Collaboration lessons from a crack clinical team

A story of one of my own high-point team experiences came up in conversation last week, prompting me to think about what lessons it might hold for other teams.

The Experience

It happened when I was working as an RN on a catch-all type unit. We took care of people having a variety of procedures who for whatever reason needed extended cardiac monitoring.?

A man approached me at the nurses’ station asking if I would check on his mother saying “something doesn’t seem right.” His voice was calm but concerned enough that I walked quickly to her room where I found her unresponsive. The heart monitor showed her pulse trending rapidly downward - 60, 40, 20 beats per minute.?

I couldn’t reach the emergency signal so I stepped into the hall and said “I need help in Room 3. Bring the cart.” By “cart,” I meant the crash cart you’ve seen in tv shows and movies containing the defibrillator and supplies for restarting someone’s heart. I did a 180-degree turn back into the room and repositioned the woman for CPR.?

None of my coworkers had been visible when I stepped into the hall. I hadn’t yelled because I didn’t want to frighten other patients and families. Yet I knew they would come. They arrived in seconds bringing the cart as requested. They even brought a couple extra nurses who happened to be on the unit.

I had taken for granted they would show up - and would know what to do when they got there. In retrospect, having seen so many other groups struggle to collaborate, I’ve often reflected on what made that kind of teamwork possible - and why it doesn’t happen more often?

Unfair advantages?

To be fair, we had a number of advantages.

Professional Homogeneity - Though ethnically diverse, we were a professionally homogeneous group.

• All RNs - so similar education and training
• We had all taken the Nightingale pledge - so similar commitment to serving others
• Everyone on the unit had 5+ years of clinical experience

Research has shown that while heterogeneous groups are more creative, homogeneous groups execute more efficiently.

Nature of the Work - Though each nurse has his/her individual assignment, many tasks require two people (or more), making collaboration a taken-for-granted aspect of the work.

I later studied three teams in the same small organization who had received identical teamwork training. In practice, however, their collaboration styles varied widely and directly reflected the nature of their work.

Personal familiarity - The 24/7 nature of hospital work meant we were always negotiating schedules and trading days to accommodate one another’s family obligations (sick kids, 8th grade graduation, piano recitals) giving us a window into one another’s personal lives. We were also a small staff and had worked together consistently for over a year.?

Collaboration may be easier for well-established professionally homogeneous groups like my nursing colleagues. And the level of personal familiarity we experienced might be considered intrusive or over-sharing in other business contexts.

Nonetheless, I think there are lessons, timeless principles, to be taken from this experience and the day-to-day work of other clinical teams around the world.

Timeless Teamwork Principles

• Purpose - No matter our pet peeves or personality differences, there was always a patient whose needs trumped whatever petty grievances or personality conflicts that might have otherwise gotten in the way. We had a “why” bigger than ourselves.
• Autonomy to Self-organize - The organization provided parameters for the work, such as the number of beds, number of staff, and equipment to do the work, but we had autonomy to negotiate assignments, prioritize tasks, and modify plans as necessary to adapt to changing conditions.?
• Leveraged our strengths - Our work history and personal familiarity gave us insight into one another’s strengths and preferences. We matched ourselves to tasks and called on one another when a particular strength was needed.???

Applying the Principles to Your Team

How might you improve collaboration in your organization?

Here are some prompts for thinking about how you might increase collaboration in your own company when what you’re seeing isn’t matching what you’d envisioned when you assembled the team.

1. Necessity - Is collaboration in this particular instance needed? As Morten Hansen wrote in a recent HBR piece, “The goal of collaboration is not collaboration, but better results... Only collaborate when it is the best way to improve performance.”
2. Purpose - Is collaboration in your organization - in your executive team - propelled by a purpose larger than the individuals’ personal desires for status, career, or control? Purpose can’t be imposed. It must be an invitation to contribute to something bigger than a performance review, bigger than an earnings report.?
3. Autonomy - Has the team been given sufficient latitude to organize their work or are they hobbled by procedural requirements?
4. Strengths - Are people’s roles and assignments making the most of their individual strengths? What are the strengths of the collective and how can we build on and amplify those?

Most professionals do want to achieve professionally.

They do want to be compensated fairly for their contribution.

And they want more. More meaning. More autonomy. More opportunity to excel.

Hi, I'm Julie. I know collaboration is the only way we're going to solve our big problems, and I know collaboration can be challenging when we try to force it within the constraints of traditional organizational practices that result in unproductive siloing, conflicts, and fear. I coach healthcare, medtech, and life science leaders on better ways to work that align and amplify a team's potential.