Collective Competence for Sustainable Interdisciplinary Teamwork
In recent years, there has been a greater focus on teamwork for improving patient care with an emphasis on building communication skills, both at the department level and across disciplines. A recent study entitled “How Communication ‘Failed’ or ‘Saved the Day’: Counterfactual Accounts of Medical Errors,” concluded that in “64% [of medical error] accounts [studied], communication played a prominent role.”1 A research project titled “Falling through gaps: primary care patients’ accounts of breakdowns in experienced continuity of care,” “found that experiences of gaps in care were common and arose from failures in communication and coordination of care.”2 Heightened awareness for the importance of prioritizing interdisciplinary communication is imperative for healthcare organizations, but implementing programs that facilitate sustainable collaboration is often met with tremendous challenges. Of particular significance is the need to integrate competency-based education with contextually relevant interdisciplinary communication.
There is consensus within academic literature stating that “Competence is generally defined as consisting of integrated pieces of knowledge, skills, and attitudes”3 that are considered a “prerequisite for adequate functioning on the job.”4 According to the article “Transforming the Workforce From Individual to Collective Competence,” “Competency management is defined as ‘a dynamic process designed to support ongoing assessment and evaluation of performance’ [however] . . . in the current complex healthcare environment . . . [organizations are] challenged to design and create efficient and effective processes that assess and evaluate competence.”5 The article further explains that “Competent individuals can provide incompetent care if they are not able to function as a team.” Additionally, “currently, many competency validation processes focus on the individual’s ability to perform a skill or task without considering one’s ability to perform within the context of the specific environment or practice setting while working within a team.”5
A reference to “principles of collaborative communication” in a recent article “Collaborative Conversations in Patient Care” states, “The Interprofessional Education Collaborative (IPEC) addresses the need to prepare healthcare professionals by developing core competencies for interprofessional collaboration while providing safe, high-quality healthcare.”6 In addition, the “IPEC provides education, tools, and resources to universities, healthcare institutions, and government agencies. It recognizes the need for communication, teamwork, mutual respect, shared values, and an understanding of the scopes of practice between providers.”6 To drive the point further, the authors cite the following reference:
According to the American Nurses Association (ANA) and the American Organization of Nurse Executives (AONE), “Communication, particularly in high-intensity environments such as health care, is not merely the transaction of words. Effective communication requires an understanding of the underlying context of the situation, an appreciation for the tone and emotions of a conversation, and the accurate information.” Healthcare settings can be stressful, highly charged environments, increasing the need for collaboration. Collaborative conversations allow members of the healthcare team to think creatively, understand the desired outcomes, make decisions, develop solutions, define a shared process, disagree without arguing, and reduce conflicts.6
A reference in the recent article “Collective competence: Moving from individual to collaborative expertise” states that, “Making collective sense of events in the workplace; developing and using a collective knowledge base; [and] developing a sense of interdependency” are “three fundamental elements” of the collective competence theory.7
Collective or team competence does not simply represent a collection of individual professionals who demonstrate competency, as defined by their professional organizations. Rather, collective competence is situated within a network of complex interactions among clinicians, the patient and family members, and the organizational setting, and is markedly contextualized.7
While surveyors are increasingly requesting to see documentation that healthcare organizations are managing staff competencies, there is little standardization as to what specific documentation criteria should entail. Many sterile processing departments do not have the supportive infrastructures that are necessary to effectively and consistently conduct, let alone maintain, the competence and professional development of their technicians at the individual level. Therefore, an industry shift must occur to leverage the power of competence-based education that facilitates the development of collective department-level competence if interdisciplinary teamwork can be a reality in the perioperative setting.
- Street, Richard L., John V. Petrocelli, Azraa Amroze, Corinna Bergelt, Margaret Murphy, J. Michael Wieting, and Kathleen M. Mazor. 2020. “How Communication ‘Failed’ or ‘Saved the Day’: Counterfactual Accounts of Medical Errors.” Journal of Patient Experience, pp. 1247–1254. https://doi.org/10.1177/2374373520925270.
- Tarrant, Carolyn, Kate Windridge, Richard Baker, George Freeman, and Mary Boulton. 2015. “Falling through gaps: primary care patients’ accounts of breakdowns in experienced continuity of care.” Family Practice, Volume 32, Issue 1, pp. 82–87. https://doi.org/10.1093/fampra/cmu077.
- Baartman, Liesbeth K.J., Elly de Bruijn. 2011. “Integrating knowledge, skills and attitudes: Conceptualising learning processes towards vocational competence.” Educational Research Review, Volume 6, Issue 2, pp. 125–134. ISSN 1747-938X. https://doi.org/10.1016/j.edurev.2011.03.001.
- Matus, Janine, Sharon Mickan, and Christy Noble. 2020. “Developing occupational therapists’ capabilities for decision-making capacity assessments: how does a support role facilitate workplace learning?”Perspectives on Medical Education 9, 74–82. https://doi.org/10.1007/s40037-020-00569-1.
- Franqueiro, Tammy, Michelle King, and Debbie Brown. 2017. “Transforming the Workforce From Individual to Collective Competence.” The Journal of Continuing Education in Nursing, Vol. 48, No. 10, pp. 440–441. https://doi.org/10.3928/00220124-20170918-02.
- Kroning, Maureen and Sara Annunziato. 2020. “Collaborative conversations in patient care.” Nursing, January 2020, Volume 50, Issue 1, pp. 58–60. https://journals.lww.com/nursing/Citation/2020/01000/Collaborative_conversations_in_patient_care.16.aspx.
- Langlois, Sylvia. 2020. “Collective competence: Moving from individual to collaborative expertise.”Perspectives on Medical Education 9, pp. 71–73. https://doi.org/10.1007/s40037-020-00575-3.
Lisa M. McKown (Wakeman), MBA, CRCST, CIS, CHL, MBTI, is a manager of research and development for Beyond Clean. She graduated with a Bachelor of Science degree in Integrative Leadership and an MBA from Anderson University. Lisa is a doctoral student in the Richard Fairbanks School of Public Health: Global Health Leadership program through IUPUI in Indianapolis, IN. She also holds a certification as a Meyers-Briggs Practitioner, specializing in interpersonal communication. Lisa contributes as an SME volunteer for standards development and other industry-related projects that promote the sterile processing profession, including writing workshops focused on creating and revising questions for the IAHCSMM certification exams. As a healthcare professional driven to influence positive change for patient safety initiatives, Lisa is a catalyst for the advancement of infection prevention within sterile processing. Her passion is education and she is energized when she can use her experience to develop people.
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