to perinatal events and medication errors” (Meier, 2014, p. 32).
An analysis of the communication failures demonstrates that such an orientation impedes the team’s performance and delivery of quality of care, with consequences ranging from death of patients and lack of team efficiency to wastage of time and hospital resources, lack of awareness or appreciation of others’ roles, conflicts of interest, isolation of team members, delay in treatment processes, and lack of trust among members.
The reviewed article has demonstrated the cardinal importance of teamwork and effective communication in the healthcare setting, not mentioning that it has effectively highlighted several communication failures that occur in the team context as well as their consequences. Overall, it is essential for healthcare professionals to ensure the effectiveness of teams and communication not only to facilitate their performance but also to ensure the delivery of quality care to patients.
Hunt, K. (2014). Communicating with the practice team. Practice Nurse, 44(10), 36-46.
Meier, C. (2014). Importance of good teamwork in urgent care services. Emergency Nurse, 22(7), 32-36.