Research shows we can end clinical 'tribes' in hospitals to improve healthcare

People naturally form themselves into cliques in the workplace but a new study has shown that they can be overcome, according to a landmark Australian study of healthcare professionals, published in BMJ Open.

The study, by Macquarie University's Australian Institute of Health Innovation, has revealed that professional divisions – the cliques – common within healthcare and other large organisations do not solely reflect innate human behaviour but are the result of the structures, cultures and history of the organisations themselves.

Hospitals and other healthcare service providers are often hindered by tribal divisions between doctors, nurses and other healthcare professionals, and many other industries and large organisations are likewise affected by professional silos, despite the clear need for effective teamwork to optimise performance.

The study, the first of its kind in healthcare, brought together 133 clinicians currently working across Australia's hospitals into a lab, and got them to play interactive games away from their politicised workplaces.

"We found that when we grouped various healthcare professionals into mixed teams they did not exhibit stereotyped behaviour based on their professional status. In fact, what was even more interesting was that observers of the participants' teamwork couldn't tell in most cases who was a doctor, nurse or allied healthcare professional," said lead researcher Professor Jeffrey Braithwaite.

The study results have implications for healthcare delivery, as well as other large organisations that are frustrated by similar divisions.

"We have now shown, for the first time, that professional 'tribalism' in healthcare organisations isn't just an inherently human way of working, or the inevitable consequence of the way clinical groups cluster in relative isolation from each other, but is a response to entrenched cultures in organisations," said Professor Braithwaite.

"This means interventions to improve teamwork can be very effective. But they do require a bit of effort on the part of managers and leaders, and the clinicians themselves," finished Professor Braithwaite.