チーム医療
チームの本質は、目標を共有し、状況を共有しながら互いに補い合うことである
と私は考える。それは、言葉にすると簡単であるが、実行することは容易ではな
い。
私はI-cubeという全国規模の、医学・看護だけでなくリハや放射線などのすべて
の医療系の学生、栄養や教育や法律などの医療に興味のある学生、さらに医療現
場で働くまたは医療についての夢を持つ社会人の集まる、600人規模(2005年4月
現在)のサークルを立ち上げた。それを通じて、いろいろなことを学んだ。
様々なバックグラウンドを持つ人間が集まったとき、その違いはやはり壁になる。
大学が違えばスケジュールが違う。専門が違えば持つ知識が違う。能力の質も、
やはり違う。同じ背景を持ち同じ言語を持つ集団が、やはりもっとも統率しやす
い。個々人を分析し、組織に組み込み、指示を出すことは、手間のかかることだ
からである。
しかし逆に、もっとも力が持つのは、様々な人間がいるチームであるということ
をそこで知った。人間が一人でできることには限界がある。同質の人間が集まっ
ても、やはりできることには限界がある。異質な人間が集まると、想定外の出来
事が起きてしまう。しばしばそれはミスに繋がってしまう。しかし、うまくメン
バーが繋がっていれば、想定外のすばらしい結果に繋がることがある。
予想を越える良い結果を得ることができるチームの条件は、目標を共有できてい
ることと、適切に情報を共有できていること、の二点であると私は考える。目標
が共有できていなければ、それぞれのメンバーの視点と行動が分散し、力を集め
ることができなくなる。情報が共有できていなければ、それぞれのメンバーが適
切な行動を起こすことができなくなる。
現在の日本医療のチーム医療の原状について考えたとき、その二点は、なかなか
実行できてはいないと私は感じる。医療の目標である患者を意識するために、患
者中心の医療、と言われるようになって久しいが、日々の忙しい医療現場の中、
医療者はしばしばそれを忘れてしまっているのではないだろうか。電子カルテ
やカンファレンスは、情報共有のためにあることを、しばしば医療従事者は忘れ
てしまっているのではないだろうか。チーム医療の実現のためには、夢や理念に
支えられた心からひとを動かす目標と、職種や個々人の違いを感じて受け入れる
情報共有の土壌とが重要であると、私は考える。
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