Unit outcome(s) addressed in this Assignment . Discuss professional work relatio
ID: 241537 • Letter: U
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Explanation / Answer
Teamwork is essential in the provision of healthcare. The division of labor among medical, nursing and allied health practitioners means that no single professional can deliver a complete episode of healthcare . Yet there is little formal training in teamwork skill development in undergraduate or postgraduate health professional education programs – teamwork skills are largely learned 'on-the-job' . In healthcare, where patient outcomes are dependent on effective interdisciplinary teamwork, there is need for better preparation of health professionals in teamwork.
Although many studies have identified teamwork as a requirement for high quality, safe patient care, within healthcare we have limited understanding of how individual health professionals contribute to effective teamwork. While there has been substantial study attempting to identify and define the requirements for effective healthcare teams, the predominant focus has been on improving existing teams. There has been little research into the educational and training needs of healthcare professionals to enhance their participation in workplace teams; healthcare team members do not understand the personal competencies required for team success. To assist in planning formal education programs this study aimed to identify the competencies held by healthcare professionals that were perceived by health service management colleagues to enhance teamwork. It has been suggested that "each team member's abilities, skills experience, attitudes, values, role perceptions and personality – all the things that make a person unique – determine what they are willing and able to contribute, their level of motivation, methods of interaction with other group members and degree of acceptance of group norms and the organization's goals", This suggests the need to focus on individual characteristics that have been found to contribute to teamwork, as "pre-requisite characteristics of effective teamwork",
Generally understood as the clusters of skills, abilities and knowledge needed for occupational tasks competency-based health professional education has had a long history and is stressed in the accreditation of healthcare management education programs worldwide. In addition, there is increasing evidence that management competencies are an important source of competitive advantage for organizations. Given the long standing focus on competency requirements for health service managers this study aimed to identify the competencies that were seen by health service managers to be related to effective teamwork within a health service workplace.
Team-based health care is the provision of health services to individuals, families, and/or their communities by at least two health providers who work collaboratively with patients and their caregivers—to the extent preferred by each patient – to accomplish shared goals within and across settings to achieve coordinated, high-quality care. The incorporation of sharing responsibilities with accountability between team members in health care systems offers great benefit. However, in practice, shared responsibility without high-quality teamwork can result in immediate risks for patients. For example, poor communication between health-care professionals, patients and their caregivers, has emerged as a common reason for patients taking legal action against health-care providers . Medical errors, “near misses” and other adverse events may also occur due to inadequacy of communication among team members even in a well coherent team. Moreover, lack of purposeful team care can also lead to unnecessary waste. Therefore, identification of best practices may help avoiding some of these dangers, and may help to control costs.
An effective team is a one where the team members, including the patients, communicate with each other, as well as merging their observations, expertise and decision-making responsibilities to optimize patients’ care. Understanding the culture of the workplace and its impact on team dynamics and functioning will make a team member a good team player.
Importance
Nowadays, patients are rarely looked after by just one health professional. In the context of a complex healthcare system, an effective teamwork is essential for patient safety as it minimizes adverse events caused by miscommunication with others caring for the patient, and misunderstandings of roles and responsibilities. Patients are undoubtedly interested in their own care and must be part of the communication process too; their early and throughout involvement has been also shown to minimise errors and potential adverse events.
The evolution of patient care
One all-knowing physician, or a private nurse living in the community in the “good old days” cared for people, and either was very easy to approach when needed at any time of the day [1]. Health care has changed enormously since then with more rapid pace in the last 20 years. It is now seen as undesirable in health care to practice in isolation and may even put the patient at risk [14,15]. The complexity of modern health care, which is evolving rapidly acts as a driving force behind the transition of health care practitioners’ from being soloists to members of teams who share a common aim [1].
Today, as both clinicians and patients integrate new technologies into their management process, the overall rapidity of change in health care systems will continue to accelerate. The U.S. National Guideline Clearinghouse has listed over 2,700 clinical practice guidelines now, and, each year, the results of more than 25,000 new clinical trials are published [16]. No single practitioner can handle, absorb and use all this information, and the need for specific knowledge in specialized areas of care by different team members has become a necessity. Now, more than ever, there is an obligation to strive for perfection in the science and practice of inter-professional team-based health care [1]. Each clinician relies upon information and action from other team members. Yet, without explicit acknowledgment and purposeful cultivation of the team, systematic inefficiencies and errors cannot be addressed and prevented [1].
