How “CHIPS” Can Save a Life: Rethinking Healthcare Collaboration

Why Collaboration in Healthcare Isn’t Optional

Collaboration is critical in any organization. In healthcare, this is particularly important in all aspects. But, I am biased to the fact that is of utmost importance in the pediatric critical care arena where the life of a child may be on the line. Interprofessional collaboration can make the difference between life and death in our field.

Understanding Team Dynamics

When we discuss collaboration within a team, there are a few different types of team dynamics. First, there is the unidisciplinary team, also known as uniprofessional, intradisciplinary, and intraprofessional. This team is comprised of a single professional who may communicate with colleagues but works independently. Next, there is the multidisciplinary team, also known as multiagency. This team is comprised of professionals from multiple disciplines, but they work independently and communicate via the leader of the team. The team members work in parallel with one another. Additionally, there is the interprofessional team, also known as interdisciplinary, interprofessional collaboration, and cross-disciplinary. The team is comprised of professionals from multiple disciplines and is more patient centered. There is frequent communication, and they work interdependently and share in the decision-making. Members hold equal status, but there is a leader who is designated to oversee care. They have a shared goal and coordinated treatment plan. Finally, there is the transdisciplinary team, also known as transprofessional or supra-professional. This team shares the principles of the interprofessional team, but the professional boundaries are blurred in that different members will have an overlap of knowledge and skills that enable them to perform duties that would be another’s responsibility or expertise. There is complete integration of the assessment and one unified plan.

With all these options for teamwork, the most important one is the interprofessional team because medicine can be very complicated, and the knowledge base is so vast that it is difficult for every team member to have the same level of expertise as the other team members. Healthcare requires a diverse team of individuals to provide the best care possible. When caring for complex medical issues, it is often said that “it takes a village”. The most efficient and effective “village” is the interprofessional team. Collaboration among different professionals is very powerful and in the intensive care unit, it can actually reduce patient mortality.

The ”CHIPS” Framework: A Physiological Analogy

The power of the interprofessional team lies in how the collaboration works. I like the analogy of comparing this collaboration to physiology of the body. In the body, there are multiple organs like the liver, brain, heart, spleen, kidneys, and many others. Physiology explains how organs, tissues, cells, and molecules work together to carry out the functions necessary for life. In the end, all these organs, tissues, cells, and molecules work together to form something that is more than the sum of its parts. This is true of the members of an interprofessional team. The team that is formed from these individuals is more than the sum of its parts, like the human body. However, there are some important foundation principles that are critical to facilitating this collaboration, “CHIPS”.

“CHIPS” is an acronym for:

• Curiosity and Humility
• Inclusion
• Psychological Safety

All of these elements play an important role in setting the foundation for collaboration within the interprofessional team and are analogous to systems within the human body.

Curiosity & Humility: The Nervous System of Teamwork

Curiosity and humility are like the nervous system of the body. These elements act to sense and investigate the environment, receive information, and respond just like the nervous system. They encourage active learning by asking deeper questions, seeking understanding beyond the immediate scope, and facilitating broader awareness and knowledge-sharing. Curiosity and humility foster innovation by driving exploration and experimentation, leading to creative solutions and improvements. They build mutual respect by reflecting a genuine curiosity with active listening and understanding about the roles and perspectives of others. They strengthen interpersonal relations through communication and openness to learning from others. Finally, curiosity and humility drive enhanced problem-solving by promoting a mindset that encourages open exploration from multiple viewpoints, improving the team’s ability to solve complex problems collaboratively.

Inclusion: The Circulatory System That Connects Us

Inclusion is like the circulatory system of the body. It allows communication between all the organs of the body and provides nutrients for survival. The circulatory system connects all of the organs, just like inclusion brings all members of a team together. Inclusion sets the stage to increase diverse perspectives with ensures varied viewpoints, leading to more comprehensive decision-making. It strengthens team cohesion by creating a feeling of being valued and heard between team members which encourages trust and respect which, in turn, leads to deeper professional relationships and cooperation. Inclusion also improves a team’s problem-solving capacity by leveraging diverse expertise, resulting in more effective and innovative solutions to complex problems. Finally, inclusion boosts engagement by creating a team experience that generates motivation, job satisfaction, and commitment. Varied viewpoints and perspectives are the point of inclusivity because if everyone is thinking the same, then nobody is thinking at all.

Psychological Safety: The Immune System of Trust

Last, but not least, psychological safety is like the immune system. It protects the team from dangerous behavior that would damage the team’s cohesiveness and genuine function just like the immune system protects the body from foreign organisms that would damage the body. Dr. Amy Edmonson defined psychological safety within the team as, “…a shared belief that the team is safe from interpersonal risk-taking.” She also noted that psychological safety promoted, “…a sense of confidence that the team will not embarrass, reject, or punish someone from speaking up. This confidence stems from mutual respect and trust among team members.” Psychological safety provides a safe environment for teammates to be curious and practice humility, as well as making inclusivity seem genuine. Curiosity, humility, inclusivity, and psychological safety all interact with one another to provide the optimal environment for the team to function within.

Bringing It to Life: Practices That Foster “CHIPS”

So, how can one practice curiosity, humility, inclusivity, and psychological safety to build the foundation to generate interprofessional collaboration? A team can learn these skills by applying them in a number of ways. Some examples of exercises or practices include:

Curiosity and Humility

1. Interprofessional teaching rounds and simulations
2. Encourage questions and innovative thinking – foster openness to others' perspectives
3. Case reviews emphasizing learning opportunities

Inclusion

1. Encourage active participation of all disciplines during rounds
2. Team-building and cross-disciplinary training
3. Peer recognition and appreciation of team members across all disciplines

Psychological Safety

1. Regular structured team debriefings (situation-specific: logistic, emotional, performance improvement, etc.) – normalize open dialogue, empathy, compassion, and common humanity
2. Leaders to model openness, receptiveness, curiosity over blame, and inclusiveness
3. Standardize communication tools (i.e., SBAR) – empowerment of team members to engage in a structured manner

Small Actions, Big Impact: Creating a CHIPS Culture

Interprofessional collaboration is akin to the functioning of the body. It is dependent upon curiosity and humility, inclusion, and psychological safety for survival, just as the human body is dependent upon the nervous, circulatory, and immune systems for survival. In fact, interprofessional collaboration improves patient outcomes in healthcare through shared and integrated expertise. So, curiosity and humility, inclusion, and psychological safety (“CHIPS”) can actually be lifesaving. They all interact and overlap in how they enhance collaboration within a team. The end result of refined interprofessional collaboration is improvement in open communication, trust, shared goals, and innovation that produces the highest functioning team possible. An important concept to understand is that there are actionable ways to improve interprofessional collaboration and a “CHIPS” culture can be established—one deliberate choice, one conversation, and one act of inclusion at a time. When we commit to these foundational principles, we don’t just build better teams—we save lives.

Which aspect of CHIPS do you think your team needs to strengthen most—and why?