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CONCEPTS & PRINCIPLES OF PARTNERSHIP, TEAMWORK AND COLLABORATION PART 1 BY: EVELYN L. REYES RN SON FACULTY UNDERSTANDING TERMS TEAMWORK Teamwork is the joint action and willingness of the people to work toward the same end goal. COLLABO...

CONCEPTS & PRINCIPLES OF PARTNERSHIP, TEAMWORK AND COLLABORATION PART 1 BY: EVELYN L. REYES RN SON FACULTY UNDERSTANDING TERMS TEAMWORK Teamwork is the joint action and willingness of the people to work toward the same end goal. COLLABORATION The action of working with someone to produce or create something. Team members have different skills sets, but still share similar goals. UNDERSTANDING TERMS PARTNERSHIP Partnership is a collaborative relationship between two or more parties based on trust, equality and mutual understanding for the achievement of a special goal. APPS, WHO Partnership – a nonspecific term for a relationship which strives for balance, equality and mutual respect, and in which information, power and responsibility are shared by two or more actual or legal persons. MEDICAL DICTIONARY TEAMWORK & COLLABORATION IN NURSING DEFINED The ability to “function effectively with nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care” (QSEN, 2019, par. 6) DEVELOPMENT OF TEAMWORK AND COLLABORATION A. Self-awareness For teams to be high-performing, they need to understand their development as a team. Team development is not always a linear process. Identifying and understanding causes for changes in the team behaviors can help the team maximize its processes and productivity. Being self-aware means understanding who you are and how others see you. SELF-AWARENESS A self-aware team commits to that same understanding at a collective level, with the right approach and true ongoing commitment: Fosters a culture that encourages communication and feedback at all levels, where honesty trumps hierarchy and even the lowest-ranking member feels safe putting problems on the table. (Tasha Eurich, 2018). Qualities critical for workplace success include 1. emotional intelligence, 2. empathy, SELF-AWARENESS 3. influence, 4. persuasion, 5. Communication 6. collaboration. All of which stem from self-awareness. Self-awareness in teams makes them more efficient, effective, innovative, and rewarding to be a part of. CULTIVATING SELF-AWARENESS Research suggests that when we see ourselves clearly, we are more confident and more creative. We make sounder decisions, build stronger relationships, and communicate more effectively. We are less likely to lie, cheat or steal. We are better workers who get more promotions, and become more effective leaders with more satisfied employees and more profitable companies. Self-awareness isn’t one truth, it’s a delicate balance of two distinct, even competing viewpoints. HOW TO CULTIVATE SELF-AWARENESS A. Understand what self-awareness really is. B. Learn that experience and power hinder self-awareness. C. Know that introspections doesn’t always improve awareness HOW TO CULTIVATE SELF-AWARENESS 2 TYPES OF SELF AWARENESS Internal self-awareness External self-awareness Represents how clearly we see our Means understanding how others own values, passions, aspirations, fit view us in terms of those same with our environment, reactions factors listed above. Research shows (including thoughts, feelings, that people who know how others behaviors, strengths and see them are more skilled at showing weaknesses), and impact on others. empathy and taking others’ perspectives. For leaders who see Internal self-awareness is associated themselves as their employees do, with higher job and relationship their employees tend to have a satisfaction, personal and social better relationship with them, feel control, and happiness; it is more satisfied with them, and see negatively related to anxiety, stress them as more effective in general. and depression. HOW TO CULTIVATE SELF-AWARENESS HOW TO CULTIVATE SELF-AWARENESS HOW TO CULTIVATE SELF-AWARENESS B. Experience and Power Hinder Self-awareness Studies have shown that people do not always learn from experience, that expertise does not help people root out false information, and that seeing ourselves as highly experienced can keep us from doing our homework, seeking disconfirming evidence, and questioning our assumptions. And just as experience can lead to a false sense of confidence about our performance, it can also make us overconfident about our level of self-knowledge. HOW TO CULTIVATE SELF-AWARENESS C. Introspection Doesn’t Always Improve Awareness Introspection is examining the causes of one’s thoughts, feelings and behaviors. The most common introspective question “why?” is a surprisingly ineffective self-awareness question because it invites unproductive negative thoughts. They are likely to land on an explanation of fears, short comings, insecurities, deficiencies, rather than a rational assessment of their strength and weaknesses. “What” questions helps one stay objective, future-focused, and empowered to act on new insights. HOW TO CULTIVATE SELF-AWARENESS WAYS TO DEVELOP SELF-AWARE TEAM 1. Being present increases productivity – being present is the better gift you can give to your productivity. Promoting self-awareness removes destructions, it helps people stay focused. 