THE ART OF COLLABORATION AND ACTIVE LISTENING

Toula Castillo, MLS(ASCP)CM, 2018-19 ASCLS-IL President

Modern day healthcare is a hailstorm of change, and it can be overwhelming not only to the novice, but to the seasoned professional as well. In these times of change, it is important to build trust and value each other to provide the best possible care for the ailing patient. A team-based approach to patient care is a way to build this trust and value. No longer is the physician the sole provider of patient care—there is a team of primary care physicians and specialists, along with countless numbers of healthcare professionals, including medical laboratory professionals.

While our role traditionally doesn’t involve much or any patient contact, we are crucial members of the healthcare team. We assist physicians in determining a patient diagnosis, evaluating effective treatment, and monitoring chronic conditions. I can only speak for my introverted self, but 20 years ago, if someone were to ask me why I went into this profession, the truth would be to avoid direct patient contact.

I still had a desire to help the ill, but seeing sick patients was something that made me apprehensive. I was very content performing my work without having to draw a single sample, without ever having to see a patient. Fast forward to today and the same introvert now says that despite my apprehension, the only way that other healthcare professionals are going to know who I am is for me to build trust and show my value to them.

Recognizing Your Worth as a Laboratory Professional
One personal experience helped lead me to this realization. I went with a family member to see the doctor. The doctor said, “You are looking more pale than usual, so I want to check your B12”. I chimed in and said, “Why don’t you also have a folate performed?” I thought, it’s more common to be folate deficient than B12 deficient, especially considering that primary care physicians prophylactically dose patients with B12 when their levels are 400 picograms or less, which is still within the reference range.

Results came back with a B12 within the reference range and a decreased folate. As I drove home that night, I wondered what would have happened if I wasn’t there to recommend the test? I realized my worth as a laboratory professional. I’ll be honest, it had been difficult to see my value when most of the people that I have daily interactions with question my choice of profession, and the others either don’t know I exist or don’t understand what I do.
As I reflected on this reality and my place in it, I wondered, did I create this reality because of my apprehension in seeing patients? Is the reason I am invisible because I wanted it that way? I still do not have a clear-cut answer to either of these questions, but I do believe that participating in interprofessional collaboration may help answer these questions.

Active Listening in Interprofessional Collaboration
Interprofessional collaboration is a means to build trust and provide value in the healthcare arena. And as medical laboratory professionals, we need to be involved in this process. The Agency for Healthcare Research and Quality (AHRQ) has created online learning modules in interprofessional collaboration that are available to anyone, free of charge.

The framework around this team-based approach is called TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). TeamSTEPPS has five key principles that include team structure and four teachable skills, which are communication, leadership, situation monitoring, and mutual support. Each one of these units have several different concepts, but at the crux of all four is active listening. Are we really listening to our colleagues? Are we listening to our patients? Are they listening to us?

Active listening helps us decipher what people don’t say, rather than what they do say. The Gold Foundation1 conducted a survey of 65 patients and asked, “How would you know that your healthcare professional is really listening to your concerns?” and they responded with some of the following:

  • Ask follow-up questions
  • Mirror back your patient’s responses
  • Validate your patient’s worrie
  • Answer my questions directly
  • Be “comfortable with silence”
  • Let your patient finish a thought
  • Be aware of your demeanor
  • Pay attention to your body positioning—make sure you make eye contact with me
  • Remember me—the initial conversation about my concerns of my last visit and ask if they were resolved
  • Take notes
  • Communicate with other providers who treat your patient
  • Spend one-on-one time with your patient
  • Follow up after the appointment
  • Give me options
  • Treat the whole patient

While these suggestions apply to patient and healthcare professional interaction, I also think these would be relevant to interprofessional collaboration. By engaging in active listening, we build trust and all professions value from each other’s contributions to patient safety.

Reference
1. www.gold-foundation.org/newsroom/blog/health-professionals-show-listening

Toula Castillo (demetra.castillo@gmail.com) is visiting assistant professor in the Health Studies Department at Northern Illinois University.