Team Working in Healthcare Communication and the use of metaphor

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Team Working in Healthcare Communication and
the use of metaphor

• Jan Mitcheson
• Programme Associate
• CDHPP University of Leeds

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Teamwork in Healthcare

• Effective team working leads to
• Reduced hospitalisation and costs
• Improved service provision
• Enhanced patient satisfaction
• Increased staff motivation
• Innovation
• And
• Effective teams kill less patients
• (Borrill 2001)

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Poor Team Working

• Bristol Royal Inquiry (2001)
• failure of communication
• Victoria Climbie Inquiry (2003)
• dreadful state of communications
• Silence Kills (AACN 2004)
• 75 concerned about poor teamwork
• 60 of errors in medication are caused by
  mistakes in interpersonal communication

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Two Important Factors

• Clear Leadership
• Effective Communication

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Importance of Communication

• An important component of team working is
  building shared understanding of the work and
  appropriate processes for delivering high quality
  patient care
• Borrill et al 2001
• Less than 1 in 4 healthcare teams build
  effective communication and team working practices

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• What do these have in common?

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The essence of a metaphor is understanding and
experiencing one kind of thing in terms of
another George Lakoff and Mark
JohnsonMetaphors We Live By
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• How do you see yourself ?

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If your team was a car which part of it are you?
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What metaphors can do

• enable you to think something different
• help you see and talk about issues in new ways
• bring new insights
• make complex issues easier to understand
• develop shared understanding
• create new energy through positive images

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Lessons from Geese
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More lessons from Geese

• When a goose falls out of formation, it feels the
  resistance of flying alone. It quickly moves back
  into formation to take advantage of the lifting
  power of the bird immediately in front of it
• Lesson we need to stay in formation with those
  headed where we want to go. Strength and safety
  in numbers
• When the lead goose tires, it rotates back into
  the formation and another goose takes the lead.
• Lesson It pays to take turns doing the hard
  tasks and sharing leadership. People are
  interdependent on each other's skills,
  capabilities and unique talents and resources.
• The geese flying in formation honk to encourage
  those up front to keep up their speed.
• Lesson We need to make sure our honking is
  encouraging. In groups where there is
  encouragement, the production is much greater.
• When a goose gets sick, wounded, or shot down,
  two geese drop out of formation and follow it
  down to help protect it. They stay with it until
  it dies or is able to fly again. Then, they
  launch out with another formation or catch up
  with the flock.
• Lesson we need to stand by each other in
  difficult times as well as when we are strong.

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