Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y1© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Workshop 02 Our Teamwork

Workshop 02 – Our Teamwork Effectiveness

ver 16D12M14Y 1© TEAMC – Toolkit to Enhance and Assist Maximizing Team Collaboration

Workshop 02Our Teamwork Effectiveness



Goals

⟩ To reflect on Workshop #1 goals for team care

⟩ To consider how teamwork principles support strengths in functioning of the team

⟩ To consider how the team’s communication structures enhance communication amongst team members

⟩ To review what works well in leading the team

⟩ To review what works well in managing team meetings

⟩ To review what helps to address conflicts in the team



Workshop Agenda

[ ] Review goals, principles for working together, strengths, enhancements, areas not being used as effectively as they could be (reached in Workshop #1)

[ ] Communicating with each other – what is and what could be[ ] Leading in the team[ ] Making the most out of our team meetings[ ] Finding a win-win during disagreements [ ] Reflection/summary/orientation to next session



Team Goals

⟩ (to be completed)



Principles for Teamwork




Team Strengths




Team Relationship Enhancers




Interpersonal Communication

“… is a continuous transactional process involving participants who occupy different but overlapping environments and create relationships through the exchange of messages, many of which are affected by external, physiological and psychological noise.” *

*Adler, Rolls, Proctor III & Towne, Looking Out/Looking In, 2009, p. 11



Effective Team Communication

“… successful communication always involves shared understanding.” *

*Adler et al, 2009, p. 15



Effective Communication

Communication has two dimensions:

(1) Content ...... What is to be discussed

(2) Relational ..... How we feel about each other

Affinity: sense of connection to another

Immediacy: interest and attention to what is being said

Respect: amount of respect shared between parties

Control: degree of control exercised over the other



Interprofessional Communication

Competency Statement

Learners/practitioners from different professions communicate with each other in a collaborative, responsive and responsible manner.



Explanation/Rationale

⟩ Communication skills are essential

⟩ Involve ability to communicate effectively with others

– Professions

– Patients/clients/families

⟩ Communication should be collaborative, responsive and responsible



Interprofessional Communication

Competency* means that:

… practitioners from different professions communicatewith each other in a collaborative, responsive andresponsible manner and should:

⟩ Establish team work communication principles

⟩ Actively listen to other team members including patients/clients/families

⟩ Communicate to ensure common understanding of care decisions

⟩ Develop trusting relationships with patients/clients/families and other team members

⟩ Effectively use information and communication technology to improve interprofessional patient/client/community-centred care

* Canadian Interprofessional Healthcare Collaborative, National Interprofessional Collaborative Competency Framework, Vancouver, B.C., CIHC, 2010, p. 16.



Guidelines for Communicating with Each Other

⟩ Jot down on post-it notes how team members should communicate with each other:

e.g. means (how to)

content (what to)

timing (when to)

⟩ Place these on the flip charts and review, eliminate duplications



Team Communication Means




Team Communication Content




Team Communication Timing




Team Functioning at MeetingsEffective meetings have a number of key features:

⟩ Their frequency and duration

⟩ There is group input into the agenda

⟩ Required attendance is established

⟩ Who chairs team meetings is established

⟩ Who takes notes and who summarizes what has been agreed upon

⟩ Who keeps meetings on agenda items

⟩ Who follows up on items agreed upon



Set ‘RULES’ for Organizing and Running Team Meetings

⟩ Working in small groups, review the checklist questions in Worksheet #6

⟩ Consider each question and how your group wishes each aspect of a team meeting to be managed

⟩ Discuss and come to a consensus and complete a clear Worksheet #10 for your final choices of the group

⟩ Share choices with all participants



Team Functioning Competency

Competency means:

Practitioners understand the principles of team work dynamics and group/team processes to enable effective interprofessional collaboration.



