Action 5.05

To deliver comprehensive care that is safe and continuous, effective communication and teamwork are critical. Implement this action with consideration of the requirements of the Communicating for Safety Standard.

A substantial proportion of potentially preventable adverse events are underpinned by failures in communication and teamwork.^1-5 Given the complexity of health care, teams and clinicians may change regularly or over time, depending on the needs of the patient.^6,7 Improvements in multidisciplinary collaboration and teamwork have been associated with outcomes such as reduced length of stay⁸, reduced risk of complications of medical care⁹ and reduced risk of surgical complications or death.¹⁰

Some Australian programs targeting improvements in multidisciplinary teamwork include:

• In Safe Hands (NSW Clinical Excellence Commission)
• TeamSTEPPS® – Team Strategies and Tools to Enhance Performance and Patient Safety (SA Health).

Although interventions to improve multidisciplinary teamwork and collaboration vary, there are consistent indications that structured tools and processes are necessary to achieve effective and lasting change.^11-13 

Work with local clinical teams to review current work processes, design or adapt relevant tools, and build the use of structured processes and tools into the workflow.

Consider providing formal teamwork and communication training.^14,15 Skills in communication, collaboration and team behaviours can be developed through simulation, workshops or lectures. Strategies to improve clinical communication are discussed in more detail in the Communicating for Safety Standard.

A substantial proportion of potentially preventable adverse events are underpinned by failures in communication and teamwork.^1-5 Improvements in multidisciplinary collaboration and teamwork have been associated with outcomes such as reduced risk of complications of medical care and reduced risk of surgical complications or death.^9,10 To deliver comprehensive care that is safe and continuous, effective communication and teamwork are critical. Implement this action with consideration of the requirements of the Communicating for Safety Standard.

Examples of tools and processes that can help to structure and facilitate effective teamwork are:

• Structured opportunities for multidisciplinary team communication
• The surgical safety checklist
• Evidence-based scoring systems, such as the Aldrete or PADDS score
• Structured communication tools such as ISBAR (see Action 6.07).

In a day procedure service, the multidisciplinary team may include the referring clinician, anaesthetist and nurse involved in delivering care for the patient.

Consider providing formal training in teamwork and communication.^14,15 Skills in communication, collaboration and team behaviours can be developed through simulation, workshops or lectures. Strategies to improve clinical communication are discussed in more detail in the Communicating for Safety Standard.

Examples of evidence

Select only examples currently in use:

• Policy documents or by-laws that outline structured communication processes that are used to ensure that members of the workforce understand their delegated roles and responsibilities when working as a multidisciplinary team
• Audits on clinical handover
• Employment documents that describe the roles, responsibilities and accountabilities of the workforce
• Organisational chart and delegations policy that show clinical governance reporting lines and relationships.

To deliver comprehensive care that is safe and continuous, effective communication and teamwork are critical. MPSs and small hospitals will need to develop structured processes to support multidisciplinary teamwork and collaboration. Implement this action with consideration of the requirements of the Communicating for Safety Standard.

A substantial proportion of potentially preventable adverse events are underpinned by failures in communication and teamwork.^1-5 Improvements in multidisciplinary collaboration and teamwork have been associated with outcomes such as reduced length of stay⁸, reduced risk of complications of medical care⁹ and reduced risk of surgical complications or death.¹⁰

Teams and clinicians in MPSs and small hospitals are likely to change regularly as agency or locum clinicians come and go. This poses a challenge to effective teamwork. There are consistent indications that structured tools and processes are necessary to achieve effective and lasting change.^11-13

Examples of tools and processes that can help to structure and encourage effective teamwork include:

• How-To Guide: Multidisciplinary rounds (Institute for Healthcare Improvement)
• Structured interdisciplinary bedside rounds (In Safe Hands program)
• Multidisciplinary meetings and case conferencing (Cancer Australia; this information was developed for cancer service providers, but much of the content is relevant more broadly)
• Standard Operating Protocols for Implementing Whiteboards to Assist with Multidisciplinary Communication on Medical Units (the Commission).

Work with clinicians to review current work processes, design or adapt relevant tools, and build the use of structured processes and tools into the workflow.

Consider providing formal teamwork and communication training.^14,15 Skills in communication, collaboration and team behaviours can be developed through simulation, workshops or lectures. Strategies to improve clinical communication are discussed in more detail in the Communicating for Safety Standard.