This is one of the recommendations from the ‘departmental’ section of the RCOG/RCM undermining toolkit.
Shift patterns and expansion of the number of consultants and junior doctors has altered the pattern of work. Therefore, new ways of working need to be devised for both safety and continuity of patient care, training, supervision and support. Staff working together may not know each other, compared with previously when teams were more stable.
‘Teaming’ is a verb used by Professor Amy Edmondson at the Harvard Business School to describe how we need to develop a new skill set to quickly relate to people we don’t know, to trust them, share knowledge and make use of their knowledge. She:
Suggested ways to introduce the concept of teaming within an obstetric unit
- At handover, use a World Health Organization (WHO)-type surgical checklist of introductions and describe the level of experience of team members. This allows both the labour ward coordinator and lead obstetrician to know the level of experience of the junior medical staff, have appropriate expectations and hence reduce the potential for undermining. This format could also be used at the start of clinics or theatre lists.
- Ensure there is an atmosphere of respect at handover meetings, both between professionals and when discussing the patients, as often derogatory comments can be made which then spill over into clinical work and communication.
- Have a list, clearly accessible on the labour ward, of the junior medical staff (possibly with photos) and their grades with an explanation of their experience, e.g. ST1 GP, FY2, ST2 O&G trainee etc.
- Similarly, have a list explaining band levels and experience of the midwifery staff.
- Spend some time getting to know the people you work with over a brief coffee or lunch. Ensure you know all the staff in your work environment, including the ward clerk, maternity care assistants and domestic staff.