A Healthy Team Shows – Boston Children’s Hospital

Boston Children’s Hospital was literally buzzing with people yesterday. There were 5 greeters in red shirts there to meet us in the valet/handicapped area. At check-in the cheery nurse saw the unique attributes of both my nephews, being admitted for routine surgery, without any hesitation about their special needs and different body movements.

The surgery team (anesthesia, surgeon, nursing, etc.) knew of each other, referred to one another as “colleague” or “teammate.” There was only necessary duplication, and each person we spoke with seemed to know what had been discussed with a previous person, helping things go smoothly with no issues or unnecessary re-explanation. Every singe risk and possibility was discussed, but with simple human language, and an emphasis on what was likely to happen, not the many bad things that were unlikely to happen under general anesthesia.

Assisting my sister in getting both patients home from a day of surgery, with the right (6!) medications, post-op instructions, and two very out of it special needs adult men, was challenging, but overall very straightforward. The lasting impression I walked away with, other than relief that they were both going to be just fine, was that this organization has teamwork completely dialed-in.

Here are some of the striking aspects of the team behavior at Boston Children’s Hospital that stood out:

1. Each person knew their role, and seemed competent in it. Each of them explained their particular job in the context of their other team members; “I am the intern, working and learning from the Resident.”

2. In between the team members’ time with us, they were clearly communicating with each other, because information was shared easily and without endless duplication.

3. Each person, including the Doctor, knew my nephews’ names and made eye contact with them, suggesting a shared team value on patient focused care and humanity.

4. When there was a problem (delay) it was explained by real people, right away, and supported by the other staff without any hint of eye rolling or “throwing them under the bus” behavior, common in teams who don’t have each other’s backs. During less than perfect moments (vulnerability), the truth was named and the result was increased confidence for us, as customers.

5. I witnessed team members holding each other accountable at least twice with feedback that was positive and direct, with no visible shame or heat. There are so many things that can be missed in a busy surgery center, that clearly mistakes do happen, and team feedback prevents that eventuality. For example: one nurse said to another, “I noticed you had this plugged in here and I’m worried about tripping on the cord. “ Another person, an anesthesia tech, said to his boss, “Oh FYI I already got their history to help us make up some time.”

6. Trust seemed high, both in each other, and in the patients and their families. I did not feel a shred of talking down to or, “here you simple patient, are the written instructions,” so often common in medical situations, especially when children are involved.

7. The goal appeared crystal clear and shared: keep these two patients healthy and comfortable during their procedure (and keep the family engaged and informed) so that they can get home soon and safely.

I do not know exactly how the Boston Children’s Hospital medical and adjunct staff specifically focuses on working as a high a performance team, but I can say that whatever they are doing, it is working beautifully. My guess is that they pay specific attention to the relationshipsrolesaccountabilities, and results between them, while also focusing on their many tactical needs as a busy teaching hospital.

We hear from clients all the time that they are just so busy that their partnerships get short shrift. When I see a team like this, with stakes that are so very high (children’s lives,) I am profoundly aware that there is truly no excuse for poor teamwork. Teams must pay attention to how and what they do together. It matters, and when it is working well, it really shows.

Now, what else must I do this week to contribute to my own team’s health at Moementum?

Jim Morris