A Final Four to Remember — and why it’s relevant to healthcare

“Effective teamwork begins and ends with communication.” – Coach K

I was fired up on Monday night – and I know I wasn’t alone with the NCAA National Championship game drawing the largest TV audience in 18 years at an average of 28.3 million viewers. This final game between Duke and Wisconsin was one of the best final NCAA tournament games I can remember.

Why? Maybe it was because no title game had been tied at halftime since 1988. Or maybe it was the sixteen lead changes and five ties, but I’d like to suggest that viewers tuned in for the first place knowing they guaranteed a good game because of it being played between two highly functioning teams.

It could also be because I’m a Duke fan; a member of my family played on the Blue Devil’s men’s basketball National Championship team in 2001. So, I have a natural bias! However, I believe regardless of players on the team or the colors they wear, there are key elements to a highly functioning team and winning program.

Elements of a Highly Functioning Basketball Team

• Shared Goals
• Clear Roles and Responsibilities
• Mutual Trust
• Reliable Execution of the Game Plan
• Adapt Quickly
• Coach to the Individual
• Learn Continuously

These are almost the exact same elements that are outlined by the Institute of Medicine (IOM) as the core principles of team-based health care.

Healthcare as a Team Sport

Healthcare is complex – however, I am a firm believer that there are a number of lessons we can learn from team-based models in other industries and even from the high performing basketball teams we watched this past weekend. It is actually this complexity that is driving the need for team-based health care.

Shared Goals

“Goals should be realistic, attainable, and shared among all members of the team.” – Coach K

The Institute of Medicine outlines that high functioning teams embrace patient and caregiver involvement in goal setting and that this, along with the team’s active adoption of a clearly articulated set of shared goals, is THE foundation of successful and effective team-based care.

Clear Roles and Responsibilities

When watching the game on Monday, it was easy to see that all players understood their role on the team. It seems simple, but often providers and patients don’t really know who is working to support the patient across the continuum of care. As I think about being a caregiver for my family members, I have struggled with trying to coordinate with everyone involved and who had which role. When you ask a provider today, “who’s on this patient’s team?” often the response is, “well, me and my staff.” They don’t have an easy way to understand and connect with the other clinicians working with the patient. Outlining these roles and responsibilities and a commitment to shared accountability is a fundamental requirement to improve care team performance.

Mutual Trust

“In leadership, there are no words more important than trust. In any organization, trust must be developed among every member of the team if success is going to be achieved.” – Coach K

With the establishment of clear roles and effective communication tools, trust will be established. This trust in a healthcare team will lead to reduced duplication and greater efficiencies.

Reliable Execution of the Game Plan

From my couch on Saturday night I observed that Wisconsin developed, understood, and executed a well-thought out game plan to win their semi-final game. High performing healthcare teams collaboratively develop a care plan, make it easy for all care team members to understand (including patients and caregivers) and have a way of assigning the different activities associated with the plan across the team. Healthcare teams need to invest in tools to ensure they can provide highly reliable care regardless of where the patient is in the plan.

Adapt Quickly

Every basketball team and healthcare team is dynamic – they change with every season or with every patient. “They’ve all been different [teams],” Krzyzewski said of his fifth national title. “The ability to adapt is key in everything. I think I’ve adapted well.”

The outcome of a basketball game can change in seconds – this is the same in healthcare. A static plan is not an option. The team needs to be ready to adjust and do so quickly. In healthcare the state of play needs to be visible to all team members and they need to be able to make adjustments to the plan in real-time; it should always be a “living plan of care”.

Coach to the Individual

Healthcare teams need tools to tailor plans and engage each individual. In basketball this means being able to “coach to the individual.” I remember asking my nephew, who played for Coach Mike Krzyzewski, what he learned from that experience. One of the points he highlighted was the Coach K is a master of coaching to the individual. His extensive experience and coaching expertise has prepared him to quickly assess individual abilities and skills and then tailor his teaching to produce world-class performances on the court. In healthcare this means giving solutions to providers that deliver the latest care pathways, with the ability to communicate and tailor each activity to the individual.

Learn Continuously

Finally, high performing teams are continually studying their prior experience and learn from the experiences of other winning teams. How many hours of tape do you think a team like Kentucky or Duke review over the course of the year?

Healthcare teams need to measure care processes – understanding team performance, workload, productivity, and measurable patient-centered goals is key to continual improvement. For many teams it is very difficult to answer the question, “how is care happening?” With the ability to track and measure care processes in real-time, providers and patients can refine and improve care.

A missed pass or dropped ball in healthcare isn’t an option. I’m cheering on organizations pursuing a team-based care model as they work daily to provide the best possible care…. Oh, and I’ll continue to cheer on Duke. 🙂