Teamwork by Inclusion: Everyone has a Part


By Greg Hunter, RT (R) (T)

      Beth Boynton, RN, MS

Teamwork has been greatly recognized as an integral part of every solution designed to address organizational issues, yet even with the immensity of its role, it is much more difficult to apply it in real life situations to improve interpersonal relationships in the workplace or to achieve desired outcomes. Perhaps when we talk about teamwork, we also have to take a lot of factors for consideration, like the uniqueness of individuals for example, or the collective attitude of one department. Or perhaps, it’s just the numerous ways we define teamwork.

Inclusion: What is it and how does it define teamwork?Teamwork in its simplest definition is the collective effort of a group of people who aims to achieve a common goal. In the healthcare setting, it is seen as a group of health care practitioners working together to care for a particular patient, a group of utility workers maintaining the cleanliness of a unit, or a group of officers improving the standards of care. When taken in a more intricate way, teamwork is the common denominator for these terms: collaboration, closed loop communication, process improvement, coordination, participation, and inclusion, among others.

Given the numerous ways teamwork is defined, the term ‘inclusion’ is one of the best ways to give this term a more meaningful and balanced approach to achieving patient outcomes and attaining organizational goals.

Inclusion means having each member of the group participate and contribute to a common cause. Often, those who work in the background away from the limelight think that their effort is too insignificant which can lower their motivation to give their best. Inclusion recognizes that every effort counts.  Inclusion believes that even small efforts can make tremendous impact through positive ripple effects, and that amidst individual differences, a common good can be achieved.

Feldman and Khademian (2000) have specified inclusion as a new emerging model of managing participation and control. This system decentralizes authority over both process and results that leads to a balance between participation and control. This model emphasizes the importance of encouraging every team member to work and contribute in earnest towards a common goal. Participation is implemented through empowerment, teamwork, and continuous process improvement.

Teamwork by Inclusion in Real Life Healthcare Scenarios

Application of this model of participation and control in the health care setting is crucial to having an overall effective healthcare delivery system. Let us take this scenario on how teamwork by inclusion was exemplified in the managed care of Ebola patients in Emory Hospital at Atlanta, Georgia.

The first case of Ebola in the US was discovered in September 2014. The patient was seen first in a local hospital after having fever, abdominal pain and headache. He was given treatment for sinusitis and was later was sent home. Days after, he was admitted in the same hospital after worsening of symptoms. The hospital employed standard droplet and contact precaution and was subsequently found positive with Ebola two days after. He was airlifted to Emory Hospital.

Out of the 48 close unprotected contacts, 10 were in the same ambulance that was used to transport the patient and 21 were healthcare workers who were not able to use complete protective equipment after having been potentially exposed to the patient's bodily fluids.

Two nurses who cared for the patient from the hospital where the he was originally admitted had too become infected, with the Ebola virus from this exposure. One of these nurses was also cared for in Emory Hospital.

In Emory Hospital, the Ebola infection was contained and there were no subsequent infections after the two patients.

What made Emory Hospital successful? Their staff gave witness to what transpired during the care of the patients.

  • They have access to updated and relevant guidelines of the Centers for Disease Control (CDC) and to real-time developments
  • They employed an effective workflow that incorporated their own expertise in handling such communicable diseases and  the CDC guidelines and every member of the team was engaged. There were:
    • Assignment of staff
    • Use of Personal Protective Equipment (PPE)
    • Isolation and quarantine procedures
  • They put aside egos and worked together as a team across different professions
  • No one in the healthcare team refused providing care
  • The hospital chaplain provided emotional support to workers
  • End of day sharing of experiences and suggestions by all members that lead to better inclusion and improvement of services that lead to better inclusion and improvement of services.

What made their workflows effective? Everyone contributed. Egos were not evident. They were knowledgeable of guidelines and protocols because they have access to updated developments. Was there empowerment? Yes. Was there teamwork? A definite yes. Was there continuous process improvement? A resounding yes.

Teamwork by inclusion may not be an easy task for most organizations. In fact, those who recognize that they need help with this part of management are the first to seek solutions. There are agencies that make this happen. ManageUP can help facilitate this  as part of our employee engagement strategies. Our platform that enables employee recognition through scores on five categories namely: (s)afety, (qu)ality, (e)ffectiveness, (e)fficiency and (z)est  or SQUEEZE®. Moreover, our agile provision of training on various fields coupled with centralized, simplified and accessible information delivery system, each member of the team can become more competent, recognized and confident.


Ebola Virus Disease Cluster in the United States — Dallas County, Texas, 2014

Jane Jordan, Greg Measer, Asha Agrawal, and James G. Hodge Jr., Legal, Operational, and Practical Considerations For Hospitals and Health Care Providers in Responding to Communicable Diseases Following the 2014 Ebola Outbreak, 23 U. Miami Bus. L. Rev. 341 (2014)

M.S. Feldman, A.M. Khademian / International Public Management Journal 3 (2000) 149–167

How to Build a More Inclusive Team,
Cases of Ebola Diagnosed in the United States