Friday, August 28, 2015

Preconference Tidbit #2 - True Collaboration
by Sean Garcia


"Tidbit #2" was written by Sean Garcia, an attending hospitalist in San Antonio. You will meet Sean at the meeting.

The idea of sending "Tidbits" began with Sean.
Sean wrote,

            I have learned so much after this past month of Collaborative Care, it would be hard to share in just one e-mail, so I am going to share what I have learned in daily tidbits. Thank you for being there with me on this exciting journey!  It has not been easy, but no process of growth ever is.

Tidbit #2 (Sean Garcia) Lessons Learned -- My big A-ha moment last week

Dear All,

            Last week I had a huge revelation. It occurred after to me after we rounded on a patient. The whole team was present and the routine was followed. The patient’s daughter was present and the plan was relayed. Everything was smooth and almost rehearsed. All of the elements seemed to have been followed, just like clockwork. Sounds like a successful collaborative rounds, right? Wrong! Why? Because the plan was told to the patient and his daughter without much interaction. Many of the people in the room nodded in agreement but did not participate. Other people in the room had their hands crossed and appeared bored. The family asked questions of the intern, but only after everyone left the room. This was more of a higher level traditional rounds where the plan is decided in advance and relayed to the patient and family. By traditional rounding standards this encounter met a very high level, but missed the spirit of collaboration.

 Contrast this with another patient who was telling us about her fears about having her leg amputated. Everyone in the room was moved by her story. An intern, who was not involved in her care, offered her sympathy and hope. Another intern offered her knowledge about prosthetics in injured veterans.  Many people in the room were moved to tears. The energy in the room was palpable. This was an example of true collaboration. 

True collaboration occurs when everyone is present, there is no hierarchy, and ideas are freely solicited and expressed. Collaboration can generate creative ideas and provide powerful support. However, collaboration does not automatically happen by having all the right professionals in the room; it requires a functioning team. We have to think about how to foster this kind of teamwork.  

I welcome your thoughts on this. 


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