Technology and Teamwork
According to the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) report Medical Teamwork and Patient Safety, “Organizing and training healthcare providers as a team constitutes a pragmatic, effective strategy for enhancing patient safety and reducing medical errors.” The report concludes simply, “Teams make fewer mistakes than do individuals, and this is especially true when every member of a team is as aware of their teammates’ responsibilities as they are their own.”
M.D. Anderson management’s first steps in its Oracle implementation align with AHRQ’s insights and will help translate those insights into practice. Steve Beck, director of the Human Resources Service Center at M.D. Anderson, is currently working on the implementation of Oracle’s PeopleSoft human capital management solutions such as case management and PeopleSoft ePerformance as part of an upgrade to PeopleSoft 9.1. Beck views these tools primarily as a way to meet the M.D. Anderson staff’s needs so that they can spend their time on their main job—curing cancer and treating people who have it. But Beck also sees the PeopleSoft solutions as helping to develop the collaborative approach to medical practice that the AHRQ report identifies and that is increasingly being recognized as critical to optimizing outcomes.
As part of optimizing outcomes, it is essential to reduce medical error—which results in 100,000 deaths in the U.S. annually, according to a recent study from Deloitte entitled Health Care and Public Policy: What Do Americans Really Want? Like most forms of process or system failure, medical error has many causes, but flawed communications is at the root of most of them, according to a 1999 report from the Institute of Medicine. Beck looks to his PeopleSoft tools as a way to facilitate the continuing development of a culture in which communication about job performance is static free. Or, as M.D. Anderson’s Fontaine puts it, Oracle’s technology will allow the center to combine silicon-based tools with carbon-based ingenuity.
PeopleSoft ePerformance is being implemented to develop staff competencies by monitoring, assessing, and communicating back to the individual an assessment of his or her performance. These assessments contain a review process with the kind of 360-degree feedback—from direct reports, customers, and peers—built into it that the AHRQ report identifies as critical to high-performance teamwork.
Prior to the implementation of PeopleSoft ePerformance, the tool that replaced M.D. Anderson’s paper-based review process allowed managers to bypass face-to-face feedback—to the detriment of an optimally functioning team—and had no mechanism for allowing the easy transfer of the 360-degree feedback into a master performance evaluation. Along with making it functionally impossible to process a review without including the feedback, the automated nature of the PeopleSoft ePerformance review enhances the ability to review 360-degree feedback. It allows people who might not have given feedback assertively to do so safely and anonymously.
“This allows employees to see how others perceive them,” Beck continues. “The 360-degree review is not so much about outcomes; it’s more about behaviors. I think medical practice is changing. This is a leveler.”
A Culture of Teamwork
Success in medical treatment will increasingly depend upon collaboration and teamwork. The effective treatment of disease, especially complicated ones like cancer, simply requires too much knowledge, too much data, and too many specialties to depend upon one person.
This will constitute a change from the historically hierarchical nature of medical practice. AHRQ’s Medical Teamwork and Patient Safety report indicated that creating a culture of teamwork requires a certain amount of change management to orient workers toward new, shared goals. “Effective teamwork depends on effective communications within the team, along with adequate organizational resources and support,” the report found.