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Ch10.pptx

CHAPTER 10COLLABORATION AND TEAM DEVELOPMENT

Copyright © 2015. F.A. Davis Company

COLLABORATION AND TEAM DEVELOPMENT

Effective teamwork in healthcare is an essential component of a healthy organizational culture.

Patients receive the best care at the hands of a team of professionals and paraprofessionals who offer different strengths and areas of expertise.

Team development is unique and challenging in healthcare settings.

Hierarchy poses a challenge to the collaboration and communication necessary for optimal teamwork.

Copyright © 2015. F.A. Davis Company

HEALTHCARE TEAMS

In healthcare, there are many teams working to provide patient care.

Teams are characterized to a great extent by their goals, norms, membership roles, expertise, and explicit and implicit rules.

The various experts on a healthcare team must follow their own scope of practice, licensing requirements, and individual job descriptions.

Hierarchal order infuses power gradients into relationships and provides a structure to activities.

Copyright © 2015. F.A. Davis Company

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HEALTHCARE TEAMS (cont’d)

Complications in Developing Teams

Members come from different educational paths and have varied knowledge bases and degrees of experience.

Members are responsible for a range of specialized and often urgent tasks.

Organizational tensions (e.g., budgetary concerns) and various agendas (e.g., filling beds) pull professionals in different directions.

There may be clinical differences of opinion, such as when to provide comfort measures versus aggressive treatment.

Copyright © 2015. F.A. Davis Company

HEALTHCARE TEAMS (cont’d)

Components of a Healthcare Team

Membership varies with staffing patterns, including shift work, weekends, and on-call assignments.

Teams are typically made up of 6 to 24 people, but there can be more or less.

Some teams are transient, such as first responders, while others have a more permanent existence, such as the nurse management team of a hospital.

Teams are also influenced by factors including diversity, fatigue, emotional intelligence, training, experience, and the quality of relationships.

Copyright © 2015. F.A. Davis Company

STAGES OF TEAM DEVELOPMENT

Gaining awareness about the five stages of small group or team development is critical, as difficult dynamics can result when team development is ignored.

These stages can occur over any length of time.

Forming is the first stage, and occurs when the team initially comes together.

Team members want to learn more about the goals, expectations, opportunities, and challenges

Team leaders should give clear goals and expectations, facilitate introductions among membership, and be accessible and visible in their roles roles

Copyright © 2015. F.A. Davis Company

STAGES OF TEAM DEVELOPMENT (cont’d)

Storming is the second stage, and is when the team starts to look more deeply at the objectives.

Members begin to challenge each others’ perspectives and possibly those of leadership

Team leaders should remain visible and accessible

Norming is the third stage, during which members begin to identify as part of the team.

Members have agreed to take on the challenges and goals before them, which prevails over bickering or competing for attention

Team leaders should take on a more collaborative demeanor

Copyright © 2015. F.A. Davis Company

STAGES OF TEAM DEVELOPMENT (cont’d)

Performing is the fourth stage, a creative and productive stage during which ideas flow freely.

Co-creative collaboration leads to new ways of thinking

Team leaders should encourage experimentation with ideas

Adjourning is the fifth and final stage, focusing on completion and closure.

Relief may set in now that the demanding work is over, as well as celebratory feelings over the team’s accomplishments

Leaders can help by making room to honor successes and say good-bye

Copyright © 2015. F.A. Davis Company

CHALLENGES IN TEAM DEVELOPMENT

Following the stages of team development in the real world of nursing is difficult due to endless emergent tasks to attend to and constant change.

Concerns about thorough team development are easily overlooked and seen as relatively unimportant when nurses are faced with urgent clinical priorities.

Teambuilding work is time-consuming and the skills hard to practice, yet key for healthy progression through team developmental stages, optimal collaboration, and patient safety.

Copyright © 2015. F.A. Davis Company

TEAMBUILDING STRATEGIES

Simple teambuilding may include informal gatherings as well as more in-depth consulting work involving assessment, recommendations, and interventions.

More extensive teambuilding activities might include meetings with senior leadership and managers, facilitated group feedback sessions, focused retreats, and customized training.

Formal teambuilding strategies have been introduced with the growing awareness of the need to collaborate effectively in order to provide safe, quality service with high reliability.

Copyright © 2015. F.A. Davis Company

TEAMBUILDING STRATEGIES (cont’d)

Crew Resource Management (CRM)

Originally developed in the aviation industry, focuses on ensuring safety in high-risk industries as well as group dynamics, leadership, interpersonal communication, and teamwork

Four principles—communication, workload management, teamwork, and technical proficiency—support the behavioral approach to communication

Promotes psychological safety through the concept that all staff must feel safe to voice concerns about workload management and resources

Copyright © 2015. F.A. Davis Company

TEAMBUILDING STRATEGIES (cont’d)

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)

Developed as an extension of CRM specifically for the healthcare industry

A standardized curriculum with a national implementation program in the United States that includes six regional training centers across the country

Four core competencies—leadership, situational monitoring, mutual support, and communication—are taught in a three-phased process

Copyright © 2015. F.A. Davis Company

HIERARCHY AND TEAMWORK

Historical hierarchy underlies all teamwork in a healthcare organization.

Traditional hierarchy in healthcare is based on the old mentality that men have more power and responsibility in decision-making and generally hold higher status than women.

Although gender roles are changing, today there exists a “command-and-control” hierarchy, in which those on the higher rungs of the ladder exert authority over those on lower rungs and with communication flowing from top to bottom.

Copyright © 2015. F.A. Davis Company

HIERARCHY AND TEAMWORK (cont’d)

Creating a Healthy Hierarchy

All healthcare workers must now learn how to become more collaborative leaders and followers as well as how to encourage patients to become more empowered.

There needs to be more sharing of authority, responsibility, and decision-making based on expertise, education, and knowledge.

Command-and- control can still be exercised to achieve the best patient care but will be challenged when appropriate by any team member.

Copyright © 2015. F.A. Davis Company

SPOTLIGHT ON CHAPTER FEATURES

Consultant Commentary

The core principles and activities associated with improvisation can contribute to the development of emotional intelligence, critical thinking, and positive interpersonal relationships necessary for successful teamwork.

Confident Voices

Team Intelligence and the Pursuit of Genuine Teamwork by Suzanne Gordon: The concept of team intelligence can help build the kind of intra- and inter-professional education and practice that makes the delivery of healthcare safer.

Copyright © 2015. F.A. Davis Company

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