March 1, 2023

Team-based care: It’s more than collaborating on clinical cases

A reflection by April Burke, PA-C, VP, Advanced Practice Providers

April Burke, PA-C
VP, Advanced Practice Providers

I’ll never forget my first week out of training as a new grad hospitalist physician assistant (PA). I was super nervous, and it was my first time working without my PA colleague there to help me at a moment’s notice. Crossing my fingers for an uneventful day, I was soon face-to-face with a very challenging patient. The patient was suffering from a severe acute condition and became combative and unreceptive to my treatment recommendations. 

I left the room flustered. I began to wonder what I’d gotten myself into by going into hospital medicine. At that exact moment, my collaborating physician called to check in about our patients. Despite my attempt to put on a brave face, it was clear I was upset. He took the time to listen to my recounting of the interaction, provided reassurance, and gave me the clinical guidance I needed to rebuild my confidence for the rest of the day. At that moment, he had no idea how much that call meant to me as a new clinician. 

Years pass quickly on the hospital floor, and soon I became the one precepting advanced practice provider (APP) students and training newly hired APPs. I kept that moment in the back of my mind, remembering how the physician made me feel when I was feeling uncertain. I made sure I was there to listen or offer support to my trainees whenever they needed. 

April with a gift basket from her team.

Throughout my career, I’ve continued working in collaborative, team-based care environments. When each of my clinical teams first came together, our conversations were mainly patient-related —discussing treatment plans and getting guidance when needed. Over time, the topics began to change. We started sharing pictures of our kids and telling stories of memorable moments from our lives. We shared challenging patient cases to teach each other, collaborated to ensure patients were seen as soon as possible, and laughed at the silliest things to make the day’s challenges weigh a little less.

The time we spend collaborating with our colleagues on clinical cases is imperative to developing mutual trust and providing the best care to our patients day in and out. However, it’s the other moments we share together that build a team.   

When APP candidates ask why I’ve stayed with Sound for so long — it’s been over seven years now — I tell them about Sound’s culture. Teamwork is one of our core values. It’s embedded at all levels of the organization, from frontline clinical teams to leadership. One of my favorite things to do as the vice president of APPs is collaborate with other leaders and site teams to develop and implement new APP models. There may be growing pains for the teams initially, but it’s great to see them work through their challenges and emulate successful team-based care models. 

My advice to all care teams is to listen to each other, teach each other, give mutual trust time to develop, and, most of all, be kind. After all, you never know what kind of day the other person is having. 

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