2. Move from blind spots to bright spots – what you don’t know, you don’t know blinds you. Knowledge, beliefs, thought and emotional blindness are the 4 common types of blind spots – that’s why teams make wrong decisions. Inaccurate assessment or members that over-rate their contributions damage performance and collaboration. WAYS TO DEVELOP SELF-AWARE TEAM 3. Nurture a Culture of Clarity and Transparency Miscommunication is the main reason behind most team tensions. The inability to discuss things openly- people see conflicts as hindering, rather than enabling growth. Clarity doesn’t just help members collaborates; self-aware teams make the immersion of new comers much easier. 4. Turn Awareness into a Team Practice. If some members have high self-awareness and others are clueless, the team will still suffer. Self-awareness is a collective journey – the whole team experiences the transformation together. Encourage team members to engage in self-awareness rituals every day. WAYS TO DEVELOP SELF-AWARE TEAM 5. Self-aware people don’t fight reality – they adapt and thrive Adaptability is a critical advantage to thrive in a fast-paced and unexpected world. The problem is that most people resist reality – they fight what they don’t know, what makes them feel uncomfortable or what they can’t understand. Self-awareness encourages curiosity – rather than resisting change, people pay attention and ask questions. Accepting reality is not passive – it doesn’t mean giving up either. Teams have to have an objective and unfiltered assessment of reality (knowledge), so they can understand why things are happening (Learn), and adjust their mindsets, strategies, and behaviors (adapt). WAYS TO DEVELOP SELF-AWARE TEAM 6. Go deep, but mind the gap 7. Encourage self-development, not just awareness Self-awareness is not an x-ray image Team development is an on-going of who you are. Self-awareness is an practice, not just a one-off. The same on-going journey, not a static way that developmental assessment assessment, it is about connecting tools only provide a snapshot, holding with the multiple layers of one’s a self-awareness workshop won’t identity, uncovering biases and blind change much. Building a practice spots – same as becoming more requires consistency and time. aware of how our mindsets and Self-development is a habit that takes emotions get in the way – requires a lifetime to master it. going deep. SELF-AWARENESS SUMMARY Developing self-awareness requires higher level cognitive processing. It requires an information-gathering perspective. This processing results in increases in adaptability and flexibility. Having increased self-awareness builds resilience and improves our ability to empathize with others. When compassion and empathy rise, so does the higher self. With intensions and purpose, a self-aware human can significantly impact the world around them as they tend to show up with confidence, self-worth, and high success rates. DYAD DYAD The most basic, fundamental type of social group that consist of only two people. The relationship between the two people can be linked through romantic interest, family relation, work, school, business, and so on. In a dyad, both members of the group must cooperate to make it work, if one fail to cooperate, the group will fall apart. DYAD MODEL IN HEALTH CARE “Dyads are mini-teams of two people who work together as co-leaders of a specific system, division, clinical service line or project” (Sanford and Moore, 2015). Most commonly used by administrators in health care settings. The purpose of a dyad leadership approach is to help organizations on the ff: meet strategic goals, enhance the leadership skills of new clinical leaders, promote shared accountability across divisions, model partnering throughout the organization as a means of collectively improving clinical outcomes. DYAD MODEL IN INTERPROFESSIONAL TRAINING The dyad model complements the curriculum components and advances trainee understanding of 4 core domains: Shared-decision-making (SDM), Sustained relationships (SR), Interprofessional collaboration (IPC), and Performance improvement (PI). GROUP GROUP Defined as a collection of individuals who have regular contact and frequent interactions, mutual influence, common feeling of camaraderie, and who work together to achieve a common set of goals. Group is mostly based on the interdependence of each member. GROUP Types of groups Groups are classified according to purpose or structure. primary and secondary groups; planned and emergent groups. GROUP Primary Secondary are clusters of people like families or are those in which members are close friendship circles where there is rarely, if ever, all in direct contact. close, face-to-face and intimate They are often large and usually interaction. There is also often a high formally organized. Trade unions and level of interdependence between membership organizations such as members. Primary groups are also the the National Trust are examples of key means of socialization in society, these. They are an important place the main place where attitudes, for socialization, but secondary to values and orientations are primary groups. developed and sustained GROUP Planned Emergent Planned groups are Come into being relatively specifically formed for some spontaneously where people find themselves together in the same purpose – either by their place, or where the same collection members, or by some external of people gradually come to know individual, group or each other through conversation organization. and interaction over a period of time. GROUP Benefits of being in a group Groups offer people the opportunity to work together on joint projects and tasks – they allow people to develop more complex and larger-scale activities. We have also seen that groups can be: Significant sites of socialization and education – enabling people to develop a sense of identity and belonging, and to deepen knowledge, skills, and values and attitudes. Places where relationships can form and grow, and where people can find help and support. Settings where wisdom flourishes. As James Suriwiecki (2004) has argued, it is often the case that ‘the many are smarter than the few’. GROUP Dangers of groups The socialization they offer might be highly constraining and oppressive for some of their members. They can also become environments that foster interpersonal conflict. Furthermore, the boundaries drawn around groups are part of a process of excluding certain people (sometimes to their detriment) and creating inter-group conflict. There is also evidence to show that groups can impact upon individuals in ways that warp their judgements and that lead to damaging decision making (what some commentators have talked about as ‘groupthink’). GROUP Group work A technique within the field of social work wherein various groups (as educational and recreational) are guided by an agency leader to more effective personal adjustment and community participation GROUP The Benefits of Group Work Increased Productivity and Performance: - groups that work well together can achieve much more than individuals working on their own. A broader range of skills can be applied to practical activities and sharing and discussing ideas can play a pivotal role in deepening understanding of a particular subject area. Skills Development – being part of a group will help one develop interpersonal skills such as speaking and listening as well as team working skills such as leadership and working with and motivating others. Some of these skills will be useful throughout the academic career and all are valued by employers. Knowing more about oneself – collaborating with others will help identify one’s own strengths and weaknesses (for example, one may be a better leader than a listener, or good at coming up with big ideas, but not so good of putting them into action). Enhanced self-awareness will both help one’s approach. GROUP Stages in Group Work To ensure a successful group outcome, activities is divided into series of steps or stages. Managing each of these stages effectively will greatly enhance group performance: Stage 1: Familiarization Stage 2: Planning & preparation Stage 3: Implementation Stage 4: Completion GROUP Stage 1 -Familiarization - this is the stage when the individual members of the group get to know each other and begin to understand the task they need to undertake. Time spent at this stage discussing individual areas of interest and skills will be invaluable in helping the group develop a sense of its own identity (including its strengths and weaknesses). GROUP Stage 2. Planning and preparation – this is the stage when the group should plan exactly what needs to be done, how it needs to be done, and who should do what. Consider the following: Agree on different elements of the task (background research, written text, overall design, graphs, images and final assembly). Agree the best way of achieving the tasks by dividing areas of responsibility amongst the group, making sure that roles and time commitments are as evenly balanced as possible. Make the most of the different areas of expertise by dividing tasks up according to the skills of different group members. Make an action plan of what needs to be done by when, working towards the final deadline. GROUP Stage 3. Implementation – whilst the group carries out its tasks, the need to preserve the group’s sense of purpose must be ensured. Effective communication is vital, particularly when the group activity extends overtime. To promote good communication, the following can be done: Share addresses, phone numbers, and email addresses, email distribution list, messenger account, at an early stage to facilitate contact between members of the group. Establish regular meetings of the whole group to check on progress and review action plans. Take notes at these meetings to help record complex discussions. GROUP Stage 4: Completion – the final stage often the most difficult and may require a different approach. It is important to regroup at this stage to agree anew action plan for the final stage of activity. GROUP Trouble Shooting Occasionally, groups can run into trouble, but it is useful to be aware of some of the problems (and the appropriate solutions) right from the start. The following list highlights some of the most common difficulties. 1. Unfair division or take-up pf labor between different group members: this can lead to resentment if someone feels they are doing all the hard work or if the group thinks that one or more members aren’t doing their fair share. Solution: use your meetings to check that people are happy with their workloads and discuss problems openly, making sure that issues are addressed as a group concern rather than putting pressure on individuals. GROUP Troubleshooting 2. Conflict between different group members: this might arise for many different reasons including two people competing for leadership or simple disagreement about ways forward. Solution: rotate leadership responsibilities or find ways of accommodating differing opinions. Group practices should be flexible and democratic rather than rigid and leader-led. GROUP Troubleshooting 