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Introduction

Ireturned from a conference on an earlier flight than scheduled to see my wife and daughter before bedtime that Friday night. I had been home for 45 minutes when I received an emergency call from the operating room. One of our surgeons was in trouble with a young man who had a collagen vascular disease that made his blood vessel walls weak and prone to forming and rupturing aneurysms. The young man was driving home with his rented tuxedo for his wedding the next day when he developed acute abdominal pain and collapsed. He was taken to a nearby hospital in Flagstaff, and then his heart arrested. Following resuscitation, he was transported to Mayo where he arrested again before being rushed into surgery. After 23 units of blood, they still couldn't control his ruptured left hepatic artery aneurysm.

When I got the call, I rushed to the hospital and was able to gain control of the artery without sacrificing the right lobe of the liver. The next day the patient was off the ventilator and talking with the nurses in the unit like nothing had happened. The following day, our chaplain performed a wedding for the couple in the hospital intensive care unit. The patient was discharged the next week with no problems.

What a great feeling to help that patient. If an opportunity arises to collaborate on a difficult case, there is no hesitancy in jumping in to help.1

Stories like this one—told by Dr. David Mulligan, chair of transplant surgery at Mayo Clinic Arizona and a liver surgery specialist—capture Mayo's culture and core competency of teamwork. Mayo employs highly capable doctors and other caregivers, but so do other healthcare organizations. What helps distinguish Mayo is effective medical staff teamwork. The Clinic excels in pooling talent for the benefit of patients.

Mayo Clinic is a collaborative organization, a pliable institution that assembles the expert care teams for individual patients. Imagine a huge store that sells everything, with experts in every department who work together to help customers. This is how Mayo Clinic is designed for medical customers. Patients don't get just a doctor; they get, in effect, the "whole company." Some patients see more than one Clinic physician. Typically, the first doctor to treat a patient is responsible for coordinating the care plan with other Mayo clinicians and the patient's hometown physician. Most Mayo patients see only one physician who, in turn, may informally consult with other clinicians on staff to reach a diagnosis or develop a treatment plan. Depending on an individual patient's needs, a surgeon and surgical nurses and technicians, nurses with specialized training, a dietician, a physical rehabilitation specialist, a social worker, and others may join the team. Once the care is provided to a particular patient, staff members reconfigure to serve other patients.

In another story of teamwork, Dr. Mulligan illustrates ...

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