MSU Teaches Teamwork to Improve Patient Care and Safety

Teamwork is always important, but in the health care arena it can mean the difference between life and death.

Recognizing this, healthcare educators worldwide are exploring new ways to ensure that new healthcare professionals enter the workforce with the skills and knowledge they need to collaborate effectively on behalf of their patients.

The trend is called “interprofessional education,” and MSU is helping to pave the way.

“Health care has become much more complicated,” said Monica van de Ridder, an assistant professor in the Office of Medical Education Research and Development in the MSU College of Human Medicine. “Instead of a doctor and nurse at the patient’s bedside, it’s common now to have a team of subspecialists around the bed: respiratory therapists, pharmacologists, physical therapists, social workers and others.”

“Students who have been trained in interprofessional teams are more likely to develop the collaborative skills and attitudes needed for effective teamwork with other healthcare professionals,” van de Ridder added.

At MSU, opportunities for such learning abound. The university is home to a wide range of health professional programs, including two medical colleges: The College of Human Medicine, which prepares M.D.s, and the College of Osteopathic Medicine, which educates osteopathic physicians. In addition, MSU houses a College of Nursing, a School of Social Work and a biomedical engineering department. The MSU College of Veterinary Medicine opens up further opportunities for interprofessional collaboration.

“Students at MSU have opportunities not available at other institutions due to the sheer number and size of our programs and our collaborative culture,” said Mary Kay Smith, an assistant professor in the College of Osteopathic Medicine. “Our students benefit -- and ultimately, patients benefit.”

Smith serves as director of the MSU Learning and Assessment Center, a state-of-the-art hub for interprofessional education. With high-tech patient simulators and web-based simulations, the center allows students to tackle realistic clinical scenarios that train and test their communication, problem-solving and data collection skills.

Faculty teach and assess teamwork using a best-practice approach developed by the Department of Defense and the U.S. Agency for Healthcare Research and Quality known as “TeamSTEPPS” (for “Team Strategies and Tools to Enhance Performance and Patient Safety”). MSU faculty were among the first in the nation to become TeamSTEPPS master trainers.

In her research, van de Ridder has validated the effectiveness of such approaches. One of her latest papers, published this spring in the Journal of Interprofessional Education, emphasizes the importance of leadership support for interprofessional education, along with strong communication and cohesiveness among the individual professions.

Van de Ridder knows firsthand that even a relatively minor lapse in communication within or among teams can threaten patient safety and undermine a family’s confidence in their healthcare providers.

When her father was in the hospital at the end of his life, it was critical that he receive insulin before having a meal. The medical students who delivered his meals had not been told to check whether he had received insulin, however.

“We as the family noticed this, and realized that the nurses had not instructed the medical students,” van de Ridder said. “This was not good teamwork, and it could have been serious for my father. Knowing there was poor communication also made us, as the family, worry even more.”

Testimonials from former MSU students offer strong evidence that interprofessional education makes a difference.

A nursing graduate, for example, recently returned to MSU to thank Smith for teaching her “CUS,” a mnemonic for effectively expressing concerns regarding patient safety. CUS stands for “I’m Concerned; I’m Uncomfortable; and I believe this is a Safety issue.”

The nursing graduate followed that script in her first month on the job, when she found herself at conflict with more senior members of the health care team regarding a patient’s diagnosis.

The team believed the patient’s epigastric discomfort was due to acid reflux but based on dramatic changes in the patient’s blood pressure, the MSU-trained nurse sensed it was something more.

After she spoke up, the team ran more tests -- and the patient made it to the operating room in time for surgery to repair a potentially fatal aortic aneurysm.

“This former student told me she was very nervous, but because of the interprofessional training that she had at MSU, she felt comfortable standing up and advocating for the patient even with others who were more seasoned than she was,” Smith said. “She felt empowered to speak up, and the patient’s life was saved.”