Paeds · professional-practice-and-evidence
Leadership and interprofessional team management
Also known as Clinical leadership paediatrics · Interprofessional team management · Crew resource management in child health · TeamSTEPPS paediatrics · Team leadership resuscitation
Fellowship guide to leading and managing interprofessional teams in child health: leadership styles, building a high-performing team, shared mental models, closed-loop communication, psychological safety and speak-up, crew resource management, TeamSTEPPS and SBAR, structured handover, conflict and burnout, and the Cochrane evidence for interprofessional collaboration and education.
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Target exams
Red flags
- A resuscitation with no named leader and no role allocation — the team drifts and doses are missed
- An order given with no closed loop — the drug may never be given, or given twice
- A junior who notices a wrong dose but stays silent because the authority gradient is too steep
- A handover with no structure — medications and tasks are lost between shifts
- A critical event with no debrief — the team does not learn and the same harm recurs
- Unprofessional behaviour left unaddressed — it erodes psychological safety and team performance
- A clinician harmed by an adverse event (a second victim) left without structured support
Life stages
Care settings
Clinical exam formats
Board mappings
- Professional qualities
- Leadership and management
- Teamwork and interprofessional practice
- Learning goal 15 essential general paediatrics
- Scholar and teacher
- Clinical Applications
- Professional Qualities
- Communication
- Long Cases
- Short Cases
- Leadership and team working
- Quality improvement
- Patient safety
- Safeguarding
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- History
- Clinical
- General Pediatrics Content Outline — Interpersonal and communication skills and professionalism
- General Pediatrics EPA: Lead an interprofessional care team
- Systems-Based Practice 2: Physician Well-Being and Team Function
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Interpersonal and Communication Skills 2: Interprofessional and Team Communication
- Professionalism
- Leader
- Collaborator
- Communicator
- Medical Expert
- Pediatrics EPA — Leading an interprofessional care team
Overview & Definition
A two-year-old arrests on the ward at three in the morning. Within a minute the bed space is crowded: a registrar, two nurses, a resident, a pharmacist, a parent watching from the door. Whether that child survives in good neurological shape depends less on any single clinician's knowledge than on how well the team works together. This leaf teaches you how to lead, join and judge that team. Deep human-factors theory lives on the patient-safety page; the improvement methods on the quality-improvement page; the conflict-handling on the difficult-encounters page. [2] [4]
Clinical leadership is setting a direction, aligning people around it, and creating the conditions in which they can do good work. The systematic reviews distinguish leadership sharply from management (planning, organising, budgeting and control) and from mere clinical expertise. A brilliant clinician can be a poor leader, and a strong leader does not have to be the most senior person in the room. [14] [15]
An interprofessional team is a group from different professions who learn with, from and about each other and share decisions around a common goal — a paediatrician, a nurse, a pharmacist, an allied-health therapist, a social worker and the family working as one. That is stronger than a multidisciplinary team, where experts work in parallel, and more integrated than an interdisciplinary team, where information is shared but decisions are not always joint. The child with medical complexity is the clearest case for genuine interprofessional care. [5] [17]
References17ShowHide
- [1]Sexton JB, Thomas EJ, Helmreich RL Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ, 2000.PMID 10720356
- [2]Leonard M, Graham S, Bonacum D The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality & safety in health care, 2004.PMID 15465961
- [3]Salas E, DiazGranados D, Klein C, Burke CS Does team training improve team performance? A meta-analysis. Human factors, 2008.PMID 19292013
- [4]Manser T Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta anaesthesiologica Scandinavica, 2009.PMID 19032571
- [5]Zwarenstein M, Goldman J, Reeves S Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. The Cochrane database of systematic reviews, 2009.PMID 19588316
- [6]Haynes AB, Weiser TG, Berry WR, Lipsitz SR A surgical safety checklist to reduce morbidity and mortality in a global population. The New England journal of medicine, 2009.PMID 19144931
- [7]Sharek PJ, Parast LM, Leong K, Coombs J Effect of a rapid response team on hospital-wide mortality and code rates outside the ICU in a Children's Hospital. JAMA, 2007.PMID 18029830
- [8]Pronovost P, Needham D, Berenholtz S, Sinopoli D An intervention to decrease catheter-related bloodstream infections in the ICU. The New England journal of medicine, 2006.PMID 17192537
- [9]Catchpole KR, de Leval MR, McEwan A, Pigott N Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Paediatric anaesthesia, 2007.PMID 17474955
- [10]Eppich WJ, Brannen M, Hunt EA Team training: implications for emergency and critical care pediatrics. Current opinion in pediatrics, 2008.PMID 18475092
- [11]Cheng A, Donoghue A, Gilfoyle E, Eppich W Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors. Pediatric critical care medicine, 2012.PMID 21499181
- [12]Reader TW, Flin R, Mearns K, Cuthbertson BH Team situation awareness and the anticipation of patient progress during ICU rounds. BMJ quality & safety, 2011.PMID 21700727
- [13]Starmer AJ, Spector ND, Srivastava R, West DC Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
- [14]Al-Sawai A Leadership of healthcare professionals: where do we stand? Oman medical journal, 2013.PMID 23904925
- [15]Berghout MA, Fabbricotti IN, Buljac-Samardžić M, et al. Medical leaders or masters? A systematic review of medical leadership in hospital settings. PloS one, 2017.PMID 28910335
- [16]Sfantou DF, Laliotis A, Patelarou AE, Sifaki-Pistolla D Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel), 2017.PMID 29036901
- [17]Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M Interprofessional education: effects on professional practice and healthcare outcomes. The Cochrane database of systematic reviews, 2013.PMID 23543515