The complexity of medical teams’ processes and flows is something that all healthcare professionals can understand.
That complexity only increases as healthcare organizations add physician leadership roles, despite the fact that physicians are rarely given formal leadership training during their time in medical school.
“This can lead to role confusion in team-based care delivery situations, especially those managed under a shared leadership structure,” said a team of OHSU emergency department physicians in a document emailed to Becker’s that recounted their experience implementing the model.
Bruce Hazen, a consultant with Three Questions Consulting, teamed up with emergency department physicians at Oregon Health & Science University in Portland, to introduce a new method for team organization.
The team service model canvas is adapted from the business model canvas, a tool developed in a business school in Luzon, Switzerland, according to Mr. Hazen.
“It was designed to visualize an operating system that is so difficult to describe in words,” he told Becker’s. “For any system, words alone are just inadequate. You can use them, but you often end up with too much detail, too much volume and you lose your audience.”
The service model canvas, also called “work modelling,” hinges on collaboration among medical professionals in any given team to fill a single-page visual, which Mr. Hazen and the ED team at OHSU say gives them a more clear, shared understanding of “both the content and the context of any role within a healthcare unit delivery.”
“While our results are qualitative, physician leaders within the OHSU community report the method is highly effective in clarifying roles, reducing confusion and strengthening teamwork,” the physicians said.
Mr. Hazen added that this method fills a key gap in most team-building exercises and team orientations.
“When you think about what most team building exercises do, which is beneficial, it develops familiarity, trust and commonality amongst people. You feel better about each other, you know each other better. That’s great,” he said. “But when you end the team building session, everybody goes back to work. They all leave with separate operating models in their head that have never been articulated, expressed or unified. People start noticing that their colleagues are operating differently than they thought they should, and the trust or the doubts or the suspicions or the controversies start to pull the team apart again.”
The model is as much diagnostic as it is descriptive, he added. By laying out the responsibilities and goals of each role within a team, physicians and nurses were also able to collaboratively identify and resolve “hot spots” where there was disagreement about how a role functioned or if a new relationship or responsibility was identified.
By distilling the responsibilities and relationships of a role into a single-page visual, as opposed to a lengthy written document, the canvas also functions as a “living document,” making it easier to add or remove details as roles evolve and adapt to changes within a larger system. The clear visualization also creates a “third object advantage,” Mr. Hazen said, allowing teams to discuss roles and responsibilities in a more objective manner — cutting out much of the potential for interpersonal conflict or disagreement.
“We go to the third object, the canvas, the model and we talk about the model and why we think the model needs to be changed,” he said. “Not why I think your opinion needs to be changed.”