3. Tackling inappropriate tasks as a whole group: groups are notoriously bad environments for carrying out such activities as writing fist drafts of documents or carrying out detailed searches. Solution: Be aware of the limitations of group activity and don’t be afraid to delegate responsibility for particular tasks to individuals. TEAM TEAM A team can be defined as (a) two or more individuals 3 who (b) socially interact (face-to-face or, increasingly, virtually); (c) possess one or more common goals; (d) are brought together to perform organizationally relevant tasks; (e) exhibit interdependencies with respect to workflow, goals, and outcomes; (f) have different roles and responsibilities; and (g) are together embedded in an encompassing organizational system, with boundaries and linkages to the broader system context and task environment. TEAM Health care Team Health care team is a group of professionals who contribute to the care and treatment of a patient. Typical members of a health care team are doctors and registered nurses. Multidisciplinary team A multidisciplinary team is a group of health workers who are members of different disciplines, each providing specific service to the patient. The team members independently and interdependently treat various issues a patient may have, focusing on the issues in which they specialize. The activities of the team are brought together using a care plan which coordinates their services and gets the team working together towards a specific set of goals. TEAM The nature of the team is varied and complex. There are different types of teams identified in a healthcare systems. The following are examples: Core teams – these teams are directly involve in caring for the patient. They usually consist of doctors, nurses, pharmacist, nutritionist, case manager, etc. Coordinating teams – the group responsible for operational management, coordinating functions and resource management for the core teams. Contingency teams – formed to deal with emergencies or specific events (example: code-blue team, disaster response teams). Ancillary teams/services teams – the group supports services that facilitate patient care such as cleaners or domestic staff members. Supports services and administration teams – are those who provide indirect, tasks specific services in a health care facility. These includes secretaries, and the executive leadership of a unit or facility. TEAM – TEAM DEVELOPMENT In team development, teams go through stages. The most commonly used framework for a team’s stages of development was developed in the mid 1960’s by Bruce W. Tuckman. And although many authors have written variations and enhancements to Tuckman’s work, his descriptions of Forming, Storming, Norming, and Performing provide a useful framework. Each stage of team development has its own recognizable feelings and behaviors; understanding why things are happening in certain ways, can be an important part of the self-evaluating process. STAGES OF TEAM DEVELOPMENT STAGES OF TEAM DEVELOPMENT STAGES OF TEAM DEVELOPMENT STAGES OF TEAM DEVELOPMENT STAGES OF TEAM DEVELOPMENT TEAMWORK Why is Teamwork Important? 1. Teamwork became an important health intervention for a number of reasons: 2. Clinical care is becoming more complex and specialized, forcing medical staffs to attempt complicated health services and quickly learn new methods. 3. Aging populations, the increase of chronic diseases like diabetes, cancer, and heart disease have forced medical staffs to take a multidisciplinary approach to health care. WHY IS TEAMWORK IMPORTANT? 4. Researchers have found that working together reduces the number of medical errors and increases patient safety. 5. Teamwork also reduces issues that lead to burnout. No longer is one person responsible for the patients’ health. 6. Because teamwork is centered on solid communication, patients and their families sometimes feel more at ease and report they can accept treatments and feel more satisfied with their health care, health workers are also found to be more satisfied with their work. STRATEGIES TO IMPROVE TEAMWORK & COLLABORATION 1. Effective Communication – a crucial part of everyday work and necessary for patient safety. Nurses have to communicate effectively with a diverse group of professionals and unlicensed personnel in caring for patients. 2. Collaboration – a collaborative relationship is not merely the sum of its parts, it is a synergistic alliance that maximizes the contributions of its participant resulting in action that is greater than the sum of individual works. STRATEGIES TO IMPROVE TEAMWORK AND COLLABORATION Principles of Effective Communication Engage in active listening to fully understand and contemplate what is being relayed. Know the intent of a message, and what is the purpose and expectations of that message. Foster an open, safe environment. Whenever giving or receiving information, be sure it is accurate. Have people speak to the person they need to speak to, so the right person gets the right information. (ANA/AONE, 2015, p.2). STRATEGIES TO IMPROVE TEAMWORK AND COLLABORATION IN HEALTH CARE Principles of Collaborative Relationship 1. Effective Communication 2. Authentic Relationship 3. Learning Environment and Culture STRATEGIES TO IMPROVE TEAMWORK AND COLLABORATION Principles of Collaborative Relationship 3. Principles of Learning Environment and Culture Inspire innovative and creative thinking. Commit to a cycle of evaluating, improving, and celebrating, and value what is going well. Create a culture of safety, both physically and psychologically. Share knowledge, and learn from mistakes. Question the status quo – ask “what if”, not “no way.” STRATEGIES TO IMPROVE TEAMWORK & COLLABORATION 3. Authentic Relationship – the principles of authentic relationship gives the nurses a guide for developing interactions with colleagues and cultivate the nurses 'sense of being cared for, that promotes their ability to do the same for their patients. 