Healthcare Core Curriculum Competency 3: Communications & The Team Dede Carr, BS, LDA Karen Neu, MSN, CNE, CNP.

Communicationsin Healthcare

Healthcare Core CurriculumCompetency 3: Communications & The Team

Dede Carr, BS, LDAKaren Neu, MSN, CNE, CNP

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Objectives Use a variety of communication techniques to

achieve effective interpersonal & team communication

Using a problem solving process applied to healthcare situations; describe how healthcare workers can effectively communicate with their clients and team membersDescribe the expectations employers have of health

care personnel in a team-centered approach to careDescribe the purpose, function, and benefits of a teamIdentify characteristics of an effective team memberIdentify & discuss roles of team members

Competency #3 & 8: Communications & The Team

Functions of a team Purpose – accomplish goals, support each other Activities – work together, support each other,

coordinate work, effective verbal/non-verbal communication

Benefits of Health Care Team ◦ Increase continuity of care, client satisfaction, job

satisfaction, self-esteem◦ Providing & improving quality of health care is a team

effort & is on-going on many levels. To succeed, every part of the health care system must become involved, including government and nongovernment organizations, doctors, nurses, pharmacists, hospitals, other providers, you, & the patient (White, n.d.)

Team Work

Team Functions Building trust Mastering conflict Achieving commitment Embracing accountability Focusing on results Each function builds on the previous one

A team that trusts each other can master productive conflict, which leads to the ability to commit to the decisions & hold each other accountable for commitments.

Finally, teams that hold one another accountable for commitments & behavior are able to focus on getting the results they need to meet their mission successfully.

(Rowley)

Functions of a Team

"A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they are mutually accountable." (Katzenbach and Smith)

Team uses group’s collective energy & creativity & accomplishes more in less time

What is a Team?

"People working together in a committed way to achieve a common goal or mission. Work is interdependent & team members share responsibility & hold themselves accountable for attaining the results" (MIT Information Services and Technology, n.d.)

"A team is a group of people working together towards a common goal" (Team Technology)

"A group in which members work together intensively to achieve a common group goal" (Lewis-McClear & Taylor)

Various Definitions of Team

Team communication is defined as the information, thoughts and expressions shared by more than 3 members of a group.

No matter what type of group, i.e. class members, sports team, health care team, each member is a valued contributor.

Team communication can be complicated and it challenges every member to effectively hear the same message.

(Papa, n.d.)

Team Communication

Essential for a healthy, productive team. Healthy communication builds an

atmosphere of trust among team members. Inspires all members to achieve a common

goal. Allows for open expression and direct

feedback.

(Papa, n.d.)

Importance of Team Communication

Contributes to guiding & directing the team as a whole.

Assists in avoiding misunderstandings and possible issues from occurring.

Team communication can be used for a variety of settings, i.e. team projects, seminars, committees, etc.

(Papa, n.d.)

Function of Team Communication

All team members feel heard and understand the goal of the team.

A safe atmosphere has been created◦ thereby allowing members to openly suggest,

discuss, and carry out the goal of the team.(White, n.d.)

The Effects of Team Communication

Example: Nursing service team: group of professional & non-professional nursing service personnel working together in planning, giving, & evaluating patient-centered nursing care to a group of patients (Leino)

Example: Multidisciplinary teams, which consist of the physician, nurses, assistants, dietician, therapists, etc.

Examples of Teams

Distributing the workload Reinforcing individual capabilities Creating participation and involvement Making better decisions Feeling like we play a part in the work

being done Generating a diversity of ideas, etc.

(AbiSamra, n.d.)

Benefits of the Team

Accomplish projects an individual cannot do - Many projects are too large or too complex for one individual to complete alone.

Brainstorm More Solution Options - Different people looking at the same problem will find different solutions. A team can review ideas & put together a final solution which incorporates the best individual ideas.

Detect Flaws in Solutions - A team looking at different proposed solutions may also find pitfalls that an individual might miss. The final solution is that much stronger.

Build a Workplace Community - Members of effective teams can form personal bonds which are good for individual & workplace morale. In healthcare settings, personnel on teams may form bonds which extend beyond the workplace

(Fresh Tracks)

Benefits of Team for Workplace

Full Participation - All team members contribute time & energy to the project. ◦ All participate in the decision making process. Having

a dominant leader may work for the very short term, but will eventually lead to morale problems later on.