The Development and Characteristics of a Successful Health Care Team
Different types of teams can be identified in health care systems [2]:
Core teams
These are directly involved in caring for the patient.
They usually consist of team leaders and members who are direct-care providers such as nurses, dentists, pharmacists, doctors, assistants…etc. They also include case managers.
Coordinating teams
The group responsible for operational management, coordinating functions and resource management for core teams.
Contingency teams
Formed to deal with emergencies or specific events (e.g. cardiac-arrest teams, disaster-response teams,. etc).
Ancillary teams/services
The group supports services that facilitate patient care such as cleaners or domestic staff.
Support services and administration
Those who provide indirect, task-specific services in a health-care facility support services. It includes secretaries and the executive leadership of a unit or facility. This team has 24-hour accountability for the overall functioning of the organization. In order for any team to form and develop in a way that makes it coherent, effective and strong enough to face future challenges, research have shown that it usually passes through the following stages [2]:
Forming: Typically characterized by ambiguity and confusion. Team members may be unclear about tasks at this stage. They have not yet chosen to work together and may communicate in a superficial and impersonal manner.
Storming: A difficult stage when there may be conflict between team members and some rebellion against the assigned tasks. Team members may get frustrated here when do not progress well in the tasks.
Norming: Open communication between team members is established and the team starts to confront the task at hand. Generally accepted procedures and communication patterns are established.
Performing: The team focuses all of its attention on achieving the goals. The team is now close and supportive, open and trusting, resourceful and effective.
After being formed and continue to develop, Healthcare teams interact dynamically and have the common goal of delivering health services to patients. In order to succeed, the team members need to share certain characteristics, which include [2]:
Go to:
Values, Principles and Benefits
The values needed in an effective team member harmonize with the core competency domain of “Values/Ethics” put forward in the meeting sponsored by Inter-professional Education Collaborative (IPEC)entitled “Team-Based Competencies”.The following are five personal values that characterize the most effective members of high-functioning teams in health care [1]:
Honesty: A high value is put on effective communication within the team, including transparency about aims, decisions, uncertainty, and mistakes. Honesty is critical to continuous development and for maintaining the mutual trust, which is prerequisite for a high-functioning team.
Discipline: Team members carry out their roles and responsibilities with discipline, even when it seems inconvenient. Such discipline allows teams to develop and stick to their standards and protocols even as they seek ways to improve.
Creativity: Team members are excited and motivated to tackle emerging problems creatively. They see even errors and some unanticipated bad outcomes as potential opportunities for improvement.
Humility: Team members do not believe that one type of training or perspective is uniformly superior to the training of others, though they recognize differences in training. They also recognize that they are human and will make mistakes. Hence, a key value of working in a team is that fellow team members can rely on each other to help recognize and avert failures, regardless of where they are in the hierarchy.
Curiosity: Team members are dedicated to reflecting upon the lessons they learned in their daily activities and using this reflective experience in continuous professional development and the functioning of the team.
Principles of Team-Based Health Care
There are many models to describe effective teamwork. Historically, these have come from other industries, such as the aviation’s crew resource management (CRM) [2]. The principles that characterize a successful team based health care include :
Shared goals: The team, including the patient and, where appropriate, family members or other support persons, generate a common and clearly defined purpose that includes collective interests and demonstrates shared ownership.
Clear roles: There are clear expectations for each team member’s functions, responsibilities, and accountabilities, which optimize the team’s efficiency and often make it possible for the team to take advantage of division of labour, thereby accomplishing more than the sum of its parts. Mutual trust and respect: Team members earn each other’s trust, creating strong norms of reciprocity and greater opportunities for shared achievement. They respect and appreciate the role of each other. They also respect each other’s talents and beliefs, in addition to their professional contributions. Effective teams also accept and encourage a diversity of opinions among members.
Effective communication: This is crucial for the teamwork success. The team prioritizes and continuously refines its communication skills. It has consistent and accessible channels for complete communication, and used by all team members across all settings.
Measurable processes and outcomes: Reliable and timely feedback on successes and failures should be agreed and implemented by the team. These are used to track and improve performance immediately and put strategies for the future.
Leadership: Effective team leaders facilitate, coach and coordinate the activities of other team members. Effective leadership is a key characteristic of an effective team.
Benefits of effective teamwork
Effective teams can improve care at the level of the organization, the team itself as a whole, the individual team member and the patient
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