4. Establishing a Culture that support communication and collaboration. organizational commitment and willingness to address the situation. Recognition and self-esteem Taking action through appropriate intervention strategies. STRATEGIES TO IMPROVE TEAMWORK & COLLABORATION The ANA/AONE’s principles of authentic relationships includes: Be true to yourself – be sure your actions match your words, and those around you are confident that what they see is what they get. Empower others to have ideas, to share those ideas, and to participate in projects that leverage or enact those ideas. Recognize and leverage each other’s strengths Be honest 100% of the time – with yourself and with others. Respect others’ personalities, needs and wants. Ask for what you want, but stay open to negotiating the difference. Assume good intent from others’ words and actions, and assume they are doing their best. (ANA/AONE, 2015, p.2). STRATEGIES TO IMPROVE TEAMWORK & COLLABORATION 5. Mutual Respect – mutual respect is of the utmost importance among all members of the healthcare team and must be valued by each individual. Mutual respect is the continuance condition of dialogue. The instant people perceive disrespect in a conversation, the interaction is no longer about the original purpose— it is now about defending dignity. DYSFUNCTIONS OF A TEAM DYSFUNCTIONS OF A TEAM Patrick Lencioni reveals the five dysfunctions that go to the very heart of why even the best teams often struggle. He outlines a powerful model with actionable steps that can be used to overcome these five common hurdles and build cohesive, effective teams. He identifies the following dysfunctions as well as positive characteristics that may overcome each dysfunction: DYSFUNCTIONS OF A TEAM Dysfunction 1 – Absence of trust – trust is confidence among team members that their peers’ intentions are good, and that there is no reason to be protective or careful around the group. Members: Admit weaknesses and mistakes Ask for help Accept questions and input about their area of responsibility. Give another the benefit of the doubt before arriving at a negative attribute. Take a risk in offering feedback and assistance. Appreciate and tap into one another’s skills and experiences. Focus time and energy on important issues, not politics. Offer and accept apologies without hesitations. Look forward to meetings and opportunities to work as a group. DYSFUNCTIONS OF A TEAM Dysfunction 2 – Fear of Conflict - it is important to distinguish productive ideological conflict from destructive fighting and interpersonal politics. The purpose is to produce the best possible solution in the shortest period of time. Teams that engage in healthy conflict: Have lively, interesting meetings. Extract and exploit the ideas of all team members. Solve real problems quickly Minimize politics Put critical topics on the table for discussion (Lencioni, 2002). DYSFUNCTIONS OF A TEAM Dysfunction 3 – Lack of Commitment – in the context of teams, commitment is a function of two things: clarity and buy-in. great teams make clear and timely decisions and move forward with complete buy-in from every member of the team, even those who voted against the decision. The two greatest causes of a lack of commitment is the desire for consensus and the need for certainly... a team that commits: Creates clarity around directions and priorities. Aligns the entire team around common objectives. Develops an ability to learn from mistakes Takes advantage of opportunities before competitors do. Moves forward without hesitation Changes direction without hesitation or guilt (Lencioni, 2002). DYSFUNCTIONS OF A TEAM Dysfunction 4 – Avoidance of Accountability – In the context of teamwork, accountability refers specifically to the willingness of team members to point out performance or behavior that might hurt the team. A team that holds one another accountable: Ensures that poor performers feel the pressure to improve. Identifies potential problems quickly by questioning one another’s approaches without hesitation. Establishes respect among team members who are held to the same high standards. Avoids excessive bureaucracy around performance management and corrective action. DYSFUNCTIONS OF A TEAM Dysfunction 5 – Inattention to Results – the ultimate dysfunction of a team is the tendency of members to care about something other than the collective goals of the group. An unrelenting focus on specific objectives and clearly defined outcomes is a requirement for any team that judges itself on performance. A team that focuses on collective results: Retains achievement-oriented employees. Minimizes individualistic behavior. Enjoy success and suffers failure acutely. Benefits from individuals who subjugate their own goals/interest for the good of the team. Avoids distractions (Lencioni, 2002). END OF PART 1 THANK YOU Part II – Tools to facilitate teamwork and prevent patient from harm Nurses’ Roles in Teamwork and Collaboration

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