◦ Involves others in the decision-making process Trust - Members trust that each member will

add value to the project, & members work to ensure that everybody does contribute & that appreciation is expressed for different contributions.◦ Respects & is tolerant of individual differences

(Fresh Tracks)

Team Dynamics

Open Communication - Main glue that holds a team together; communication is effective when all members: ◦ Contribute ideas◦ Provide feedback constructively◦ Ask for clarification on anything that might be

confusing◦ Provide frequent updates◦ Listen to each other carefully◦ Shares openly & authentically with others

regarding personal feelings, opinions, thoughts, & perceptions about problems & conditions

(Fresh Tracks)

Team Dynamics

Clear Roles - Teams tend to function better if member roles are defined. There are several ways "roles" can be defined, & they need not be mutually exclusive.

◦ By work function - Most healthcare teams assign roles by work function. For instance, healthcare team that provides patient care requires registered nurses, licensed practical nurses, and nursing assistants.

◦ By meeting function - Many sources also suggest assigning some or all the following roles for projects which require significant brainstorming: (Team Technology)

Team Roles

Initiator: Puts ideas on the table Facilitator/Leader: Defines problem & sets agenda. Recorder/"Secretary” Records all ideas with no

other comment. Can also act as a timekeeper. Devil's Advocate/Skeptic: Reviews ideas for

potential problems Optimist: Person who keeps a positive frame of

mind & facilitates search for solutions (Team Technology)

(Team Work Function Roles continued on next slide)

Team Work Function Roles

Team Work Function Roles Continued

Summarizer/Clarifier: Summarizes & clarifies results. Is often the same as the facilitator.

Liaison/Spokesperson: Maintains contact with the supervisor on behalf of the group. Could be the same as the recorder or the facilitator.

Reflector: Does not participate in the group activities, but observes

(Team Technology)

Team Work Function Roles

Belbin’s Model of Team Roles

Shapers: Individuals who challenge the team to improve

Implementers: Team members who get things done

Completer-Finishers: Members who see that projects are completed thoroughly

Coordinators: Member who acts as traditional team leader

(Team Technology)

(Belbin’s Model of Team Roles continued on next slide)

Nine Team Roles for Success

Belbin’s Model of Team RolesTeam Workers: Members who are

negotiators, & make sure team is working together.

Resource Investigators: Members who work with external stakeholders to help the team meet its objectives.

Plants: Members who come up with new ideas & approaches.

Monitor-Evaluators: Members who analyze & evaluate ideas that other people come up with.

(Team Technology)

Nine Team Roles for Success

Coaches produce agreement & harmony across the team, trying to create a positive team atmosphere & reach a consensus.

Crusaders produce a sense of priority, stressing those issues that have most importance so that discussions are focused on the most valuable topics

Explorers uncover new potential in situations & people & explore new areas & the possibilities that they present

Innovators produce a sense of imagination & contribute new & alternative perspectives & ideas

(Team Technology)

Team Roles & Functions

Sculptors bring things to fruition, producing action to address the most urgent matters, & using tools or techniques that they know (from experience) will work

Curators produce a clarification of ideas & information, producing a better knowledge & clearer picture of any situation

Conductors produce structure & introduce a logical organization into the way things are done

Scientists produce explanation of what is happening & the cause of problems, & generate models to demonstrate how things work

(Team Technology)

Team Roles & Functions

Quality Control - Successful teams are willing to collectively review their output & processes to ensure that the final product or solution meets or exceeds the team goal.

Risk-taking - A successful team will also be willing to take creative chances or experiment. That could mean that a team may do something not within the stated project guidelines.

Social/Business Balance - Although teams shouldn't socialize 100% of the time, it shouldn't be all business either. A dose of chit-chat allows members to know each other better, leading to better working relations

(Team Technology)

Successful Teams

1. FORMING: “Honeymoon" stage - becoming acquainted & familiar with each other’s strengths & weaknesses. Typically there is harmony at this time, but too much harmony too soon may mean that the team may not accomplish much later.

2. STORMING: Conflicts begin as team members negotiate work assignments & express disagreement on what to do. Frustratingly, this process can take some time, but it is vital for the team to learn to function.

3. NORMING: After a period of negotiation & discussion, the team reaches a stage where ground rules of conduct are established & members learn to work together. Time teams begin to be productive, & a sense of team pride develops.

4. PERFORMING: Group settled down into a functional team & most of the work gets done. This stage can actually be relatively short in terms of a project life cycle - as little as 25% of the total time.

(Marquis & Huston, p. 457)

Stages of Team Development

Attend all meetings (task or work/part of job & professional to attend) even if meetings seem habitual & regular

If absolutely unable, respond to meeting request & decline professionally

If assigned a topic to discuss, research prior to meeting; write down possible questions others may have & be ready to answer; outline what you plan to speak about & stick to discussion timeframe

Go to a meeting prepared with a pen and paper to take notes of important information

Actively participate during brainstorming sessions & discussions

Use open & honest communication sharing your opinions & asking questions to clarify information (AHEC, n.d.)

