美国国家公共电台 NPR Teaching Medical Teamwork Right From The Start

Teaching Medical Teamwork Right From The Start

DAVID GREENE, HOST:

In health care, they say it's all about the team - doctors, nurses, others working together to treat patients. But for the most part, they still train separately. Well, in Cleveland, two big health organizations are trying to create a structure that encourages teamwork. Julie Rovner has the story.

JULIE ROVNER, BYLINE 1: There is a new building going up on the campus of the Cleveland Clinic, a really big building.

RUSS SAGHY: The skylight that we're standing 2 under will eventually cover the area of an entire football field.

ROVNER: That's Russ Saghy, who oversees 3 construction projects for the Cleveland Clinic. He's talking about the new Health Education Campus for Case Western Reserve University. It's a joint 4 project of the clinic and the university to the tune 5 of half a trillion dollars.

The building eventually will provide eight and a half football fields' worth of space and house four separate training programs - the Case Western medical, nursing and dental schools and the Cleveland Clinic's own in-house medical school. It's a move that reflects a change in the nature of medical care itself.

JAMES YOUNG: Health care is no longer a gladiatorial sport where you had the one health care provider, you know, mano a mano, one on one battling a disease.

ROVNER: That's James Young, who heads the Cleveland Clinic school of medicine. He says medicine in the 21st century has become so complex that teamwork is a necessity.

YOUNG: I'm involved with heart transplantation and mechanical devices for the heart. Boy, you can't do it by yourself.

ROVNER: The new building is actually the culmination 7 of ongoing 8 efforts at Case to train its health care teams together. For years now, it's been bringing together students from medicine, nursing, dentistry, social work and public health. For example, the university has a free oral health clinic that puts dental and nursing students side by side treating patients.

Carol Savrin, an administrator 9 at the Case nursing school, says the various health schools also have joint projects around specific health problems - obesity 10, for example and pain.

CAROL SAVRIN: We all have to deal with pain, whether it's dentists or social workers or nurses. So they're taking a common thread and coming at it from a variety of different angles.

ROVNER: Students from all the disciplines also come together twice a year for mandatory 11 workshops, where they role-play through various patient scenarios 12. Scott Wilkes, an assistant dean at the Case Western school of social work, says this generation is particularly well-suited to teamwork.

SCOTT WILKES: They get it. When they're in the room together and they're talking with one another, they understand how important this is.

ROVNER: That's a good thing because efforts to train doctors, nurses and other health care professionals together haven't always produced the best results. In many cases, students have been just as quick to adopt stereotypical 13 roles as their more-trained elders are, says Wilkes.

WILKES: I think that they come in with some preconceived or stereotype 14 notions of what a doctor - a social worker is.

ROVNER: Yet, Patricia Thomas, a vice 6 dean at the Case medical school, says closer knit teams are necessary, among other things, for preventing medical mistakes.

PATRICIA THOMAS: The root of many of our errors had to do with the fact that our professions were not working effectively together for patient care.

ROVNER: Thomas concedes that no one is exactly sure how to train health professionals effectively to work in teams.

THOMAS: It's true. We don't have a great evidence base for what works.

ROVNER: But having students cross paths, not just in their formal schooling 15 but in more relaxed areas of the new building, will foster the team spirit they're trying to build, says nursing administrator Savrin.

SAVRIN: It needs to be reinforced. So we can teach these people about each other in year one, but they need to keep reinforcing that throughout the four years of their education.

ROVNER: The first students are scheduled to move to the new building in 2019. I'm Julie Rovner.

GREENE: Julie Rovner is with Kaiser Health News.