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Suggested Readings and Key References Cosgrove T The Cleveland Clinic Way: Lessons in Excellence From One of the World’s Leading Health Care Organizations New York: McGrawHill; 2014 Duhigg C What Google learned from its quest to build the perfect team The New York Times Magazine February 25, 2016 Available online at https://www.nytimes.com/2016/02/28/magazine/what-google-learnedfrom-its-quest-to-build-the-perfect-team.html Edmondson AC Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy San Francisco, CA: John Wiley & Sons, published by Jossey-Bass; 2012 Edmondson AC The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth Hoboken, New Jersey: John Wiley & Sons; 2018 Gordon S, Feldman DL, Leonard M Collaborative Caring: Stories and Reflections on Teamwork in Health Care Ithaca, NY: Cornell University Press; 2014 Katkin JP, Kressly SJ, Edwards AR, et al Guiding principles for teambased pediatric care Pediatrics 2017;140(2):e20171489 Kim S-H, Song H, Valentine MB Cross-disciplinary temporary teams in health care organizations: the role of partner variety and shared experience 2013;1–42 Business 2018 on line at https://www.semanticscholar.org/paper/Cross-Disciplinary-TemporaryTeams-in-Health-Care-KimSong/055897dd4c8f542b2ff80975978ab01fc45185c6 Laurenson M, Heath T, Gribbin S Intervention in health care teams and working relationships J Healthcare Leadership 2012;4:117–126 Orchard CA, Curran V, Kabene S Creating a culture for interdisciplinary collaborative professional practice Med Educ Online 2005;10(1):4387 Reiss-Brennan B, Brunisholz KD, Dredge C, et al Association of integrated team-based care with health care quality, utilization, and cost JAMA 2016;316(8):826–834 Risser DT, Rice MM, Salisbury ML, et al The potential for improved teamwork to reduce medical errors in the emergency department The MedTeams Research Consortium Ann Emerg Med 1999;34:373–383 Rosen MA, DiazGranados D, Dietz AS, et al Teamwork in healthcare: key discoveries enabling safer, high-quality care Am Psychol 2018;73(4):433–450 Salas E, Cooke NJ, Rosen MA On teams, teamwork, and team performance: discovery and developments Hum Factors 2008;50(3):540–547 Salas E, Sims DE, Burke CS Is there a “Big Five” in Teamwork? Small Group Research 2005;36(5):555–599 Seow E Leading and managing an emergency department—a personal view J Acute Med 2013:61–66 Welp A, Manser T Integrating teamwork, clinician occupational well-being and patient safety—development of a conceptual framework based on a systematic review BMC Health Serv Res 2016;16(1):281 CHAPTER ■ HUMANISM IN THE EMERGENCY DEPARTMENT STEPHEN LUDWIG The emergency department (ED) environment is fraught with challenges It is a place of high-patient acuity often buried in a sea of routine and sometimes mundane care It is a place of high emotion Patients and families are worried, even panicked, by the onset or progression of illness that they may not understand The ED practitioner must have a broad skill set from diagnostician to therapeutic interventionist There are patient populations and family configurations that are extremely diverse The children are also diverse in age, skill sets, language and social interactions from the preverbal baby to the recalcitrant, possibly sullen, adolescent There is most often no pre-existing relationship between the medical staff and the patient Amidst all these challenges the ED physician must maintain their professionalism and their humanism WHAT IS PROFESSIONALISM? Professionalism is a set of behaviors that defines the way a competent physician thinks and behaves There are many tenants to professionalism best detailed in a report edited by Harold Sox and shown in Table 5.1 Being a professional is a process that evolves throughout the course of one’s career The ED physician must always strive to be professional yet ultimately it is a goal that can never be achieved in every patient interaction WHAT IS HUMANISM? Humanism is a mindset and a component of the practice of medicine that balances the objective, scientific, professionalism and the warmth, empathy, concern and compassion for the patient, his/her culture, family and community Jordan Cohen has written that “humanism is the passion that drives professionalism.” A definition of humanism by Martimianakis et al that resonates is: The ability to provide care based on the health professional’s ability to maintain the perspective that the professional and patient are equal members of the human family Humanism is often not taught but is always a part of the hidden curriculum WHAT IS THE RELATIONSHIP OF HUMANISM TO PROFESSIONALISM? Humanism and professionalism are in perfect balance within each of us We wish to be objective, evidenced based and fully competent in delivering the best care We also want to be kind, empathetic and compassionate and practice the art of medicine along with the science Care is not optimal when this balance is disrupted One neither wishes to be perceived as cold and uncaring even while making the correct diagnosis and applying the right treatment Doing so will lead to nonadherence, lack of follow-up, dissatisfaction and in extreme cases questions of malpractice On the other hand, the doctor who is caring and empathetic who does not make the correct diagnosis and applies the correct therapy is also not fulfilling their responsibility Keeping the balance is important Studies have identified the characteristics of the humanistic physician as seen through the eyes of patients, colleagues and trainees Some have suggested that resident training need to stress both professionalism and humanistic values and that there has been a decline in humanistic values throughout medical practice WHY IS BALANCE IMPORTANT? TO THE PATIENT? TO THE DOCTOR? The balance of humanism and professionalism is important to the patient and family as the recipients of care want to feel the caring A parent wants to be sure that their most valuable and loved child is in competent and caring hands The balance is also good for the doctor or nurse who wants to feel that they are not on a medical assembly line but that they are helping people and fulfilling their chosen goals as a healthcare professional Those who lose track of their core mission and their North Star are prone to fatigue, burn-out, and even depression To act in a humanistic way requires that one feels human, fulfilled, cared about, protected and encouraged When the doctor feels these things, he/she is able to reflect them to others HOW DO WE MAINTAIN AND PROJECT OUR HUMANISM? ... systematic review BMC Health Serv Res 2016;16(1):281 CHAPTER ■ HUMANISM IN THE EMERGENCY DEPARTMENT STEPHEN LUDWIG The emergency department (ED) environment is fraught with challenges It is a place... “Big Five” in Teamwork? Small Group Research 2005;36(5):555–599 Seow E Leading and managing an emergency department—a personal view J Acute Med 2013:61–66 Welp A, Manser T Integrating teamwork,... patient interaction WHAT IS HUMANISM? Humanism is a mindset and a component of the practice of medicine that balances the objective, scientific, professionalism and the warmth, empathy, concern