As its subtitle makes clear, this is not a book about group psychology, collaboration theory, or research on health care delivery, although it is grounded in all of these. The editors invited clinicians to submit “short, concise narratives that describe a concrete example in which you personally have been involved.” They also sought personal reflections “that would enhance our understanding of either how to produce genuine teamwork or the obstacles that stand in its way.” The result is a compilation of lived experiences and astute observations from people on the front lines of patient care.
The editors provide just enough conceptual and theoretical background to give these essays clear context. Their definition of teamwork is largely based on the work of Harvard sociologist J. Richard Hackman. Collaborative Caring: Stories and Reflections on Teamwork in Health Care rests on several key themes, like notes on the bass clef on a sheet of music:
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Because humans make mistakes, health care is inherently risky.
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Clinical errors injure or kill thousands of patients every year...and increase the cost of health care.
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Patients and their welfare come first, always. (Or should.)
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Traditional health care providers work in professional silos and health professions education perpetuates this practice.
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Effective teamwork and clear communication are essential in order to improve quality and reduce costs.
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Teamwork requires psychological safety for all team members.
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The patient is a key player on the health care team.
Each of the eight sections in the book explores health care teamwork from a different perspective. Each begins with a brief introduction that sets the stage for the essays that follow, with a few supporting references from the literature.
The first section, “Playing on a Real Team,” relates success stories. At first, it seems the editors have started at the end rather than the beginning, but in reality, these stories say, “Look—it can be done!” before getting into the formidable challenges to developing high-functioning teams. Having seen in section one what great teamwork looks and feels like, the reader is brought back to typical reality in section two, with three examples of poor teamwork and its unpleasant results. And it is not just the patients who suffer; bad or nonexistent teamwork damages clinical caregivers, too.
The following sections talk about the patient as a team member, the necessity of psychological safety for team success, teaching and coaching, and collaborative patient advocacy. The penultimate chapter looks at the significant barriers to collaborative care, including traditional limitations and hierarchies in professional roles, time pressures, and limitations of health care reimbursement.
At heart, infusing collaboration and teamwork into the delivery of health care is about changing culture, and the last chapter, “Taking Teamwork Institution- and System-Wide,” reports several examples of such initiatives.
Collaborative Caring makes a compelling case for moving to a collaborative culture in health care, though that is hardly necessary. Other books and articles have done that, including Creating the Health Care Team of the Future: The Toronto Model for Interprofessional Education and Practice by Sioban Nelson, Maria Tassone, and Brian D. Hodges, reviewed in the April 2015 issue of the Journal of the Medical Library Association. (In fact, at least one contributor is from the Centre for Interprofessional Education at the University of Toronto.) What Collaborative Caring does, as the editors intend, is to show rather than tell how true teamwork can make the health care system be what it should be. It is the practical side of the collaboration coin, and it both informs and inspires.
Despite its large number of contributors, this book is fairly consistent in style and is very readable. Most of the essays are just a few pages long, inviting quick revisits once the book has been read. Unfortunately, the lack of an index makes it difficult to find specific information in the book. The text is remarkably free of editorial mistakes, and the occasional grammatical lapse is quite forgivable given the anecdotal nature of the essays. Suzanne Gordon, David L. Feldman, and Michael Leonard, who between them contributed five of the book's fifty chapters, have made an important contribution to the literature of collaboration in health care. This reasonably priced book should be required reading for anyone in a health professions education program and is strongly recommended for anyone already working in health. After all, as several of these stories show us, health care teams can and should include all of the workers who help to make our hospitals and health systems safe and effective.