Chapter 10 Teamwork PDF

Chapter 10 Teamwork  Objectives Distinguish between a face to face team, a virtual team, a task force, and a committee. Compare and contrast disciplinary, interdisciplinary, and cross-functional teams. Discuss the challenges associated with teamwork in health care or...

Chapter 10 Teamwork  Objectives Distinguish between a face to face team, a virtual team, a task force, and a committee. Compare and contrast disciplinary, interdisciplinary, and cross-functional teams. Discuss the challenges associated with teamwork in health care organizations. Compare and contrast the benefits and costs of face to face and virtual teamwork.  Objectives (Cont’d.) Summarize research findings on the importance of effective teamwork in health care. Analyze differences between tame and wicked problems. Assess ways to fit into a team and to select team members.  Objectives (Cont’d.) Apply current thinking on emotions to teamwork scenarios. Critique strategies for managing communication and conflict on a team. 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 who are committed to a common approach for which they hold themselves mutually accountable, working together to achieve a common goal.  Short vs. Long Term Different tasks/timeframes, different team structures: – Cross functional teams (CFTs) – Virtual teams – Task forces – Committees  The Challenge Formal teamwork educational training for physicians and nurses is rare. Developing teams and facilitating team activities are recognized competencies for health care managers (Stefl, 2008). However, there is little formal preparation in teamwork in undergraduate and graduate health care management education programs (Leggat, 2007).  Clinical vs. Managerial Conflicts between physicians and nurses are often due to physicians’ refusal to embrace teamwork. Physicians and nurses work from a clinical framework, advocating at the individual level for patients and families. Health care managers are trained to look at population level and organization-wide issues.  Benefits of Effective Teams Teams that are empowered to be innovative and rewarded for performance: – improve coordination and quality of care. – use health care services more efficiently. – increase job satisfaction among team members. – increase patient satisfaction. – increase productivity.  Surgical Teams A multi-site retrospective study of 74 Veterans Health Administration (VHA) facilities found that “participation in the VHA Medical Team Training program was associated with a lower surgical mortality rate” (Neily, Mills, Young- Xu, Carney, West, Berger, Mazzia, Paull, Bagian, 2010, p. 1693).  Higher Level Managers For this audience, the answer lies in the bottom line: improved communication. increased productivity. decreased absenteeism. increased job satisfaction. decreased nursing turnover.  The Costs of Teamwork Meeting time, place to meet, and food and coffee. Opportunity costs, i.e., how that time might have been better spent. Perceived loss of autonomy. Risk-taking associated with letting go of one’s turf. Resistance to organizational change.  Tuckman’s Stages Forming: getting oriented to the team goals and each other, finding out what the tasks are, and who they will be working with. Storming: intragroup conflict, attempts at dominance, passive-aggressive behavior, along with information withholding and other forms of resistance to team tasks and goals.  Tuckman’s Stages (Cont’d.) Performing: peace breaks out and team members actually begin the work at hand, have open dialogue with one another, and share information to accomplish the team’s goals. Adjourning: team members have worked together over a long period of time, have developed respect for one another, and like each other as individuals and the team as a whole and become sad that they are disbanding.  Virtual Teams Remote locations, such as rural areas, space stations, and the Antarctic require the use of virtual teamwork. The health care industry has adopted telecommuting for some segments of the industry, such as billing, revenue recovery, and customer service.  Pros and Cons of Virtual Teams Pro: Less interpersonal conflict, reduced travel, and access to diverse employees and talents regardless of geography. Cons: Communication challenges, intellectual property issues, need for careful selection of team members, work hours may not be limited to normal work week; problems with determining who the supervisor is when there are HR issues.  Tame vs. Wicked Problems Tame problems can be defined and while not easy, can be solved. Wicked problems are difficult to define and not easily resolved—and sometimes can never be truly solved due to multiple layers of issues, such as we see in health care (Drinka and Clark, 2000, p. 37).  Your New Team Role Some of the questions you team meet? can ask when assigned to a – To whom do I report? team: (Sometimes staff members – What are the goals of the are loaned to teams, so team? this is an important issue – How will they be to resolve.) measured? – What is my role on the – What are the short-term team? and long-term deadlines? – What are my – When and where does the responsibilities in that role?  