Core Competencies

3.23 Team Approach and Multidisciplinary Care

© 2017 Society of Hospital Medicine

Multidisciplinary care refers to active collaboration among various members of the healthcare team to develop and deliver optimal care plans for hospitalized patients. In an era of healthcare delivery reform, team-based care delivery is an integral strategy for enhancing care quality, improving patient safety, decreasing length of stay, lowering costs, and improving health outcomes.1,2 It is well documented that communication and teamwork failures are the root cause of many preventable adverse events.3-5 In addition, patients’ rating of nurse-physician coordination correlates with their perception of the quality of care they have received.6,7 Hospitalists often lead multidisciplinary teams to coordinate complex inpatient medical care to address these and other issues and to improve care processes.

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Hospitalists should be able to:

  • Describe the important elements of teamwork including mutual respect, effective communication techniques, establishing common goals and plans, and individual and team accountability.
  • List behaviors and skills that contribute to effective and ineffective interactions, which may also influence team performance.
  • Describe factors within an institution, including its local organizational culture, that may influence the structure and function of multidisciplinary teams.
  • Recognize the complexity of healthcare systems and the myriad factors involved in patient care.


Hospitalists should be able to:

  • Determine an effective team composition and work collaboratively to designate individual responsibilities within the group.
  • Demonstrate skills necessary to lead a team, including effective communication, negotiation, conflict resolution, delegation, and time management.
  • Assess individual team member abilities to identify areas of strength and improvement such that each member is incorporated effectively and productively into the team.
  • Assess and reassess group dynamics as needed and make necessary changes to optimize team function.
  • Use active listening techniques during interactions with team members and engage team participation.
  • Communicate effectively with all members of the multidisciplinary team.
  • Conduct effective multidisciplinary team rounds, which may include patients and their families.
  • Appropriately integrate and balance the assessments and recommendations from all contributing team members into a cohesive care plan.
  • Assess performance of all team members, including self-assessment, and identify opportunities for improvement.
  • Provide meaningful, behavior-based feedback to improve individual performance.


Hospitalists should be able to:

    • Emphasize the importance of mutual respect among team members.
    • Role model in professional conflict resolution and discussion of disagreements.
    • Within appropriate scopes of practice, share decision-making responsibilities with care team members.
    • Create an environment of shared responsibility with patients and caregivers and provide opportunities for patients and/or caregivers to participate in medical decision-making.
    • Encourage interactive education among team members.
    • Encourage team members to educate patients and families using effective techniques.


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