Meeting Responsibilities

Observe meeting etiquette & ground rules Conduct self in professional manner that is socially

acceptable & respectable to others Be punctual Listen attentively (side conversations & chit chat

are rude) Avoid distractions (mobile telephones) Avoid arguing with others; focus on issues Offer cooperation to the team & contribute

enthusiastically (Team Technology)

Meeting Responsibilities

Unified workforce headed toward a common goal in health care

Goal in healthcare is to provide “Quality Care” Each employee is important to success of

accomplishing goals Each employee has a distinct role

Employer Expectations Dedication to duty: Important because each

member dependent on another. This is difficult to teach, so employee must develop.

Many employers hire people with a proven track record of dedication to duty (Team Technology)

Employer’s Expectations of Team Members

A willingness to sacrifice for the good of the team

There is no "I" in the word "team." Individuals must be willing to sacrifice their own interests for the good of fellow team members.

Rather than pursuing individual goals, staff members should be focused on common goals (unified team)

Loyalty Employees must be loyal to

organization/company’s best interest at heart; should speak well of organization (Team Technology)

Employer’s Expectations

Employees should have a “positive attitude” Agencies goals cannot be achieved unless every

team member exhibits a positive attitude. Attitudes can be infectious, & can elevate the mood

of workplace environment. ◦ In fact, you might be surprised at how much business can

be accomplished once employees exhibit a degree of optimism.

With positive attitude, team members will come up with creative ways to meet challenges & overcome them

Workplace is happier & healthier for all Attitude impacts how people work on a job and the

quality of care given (Team Technology)

Employer’s Expectations

Punctuality Dependability Getting along with

others Working as a team

member Organizing the work

activities of others Understanding written

information Basic writing skills Basic speaking skills

Being neat & clean in appearance

Maintaining good health Knowing your strengths &

weaknesses Giving an honest day's

work Loyalty to the

organization Making independent

decisions Knowledge of operating

procedures (Employers’ Expectations, n.d.)

Employer’s Expectations

Using initiative & imagination

Knowing what is expected

Basic arithmetic skills Knowing how to use

materials & equipment

Locating information Having specialized

training

Following instructions Working without close

supervision Working under

pressure Adjusting to work

situations Managing time and

materials effectively Following safety

regulations (Employers’ Expectations, n.d)

Employer’s Expectations

Make sure you understand the group's goals. Ask key questions like these: Why are we here? What is the 'perfect ending' to this project? What is our deadline? How often will we meet? What is our budget? Who is in charge of implementing our ideas? What roles and responsibilities will each of

us have?(Area Health Education Center [AHEC], n.d.)

Good Team Player

Be Reliable Keep promises you make Simply deliver what you said you would do

– on time◦ If you have high standards, people will depend

on you to produce quality work. ◦ If your output is excellent one day, but only

average the next, the team may regard you as being unreliable

(Mind Tools)

Good Team Player

Be a good communicator When you communicate with your team

members – whether showing support, or challenging their thinking – it's important to stay positive & respectful.

Even if you disagree with someone, don't become emotional. Being objective & fair will make a good impression; getting upset & angry won't.

"Owns" problems rather than blaming them on others (Mind Tools)

Good Team Player

Be flexible Things can change—People join or leave

the group; budgets are reduced; or goals are redefined

Don’t fight change—Embrace it! Look at it as a new opportunity for growth!

Your willingness to remain comfortable & positive in a constantly changing environment is an important business skill (Mind Tools)

Good Team Player

Don't cherry-pick projects: If you choose more difficult projects & accept what’s offered you will gain a reputation of being a hard worker

Support other people on your team by offering positive feedback & provide help as needed—give good impression that you are a collaborator

Share information & resources with your team --Remember, you're all there for one purpose – and by keeping everyone informed, you contribute to that goal

Keep a positive attitude—Helps others stay focused & productive (Mind Tools)

Tips for Good Team Players

Separate people from the problem (i.e. diffuse the emotional component of the conflict by showing respect, listening carefully,& giving all parties an opportunity to express their views)

Clarify the conflict/recognize the problem Involved parties need to agree to work toward a

solution Deal with one problem at a time, beginning with

the easier issues Brainstorm about possible solutions

(Area Health Education Center [AHEC], n.d.)

Team Negotiations Strategies

Focus on common interests, not positions Use objective criteria when possible Invent new solutions where both parties

gain Implement the plan Evaluate and review the problem-solving

process after implementing the plan (AHEC, n.d.)