Good Managers Good managers don’t mind if a new staff member makes a list of questions and asks for clarification and direction. Coaching, mentoring, and guiding are all part of the manager’s role. Good managers want thoughtful observations from a new perspective: yours. When You Get to Choose the Team Does this person: Belong to an area that’s affected by the problem at hand? Have the knowledge, skills, and disposition to do the tasks at hand? Have a clearly defined role on the team? Have the authority to make decisions and implement recommendations?  When You Get to Choose the Team (Cont’d.) Follow through on assignments and tasks? Meet deadlines? Think beyond the confines of a department or discipline? Work collaboratively and respectfully with other disciplines?  When You Get to Choose the Team (Cont’d.) Have the ability to defuse tensions and de- escalate conflict? Have a sense of humor? Have a good reputation within the organization as a team player? Value the perceptions and ideas of others? See organizational goals as superseding individual goals?  Myers-Briggs Type Indicator Myers-Briggs Type Indicator (MBTI) is a paper-and-pencil personality inventory used for understanding differences in team members’ personalities, based on Jung’s theory of psychological types. Assesses four domains and four subsets within those domains on a four-by-four grid.  Myers-Briggs Type Indicator The MBTI assesses four domains and four subsets within those domains on a four-byfour grid (Wideman, 2003). On the vertical axis of this grid is the Introvert- Extrovert scale; on the horizontal axis is the Sensing- Intuitive scale. Within each of the four quadrants of this grid are two more axes—the Perceiving Judging axis and the Thinking-Feeling axix they would want an “ESTJ,” someone who is “responsible, dependable, highly organized, likes to see things done correctly, tends to judge in terms of standard operating procedures, realistic, matter-of-fact, and loyal to institutions”s. 24  Emotional Contagion (EC) People emotionally in tune with others can read emotions within nanoseconds. Women and physicians scored higher on EC scale, i.e., the ability to read other people’s emotions. Teammates catch each others’ moods.  Leadership and EC Enthusiasm, confidence, and optimism are critical to leading others. Emotionally aware team members can change an organization’s emotional environment and improve the quality of employees’ and patients’ lives by helping others to become “infected” with positive emotions (Buchbinder, 2009b).  Newer EI Terminology In 2006, Goleman moved to the terminology Social Intelligence (SI) to separate out the last two components of EI, social awareness and “social facility” instead of social skills (Goleman, 2006).  Participative Work Climate Healthcare employees who view their work unit climate as participative as opposed to authoritarian provide higher levels of customer service, commit fewer clinical errors, and express less likelihood of leaving the organization (Angermeier, Dunford, Boss, and Boss, 2009). Patient centered care requires excellent interdisciplinary teamwork.  Eisenhardt, Kahwajy, and Bourgeois (1997) Found that effective teams: – work with more information. – developed multiple alternatives. – had common goals. – injected humor into the process. – maintained balanced power structures. – kept focus on the facts and not on personalities in open dialogue.  Crew Resource Management Crew Resource Management (CRM), in the high-stakes airline industry, has been developed to address attitudes, change behavior, and improve performance. Sexton, Thomas, and Helmreich (2000) have applied crew resource management research to hospitals, where stakes are also high and lives depend on the smooth functioning of the health care team.  TeamSTEPPS TeamSTEPPS is a teamwork system designed for health care professionals that is: – a powerful solution to improving patient safety within your organization. – an evidence-based teamwork system to improve communication and teamwork skills among health care professionals.  TeamSTEPPS (Cont’d.) A source for ready-to-use materials and a training curriculum to successfully integrate teamwork principles into all areas of your health care system. Scientifically rooted in more than 20 years of research and lessons from the application of teamwork principles. Developed by Department of Defense's Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.  Higher Quality, Safer Patient Care TeamSTEPPS produces highly effective medical teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for patients. Increases team awareness and clarifies team roles and responsibilities. Resolves conflicts, improves information sharing, and eliminates barriers to quality and safety.  Team Process: How To’s Team Leader : Team Members: asks for ideas. Take assignments with acknowledges input, deadlines and follow writes it down. through. doesn’t interrupt and Critical Elements: doesn’t let others Summary of meeting is interrupt;\. shared. asks critics for Follow up and follow suggestions. through are critical. remains calm.  Conflict Management for Teams Bargaining Voting Problem solving Research Third-party mediation