“Team work is like doing a puzzle. If a piece of the puzzle falls off the table and someone notices or doesn’t bother to pick it back up, the puzzle can’t be finished.” – A Team Member on a Critical Care Medical Transport Team

As i have gotten older and practiced medicine longer and longer, one of the most important roles that has over time become my biggest “Calling” is that of a Team Lead. Running high performance high fidelity teamwork, a skill you can never truly master that is repeatedly humbling, depends on multiple aspects coming into perfect sync, like a planetary alignment. The importance of high reliability teams in extremely intense or critical situations can not be understated and has become a focus of so much importance that there are endless papers and multiple people taking time to research the dynamics that make a team successful. Open closed-loop communication, awareness, acknowledging limitations, advocacy of individual strengths and being able to envision a holistic picture beyond a granular solitary perspective become quintessential for all teams in all professions in all situations. Optimizing these traits always becomes a challenge and takes practice over decades and a life time to get better at. I, admittedly, despite several years now of being in the position to lead the team, am still quite a novice and each time I’m in the situation to be the Captain, it is always accompanied by a point of delicate reflection. However, all of that aside, an important aspect outside of an emergency situation is that team work depends on multiple members or “stakeholders” contributing equal energy and focus to a shared goal.

Much like a puzzle, it is easy in complicated situations to have something fall through the cracks and despite multiple people watching out for these instances, it can be hard to find the piece once it’s on the floor. While many eyes may be watching many different things, speaking up and having a shared goal can sometimes be difficult to agree on. When a puzzle piece is seen falling off the table, if someone bats their eye at it and let’s it disappear, you can never complete the puzzle. Even if every other piece is found, there will still be a hole in the end and completion proves impossible – this analogy for me always becomes one of the most frustrating situations and can extrapolate to poor outcomes and the inability to achieve a goal.

As a team leader holding up the box to look at the full picture, I constantly seek the advice and the interjections from my team members. Whether in an acute emergency or on the day-to-day in convalescent medical care, it is important to me that I always keep my eyes open for puzzle pieces that fall on the floor but even more important that others are willing to pick up a piece when they see it fall themselves. To see the whole picture, it is important to have other perspectives from different angles. We might all be viewing the puzzle from a different direction and together the collaboration of these viewpoints helps to piece together a beautiful picture.

Image Credit: ChatGPT