Team Negotiations Strategies

Everyone participates actively & positively in meetings & projects.

Team goals are understood by everyone. Individual members have thought hard about

creative solutions to the problem. Members are carefully listened to & receive

thoughtful feedback. Everyone takes initiative to get things done. Each teammate trusts the judgment of the others. The team is willing to take risks (Mind Tools)

Characteristics of a Good Team

Everyone is supportive of the project & of others. There is plenty of communication between team

members. Team decisions are made using organized, logical

methods. Full team acceptance is expected as decisions are

made. Differing opinions are recorded, & may be

revisited if future situations dictate Team goals are given realistic time frames Everyone is focused on the ultimate goal of the

project, while also digging into the underlying details

(Mind Tools)

Good Team Characteristics

All members agree on the goal & they are working toward the goal.

Everyone is doing their part & everyone is helping the other members of the team.

All are able to freely share their thoughts & feelings for the purpose of helping the group move ahead.

Everyone has a part in making decisions. The group is able to solve problems. Leadership is shared among the team

members(Burke)

Signs of Good Team Work

Members are able to talk about their negative feelings.

Conflict is NOT stopped, but allowed to happen because it improves the group work.

The knowledge, skills & experiences of all members are known & tapped into when needed.

People feel free to be creative & to take risks.

Mistakes are looked at as a way of learning & not punished (Burke)

Signs of Good Team Work

Share leadership, values & norms; Develop a sense of belonging so that all feel

a part of the team Always have eye on the common goal that

is shared by all Share the task to be done Focus on equal work & a quality outcome (Burke)

Winning Team in Health Care

Help people to be creative and to come up with new solutions to old problems

Able to solve problems without attacking people [Focus on the issue not the person]

Use open communication & the members do not judge or criticize others

Can respond to new challenges (Burke)

Winning Teams in Health Care

"A team is a group organized to work together to accomplish a set of objectives that cannot be achieved effectively by individuals.“

(Burke)

“The whole team is greater than adding up the parts, or the number of people

in the team” (Burke)

PATIENT is the most important member of the team

Healthcare workers must all work to meet the needs & desires of the patient

Healthcare team works every day & every minute towards the goal of good health care

The patient is the main decision maker Patient is main focus of the team Patients have a right to good care by all of

the members of the healthcare team (Burke)

PATIENT is the CENTER OF the TEAM

Lesson #4: Team Roles Activity Go to Lesson #4: Team Roles Activity - follow specific

directions to complete this activity assignment. Review Belbin’s Model of Team Roles

Lesson #4 Stop & Think Activity

AbiSamra.N. (.n.d.). Benefits of organized teamwork. Retrieved from http://nadabs.tripod.com/team/benefits.html

Area Health Education Center of District of Columbia. (n.d.).Interdisciplinary teambuilding. Retrieved from http://dcahec.gwumc.edu/education/session3/models.html

Burke, A. (2009). Teamwork and patient partnering. Retrieved from http://www.nursingassistanteducation.com/site/courses/eng/nae-team-eng.php

Employer expectations. (n.d.). Retrieved from http://www.thomas.edu/career/tips/employerexpct.htm

Fresh Tracks. (2010). Team building events. Retrieved from http://www.freshtracks.co.uk/teambuilding.htm

References

Katzenbach, J.R. & Smith, D.K. (1993). The wisdom of teams: Creating the high-performance organization. Boston, MA: Harvard Business School

Leino, A. (1951). Planning patient-centered care. American Journal of Nursing 52 (3), 324-325.

Lewis-McClear, Kyle and Taylor, M.S. (1998, August). Psychological contract breach and the employment exchange: Perceptions from employees and employers. San Diego, CA: Author

Marquis, B.L. & Huston, C.J. (2009). Leadership roles and management functions in nursing: Theory and application (6th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins

References

Mind Tools, LTDs. (1996-2011). How to be a good team player: Maximizing your contribution. Retrieved from http://www.mindtools.com/pages/article/newTMM_53.htm

Papa, J. (n.d.). Team Communication. Retrieved from http://www.ehow.com/about_5340885_team-communication.html Rowley, C. (2002-2011). The five functions of a team. Retrieved from http://www.metavoice.org/consultations/functions-team.shtml

Team Technology. (1995-2006). The basics of team building. Retrieved from http://www.teamtechnology.co.uk/tt/t-articl/tb-basic.htm

Team Technology. (1995). Working out your team role. Retrieved from http://www.teamtechnology.co.uk/workingoutyourteamrole.htm

White, J. (n.d.). Characteristics of Effective Communication. [Website]. Retrieved from

http://www.ehow.com/about_5057520_characteristics-effective-communication.html

References