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Through the development of effective relationships with unit-based colleagues and other members of the healthcare team, the best possible outcome is achieved for the patient and family.

In this Chapter

  • Stopping a moving train

  • Listening even when it is hard to hear

  • Setting the stage for effective learning

  • Rallying support

  • Laughing through the rough patches


For many years, teamwork and collaboration addressed creating a positive work environment. Over the past decade, the role of teamwork and collaboration in quality and safety has brought new prominence (IOM, 2000, 2001, 2004; JCAHO, 2008) to the importance of a healthy environment of care. The narratives that clinicians at Massachusetts General Hospital (MGH) have written reflect how teamwork and collaboration are not only a critical theme in their personal development, but also how each clinician develops in his or her own comfort and approach to being part of a team.

Narratives—Entry Level of Practice

In their academic preparation, advanced beginners or Entry-level clinicians learn the value of teamwork and collaboration; yet, as they enter into practice, they often feel ill-prepared. Becoming a member of the team requires them to recognize and understand the various roles of the team members and to gain the confidence and credibility necessary to collaborate. Narratives at this stage often reflect the clinician’s challenge of trying to fit in with the team. In unbundling the narratives, colleagues and leadership are able to dialogue with the clinician about each team member’s role and how they can assist the novice clinician in addressing patient needs.

Narratives—Clinician Level of Practice

At the competent or Clinician level, the clinicians’ narratives reflect their comfort in becoming part of the team and participating in interdisciplinary forums. Their narratives reflect the value they have for the team and openness to addressing issues and concerns with members of the team, though often they require the backup of others. In these narratives, it is possible to help the clinicians identify opportunities to further understand their role and work with other members of the team in accomplishing patient, professional, and organizational goals.

Narratives—Advanced Clinician Level of Practice

Narratives at the proficient or Advanced Clinician levels reflect a clinician who is known by other members of the team as someone who is knowledgeable and skilled, who seeks out opportunities to collaborate, and who is increasingly comfortable managing conflict. The ability to manage conflict at this level and the expert (Clinical Scholar) level reflects commitment to creating a healthy work environment in which all members are heard and respected—even when in disagreement.

Narratives—Clinical Scholar Level of Practice

Clinicians’ narratives at the expert or Clinical Scholar levels reflect their confidence and authority in working ...

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