Teamwork in Healthcare Organizations

Teamwork Objectives

• Distinguish between face-to-face teams, virtual teams, task forces, and committees.
• Compare and contrast disciplinary, interdisciplinary, and cross-functional teams.
• Discuss challenges of teamwork in healthcare organizations.
• Compare benefits and costs of face-to-face and virtual teamwork.
• Summarize research on the importance of effective teamwork in healthcare.
• Analyze differences between tame and wicked problems.
• Assess ways to fit into a team and select team members.
• Apply current thinking on emotions to teamwork scenarios.
• Critique communication and conflict management strategies in teams.
• Create a personal development plan for becoming an effective team member.
• Investigate sources of research on teamwork.

What is a Team?

• A team is a group of people with complementary skills, committed to a shared approach, mutually accountable, and working together to achieve a common goal.

Short vs. Long Term

• Team structures vary based on tasks and timeframes.
  • Cross-functional teams (CFTs)
  • Virtual teams
  • Task forces
  • Committees

The Challenge

• Formal teamwork training for physicians and nurses is rare.
• Developing teams and facilitating activities are recognized competencies for healthcare managers.
• Little formal preparation in teamwork exists in undergraduate and graduate healthcare management education.

Clinical vs. Managerial

• Conflicts between physicians and nurses often stem from physicians' refusal to embrace teamwork.
• Physicians and nurses often work from a clinical framework, advocating at the individual level for patients.
• Healthcare managers focus on population level and organizational issues.

Benefits of Effective Teams

• Empowered teams that are rewarded for performance improve coordination and quality of care, use health services efficiently, increase job satisfaction among team members, increase patient satisfaction, and increase productivity.

Surgical Teams

• A study of 74 Veterans Health Administration facilities found that participation in a Medical Team Training program was associated with lower surgical mortality rates.

Higher Level Managers

• Teamwork leads to improved communication, increased productivity, decreased absenteeism, increased job satisfaction, and decreased nursing turnover.

The Costs of Teamwork

• Meeting time, place, and expenses (food/coffee)
• Opportunity costs (time better spent elsewhere.)
• Perceived loss of autonomy.
• Risk-taking associated with relinquishing control/turf.
• Resistance to organizational change.

Tuckman's Stages

• Forming: Team members become oriented to goals, learn about tasks, and meet other team members.
• Storming: Intragroup conflict emerges, including attempts at dominance, passive-aggression, and information withholding.

Tuckman's Stages (Continued)

• Performing: Peace prevails; team members actively work together, sharing information to accomplish goals.
• Adjourning: Team members have developed respect for each other, and they are sad to disband.

Virtual Teams

• Remote locations (e.g., rural areas, space stations) require virtual teamwork.
• Telecommunicating is common in healthcare (e.g., billing, revenue recovery, customer service).

Pros and Cons of Virtual Teams

• Pros: Reduced interpersonal conflict, and access to diverse employees and talents.
• Cons: Communication challenges, intellectual property issues, need for careful team member selection. Work hours may not be limited to normal work weeks; issues determining who the supervisor is.

Tame vs. Wicked Problems

• Tame problems are definable and resolvable, though not always easy.
• Wicked problems are difficult to define and resolve; multiple layers of issues can complicate effective solutions.

Your New Team Role

• Questions to ask when assigned to a team, include goals, how they're measured, short-term and long-term deadlines, where and when the team meets, who to report to, your role on the team, and your responsibilities.

Good Managers

• Good managers have patience if a new team member takes time to clarify questions or their role.
• Coaching, mentoring, and guidance are essential aspects of management.
• Seeking thoughtful observations from new perspectives is crucial for better insight.

When You Get to Choose the Team

• Consider whether the team member belongs to the affected area, has the required knowledge/skills/disposition, has a clearly defined role, and has authority to implement recommendations.

When You Get to Choose the Team (Continued)

• Evaluate whether the team member can follow through on tasks, meet deadlines, work beyond departmental/discipline boundaries, work collaboratively, defuse tensions, de-escalate conflict, possesses a sense of humor, has a good reputation as a team player, and values organizational goals over individual goals.

Myers-Briggs Type Indicator

• The MBTI is a paper-and-pencil personality inventory which understands differences in personality based on Jung's theories .
• It assesses four domains, and four subsets on a four-by-four grid.

Myers-Briggs Type Indicator (Continued)

• The vertical axis is Introvert-Extrovert.
• The horizontal axis is Sensing-Intuitive.
• The grid includes Perceiving-Judging axis, along with Thinking-Feeling.
• Example type: ESTJ (responsible, dependable, highly organized, likes to see things done correctly, judges by standards, realistic, matter-of-fact, and loyal to institutions).

Emotional Contagion (EC)

• People can read emotions quickly.
• Women and physicians score high on reading emotions
• Teammates can influence each other's mood.

Leadership and EC

• Enthusiasm, confidence, and optimism are key to leading others .
• Emotionally aware team members can influence a positive workplace environment
• This improves the quality of employee and patient care.

Newer EI Terminology

• Social Intelligence (SI) separated social awareness and social facility instead of social skills.

Participative Work Climate

• Employees in a participative work environment provide higher customer service, commit fewer errors, and are less likely to leave their job.
• Patient-centered care requires strong interdisciplinary teamwork.

Eisenhardt, Kahwajy, and Bourgeois (1997)

• Effective teams use more information, develop multiple alternatives, share common goals, inject humor into the process, maintain balanced power structures, and focus on facts rather than personalities.

Crew Resource Management

• CRM in high-stakes industries like airlines is instrumental in addressing attitudes, influencing behaviors, and enhancing performance.
• CRM principles are applicable in hospitals, where the well-being of patients depends on effective teamwork.

TeamSTEPPS

• TeamSTEPPS is an evidence-based teamwork system in healthcare that improves communication and teamwork skills while focusing on patient safety.

TeamSTEPPS (Continued)

• This system provides ready-to-use materials and a training curriculum to integrate teamwork principles into all areas of healthcare settings.

Higher Quality, Safer Patient Care

• TeamSTEPPS enhances medical teams by optimizing the use of information, people, and resources to achieve the best clinical outcomes.
• Team awareness and roles are clarified.
• Conflicts are resolved, information is shared, and barriers to better quality and safety are eliminated.

Team Process: How To's

• Teams benefit with clear expectations, mutual understanding, respect, and calm interactions for a clear output.

Conflict Management for Teams

• Effective conflict resolution in teams can include bargaining, voting, problem solving, research, and third-party mediation.

This quiz explores the various types of teams, including face-to-face and virtual teams, in the context of healthcare organizations. Participants will assess the challenges and benefits of teamwork, examine roles within teams, and create a personal development plan. Learn about effective communication and conflict management strategies that enhance collaboration in a healthcare setting.