Courtney H. Van Houtven (
S. Nicole Hastings is center director and a research scientist in the Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, and an associate professor of medicine and population health sciences and a senior fellow in the Center for the Study of Aging and Human Development at the Duke University School of Medicine.
Health Aff (Millwood). 2019 Jun;38(6):934-940. doi: 10.1377/hlthaff.2018.05486.
Although most care for people with serious illness is delivered by multiple providers and agencies, there is no gold standard for how to assemble, train, unify, and sustain strong teams. Using lessons from complexity science, a way of studying complex systems, we propose improving team connections; the quality, quantity, and timeliness of information flow; and the purposeful seeking of diverse perspectives to interpret information and make decisions as a means of driving effective self-organization of teams and leading to high-quality outcomes. We highlight an adaptable intervention that helped improve connections, information flow, and cognitive diversity and resulted in effective self-organization in the Department of Veterans Affairs health care system. Finally, we describe challenges to building teams across systems and sectors, and we present research priorities for spreading a complexity science-based approach to optimize teams that care for people with serious illness.
尽管大多数重病患者的护理都是由多个提供者和机构提供的,但如何组建、培训、统一和维持强大的团队并没有黄金标准。我们借鉴复杂性科学的经验,这是一种研究复杂系统的方法,提出了改善团队联系、信息流的质量、数量和及时性以及有目的地寻求不同视角来解释信息和做出决策的方法,以推动团队的有效自我组织并实现高质量的结果。我们强调了一种适应性干预措施,该措施有助于改善退伍军人事务部医疗保健系统中的联系、信息流和认知多样性,并实现了有效的自我组织。最后,我们描述了在跨系统和部门建立团队所面临的挑战,并提出了研究重点,以推广基于复杂性科学的方法来优化照顾重病患者的团队。