Collaboration in Healthcare: Beyond the Silo

By Keith Carlson via Multibriefs

Silos are a common sight in the farmlands of the world, but what about the silos we inhabit as healthcare clinicians, researchers, academicians, and administrators?

Individually and collectively, why do we wall ourselves off at the expense of advancement and discovery? What would happen if the silos disappeared? What kind of collaborations might result and how would the face of medicine and healthcare change?

APRNs and MDs

Historically, nurses have been at the beck and call of physicians, relegated to tasks previously identified as “non-professional.” Recently, the separate silos of nurses and doctors have become less pronounced, allowing for increased trust, collaboration, and shared practice.

The rise of advanced practice nurse (APRN) autonomy, especially here in the United States, has put nurse practitioners more on par with physicians. And as the Doctor of Nursing Practice (DNP) terminal degree becomes de rigueur and an increasing number of APRNs earn their DNP, parity of training and education with doctors becomes more robustly realized.

Moving APRNs from working under the direct supervision of physicians to a place of autonomous practice allows these nurses with highly advanced training to come out of the old-school nursing silo into the realm of being highly valued providers in their own right.

In this respect, a bridge has been built for APRNs who can now coexist in a much broader field of knowledge that links them on many levels to their physician colleagues. Additionally, the advent of nursing research and science has allowed RNs more autonomy, with an increase in respect for the knowledge and skill they bring to the table.

Healthcare Innovation

Tech-oriented innovation in healthcare is a bellwether of the changes afoot in the 21st century. While 20th-century tech appeared to be siloed away in its own universe, various factors have led to healthcare providers themselves having more of a hand in the rise of new technologies.

First, professional healthcare providers now have the means to harness computing power in the development of innovative ideas. Using 3-D printers, user-friendly design software, and other new technologies, there are healthcare providers who can themselves choose to launch collaborative efforts for a plethora of relavant applications.

Around the world, healthcare entrepreneurs — including nurses — are creating startups where the fabrication of prototypes and the bringing of new hardware and software to the market is increasingly feasible for those with bold ideas.

Whereas new bedside tech was previously generally developed in research labs by non-clinicians and then beta-tested with actual nurses, we now see more nurses involved long before the prototypes are created; this saves resources and brings nurses’ knowledge to bear from the start, rather than once the design decisions have been made by someone unfamiliar with what nurses actually do.

Medical innovation is now being fueled by both academics and non-academics, who bring more parties to the table, avoiding the silo mentality that keeps us separated and mistrustful of our multidisciplinary colleagues.

Creativity and Multidisciplinary Innovation

When we bring academics, clinicians, researchers, and others to the table for conversations that have the potential of leading to new collaborative efforts, much creativity can result. When a nurse has an MBA, for instance, they can speak knowledgeably about healthcare economics and have the opportunity to truly collaborate with those on the financial end of healthcare delivery.

If nursing and medical students are trained in tandem during portions of their studies, it can bring about increased trust, the willingness to listen, and open-mindedness. For nurses and physicians, a mutual valuing of each profession’s contributions, skills, and knowledge can lead to powerful outcomes that benefit everyone, including patients, the true end users within the healthcare milieu.

Silos keep us separate, but breaking down the walls brings us together and opens the door to new ideas and solutions to problems. If we continually challenge ourselves to “reach across the aisle” (to borrow an overused political term) towards those with differing viewpoints and backgrounds, we create an environment where listening, respect, and true partnership result.

The increased understanding and acceptance of homosexuality, new forms of gender identity, and the expanded roles of women are examples of the deconstruction of silos that have long thwarted the attainment of a more just human society, even as discrimination, racial supremacy, homophobia, and other human ills are still alive and well.

We may have a long way to go, but we can draw interesting parallels between such aforementioned close-mindedness and how pushing back against it can benefit the collective good.

When physicians stop judging nurses and allow them to practice to the fullest extent of their license, everyone wins. When clinicians are brought to the design table for new software or hardware, that collaborative effort subverts the old silos that long kept us apart.

At this point in history, we can clearly see that silos do little or nothing for the innovative spirit of healthcare.

Thus, the more we emerge from our silos and see others for who they truly are and what they might contribute to the conversation, countless unforeseen benefits will emerge. So, exit your silo and see what the future can bring.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway, a widely read freelance nurse writer, and motivational/keynote speaker. Keith is the host of The Nurse Keith Show, a popular nursing career podcast. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.