10 Tips for Emergency Medicine-Hospital Medicine Collaboration

Posted on Wed, Jan 13, 2016
10 Tips for Emergency Medicine-Hospital Medicine Collaboration

By Ginger Wirth, RN

According to Merriam-Webster, the full definition of collaborate is:

  1. To work jointly with others or together, especially in an intellectual endeavor
  2. To cooperate with or willingly assist an enemy of one's country and especially an occupying force
  3. To cooperate with an agency or instrumentality with which one is not immediately connected

I know that collaboration in healthcare can sometimes seem like assisting another country. The relationships between departments, disciplines, practices and partners have both rewards and challenges. Collaboration is key on so many levels to achieving the best outcomes and delivering the overall best care for patients. This is essential between nursing and providers in the emergency department when planning and executing care. Effective communication and collaboration plays into the safety, clinical quality and satisfaction of each patient’s visit.

Another important collaborative relationship is the emergency physician and the hospitalist. Continuity of care and the handoff of the admitted patient are essential to those same aspects of the patient’s overall experience: safety, satisfaction and clinical quality. This collaboration should happen not only when directly dealing with a patient, but also when processes, order sets or clinical pathways are being developed and reviewed. Healthcare is unique in the fact that we have governing and regulatory bodies that have standards, guidelines and measures that set basic expectations for outcomes. However, ultimately it is the provider-to-provider relationship and collaboration where the “magic happens.” Strong relationships among emergency medicine and hospital medicine teams have proven not only to meet standards but exceed them. Best practice is to have regular team meetings between these specialties to discuss opportunities and share the wins and outcomes of cases. Again, strong collaboration is a “win-win” for all – especially for the patients to which we provide care.

10 Lessons in Collaboration

Regardless of your industry, collaboration is so important. Here are some tips from Deborah B. Gardner PhD, RN, CS:
  • Lesson #1: Know thyself. Many realities exist simultaneously. Each person's reality is based on self-developed perceptions. Requisite to trusting yourself and others is in knowing your own mental model (biases, values, and goals).

  • Lesson #2: Learn to value and manage diversity. Differences are essential assets for effective collaborative processes and outcomes.

  • Lesson #3: Develop constructive conflict resolution skills. In the collaborative paradigm, conflict is viewed as natural and as an opportunity to deepen understanding and agreement.

  • Lesson #4: Use your power to create win-win situations. The sharing of power and the recognition of one's own power base is part of effective collaboration.

  • Lesson #5: Master interpersonal and process skills. Clinical competence, cooperation and flexibility are the most frequently identified attributes important to effective collaborative practice.

  • Lesson #6: Recognize that collaboration is a journey. The skill and knowledge needed for effective collaboration takes time and practice. Conflict resolution, clinical excellence, appreciative inquiry and knowledge of group process are all life-long learning skills.

  • Lesson #7: Leverage all multidisciplinary forums. Being present both physically and mentally in team forums can provide an opportunity to assess how and when to offer collaborative communications for partnership building.

  • Lesson #8: Appreciate that collaboration can occur spontaneously. Collaboration is a mutually established condition that can happen spontaneously if the right factors are in place.

  • Lesson #9: Balance autonomy and unity in collaborative relationships. Learn from your collaborative successes and failures. Becoming part of an exclusive team can be as bad as working in isolation. Be willing to seek feedback and admit mistakes. Be reflective, willing to seek feedback, and admit mistakes for dynamic balance.

  • Lesson #10: Remember that collaboration is not required for all decisions. Collaboration is not a panacea, nor is it needed in all situations.

To read more about emergency medicine-hospital medicine integration and collaboration, read our recent white paper, “Integration Changes Everything.”

Ginger Wirth

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.

Beth Boynton
Excellent post and tips! Following this advise will have a positive influence on every single issue we face in healthcare! This blogpost is a great example of an ED doctor who exemplifies these tips in his practice!
1/30/2016 6:39:15 AM