Turning a bedridden patient on the third floor of the University of Virginia Medical Center the other day, UVA physician Amber Inofuentes was struck when the patient’s family expressed surprise that she was a “doc not afraid to get her hands dirty.”
While unit nurses and patient-care assistants most often position patients, Inofuentes said the experience illustrates the hierarchies that persist in American hospitals, especially between doctors and nurses.
Though great strides have been made in the last decade in educating nurses and physicians together during their formal learning – a concept called “interprofessional education” – gaps persist for more senior nurse and doctor leaders who were educated in silos without the practice of being part of – or leader to – cohesive, coordinated, mutually respectful health care teams.
“So much of what we do in medicine starts with being able to treat everyone like their job is equally important, to be both respectful and respected,” observed Inofuentes, who earned a bachelor’s degree in engineering from UVA in 2005 and her M.D. from UVA’s School of Medicine in 2010. “There’s a healthy degree of humility required with this job, something that I don’t think is second nature for many of us who are Type-A, and goals- and objectives-focused. That’s paramount to what we do – to be humble in your inquiry and not jump to conclusions and solutions without getting others’ perspectives, too.”
Hierarchies inhibit communication and collaboration, and can breed malcontent among health care teams in an era where medical errors cost some $400 billion annually. Ultimately, such breakdowns come at immense financial, professional and human cost to the institutions where they occur – and, most critically, to the patients and their loved ones.
UVA, however, has a solution: Create better partnerships through practice. Learn nuts-and-bolts ways to lead, partner and communicate effectively. Learn to listen deeply, collaborate and respect others. And tap some of the best minds in nursing, medicine and business to teach those practical, critical skills.
Beginning late this month, eight nurse-doctor pairs from hospitals around Virginia – including Inofuentes and her colleague, 3 Central nurse manager JoDean Chisholm – will participate in UVA’s new Leadership Partners in Healthcare Management program. A collaboration between the School of Nursing, the Darden School of Business and Darden Executive Education specifically targeted for physicians and nurses working together in high-stakes environments, the program comes in an era when patients, insurers and regulators expect cohesion and seamlessness in a cutting-edge, safe, efficient and compassionate environment.
The new program focuses on practical, purposeful collaboration, communication and transformational leadership techniques that improve the professional environment, reduce waste, error and attrition and engage clinical leaders in frank conversation about their respective work environments. It also aims to fill the practical gap that many American medical and nursing schools don’t address.
“The focus in medical school is almost entirely about your skills as a clinician,” Inofuentes said, “but being able to lead a clinical team and leading work on the unit require a very different set of skills. Whether it’s quality and safety issues or effective interactions with your colleagues, those aren’t things particularly thought of as part of the formal education. It’s a need, and I’m excited to be part of this new program that’s being offered.”
In a tag-team approach, four School of Nursing faculty members will partner with five Darden faculty members along with experts from UVA’s School of Medicine and McIntire School of Commerce to teach classes and lead monthly, three-day, on-Grounds modules focusing on:
- Developing, leading and assessing interprofessional teams
- Health care organizations and the history and concept of shared leadership
- Managing others and managing oneself in the face of crisis, or moral or ethical dilemmas
- Budgeting and measuring performance
- Aligning, designing and strategizing to create on-unit innovations and real-time solutions
- Improving quality and safety in real time
Building off the success of the program’s inaugural cohort, which convenes on Grounds mid-month, an expanded group of 15 R.N.-M.D. pairs is assembling for this fall, and organizers are seeking nominations from health systems around the U.S. For information, visit the program’s website.