Team Functioning Descriptors

⟩ Understand the process of team development

⟩ Develop a set of principles for working together; respects the ethical values of members

⟩ Effectively facilitate discussions/interactions among team members

⟩ Participate and be respectful of all members’ participation in collaborative decision-making

⟩ Reflect, at regular intervals, their functioning with team practitioners and patients/clients/families

⟩ Establish and Maintain effective and healthy working relationships with practitioners, patients/clients and families

⟩ Respect team ethics, including confidentiality, resource allocation and professionalism



Leadership in the Team

How is leadership determined?⟩ One designated person⟩ Rotational person⟩ Depends on the needs of the patient

AND

How will the team continue to decide on who is the leader?



Collaborative Leadership

* Linden, R., The Discipline of Collaboration. Leader to Leader (Summer), 2003, p. 42.

“… the art of pulling people together from different [perspectives] … to accomplish a task that none of them could accomplish – at all or as well – individually.”*



How Will Your Team Support Collaborative Leadership?

⟩ Discuss the use of collaborative leadership in your team

⟩ Compare this concept to how leadership is currently handled

⟩ Consider if the team wishes changes to the current state

⟩ Be prepared to share your discussion with the total group




⟩ Using collaborative leadership, a team can “invent new ways to attack a problem and collectively make sense together from what once was …”* not known

*Raelin, J. , Does Action Learning Promote Collaborative Leadership? Academy of Management Learning & Education,, 2006,, 5(2), p,152-168.



“Modeling The Way” *

In IPE this means:

⟩ Knowing your personal values and how these may enhance or interfere in working with others

⟩ Helping the team to stay focused on patient care

*Kouzes, J.M., & Posner, B.Z., The Janusian Leader, Management 21C, Englewood Cliffs, Prentice Hall, 2000.



“Inspire A Shared Vision” *

In IPE this means…

⟩ Focusing on patient-specified goals and helping the team to consider how to get there

⟩ Helping team members to bring their ideas together in an agreed upon plan with the patient

*Kouzes & Posner, 2000.



“Challenge The Process” *

In IPE this means encouraging…

⟩ On-going reflection on how the team is working together with the patient and, based on feedback, making needed changes

⟩ Members thinking about their professional roles within an interprofessional patient-centred context

* Kouzes & Posner, 2000.



“Enable Others To Act” *

In IPE this means the collaborative leader…

⟩ Helps to guide the team in promoting respect for all members and in arriving at shared goals with patients and team members

⟩ Encourages other team members to take on the leadership role and supports patients in their decision making with the team




“Encourage The Heart”*

In IPE this means…

⟩ The collaborative leader recognizes the positive work of all team members, including the patient, towards meeting patient-set goals for care

⟩ The team, with the patient, celebrate achievement of steps towards patient-set goals of care




Small Group Work: Collaborative Leadership

• Using worksheet #7 consider what strengths are already present in the team to support each of the leadership elements; enter these into column 1.

• Consider what enhancements to teamwork are still needed; enter these into column 2

• Be prepare to share your work with all the other participants




Competency Statement:

Practitioners work together with all participants, including patients/clients/families, to formulate, implement and evaluate care/services to enhance health outcomes.



Collaborative Leadership Competency Means …

Practitioners collaboratively :

⟩ Work with others to enable effective patient/client outcomes

⟩ Advance interdependent working relationships among all participants

⟩ Facilitate effective team processes and decision-making

⟩ Establish a climate for collaborative practice among all participants

⟩ Co-create a climate for shared leadership and collaborative practice

⟩ Apply collaborative decision-making principles

⟩ Integrate principles of continuous quality improvement to work processes and outcomes



Dealing with Conflicts

Conflicts arise from many sources:

⟩ Role conflicts

⟩ Goal conflicts

⟩ Treatment conflicts

⟩ Interpersonal conflicts

⟩ Professional conflicts



Characteristics of Disagreements*

⟩ Expressed struggle

⟩ Perceived incompatible goal

⟩ Perceived scarce rewards

⟩ Interdependence

⟩ Interference from the other party

*Adler, Rolls, Proctor III & Towne, Looking Out/ Looking In, 2009, p. 340



We all act in certain ways when our needs are not being met:

⟩ Nonassertive

“people who avoid conflicts usually believe it’s easier to put up with the status quo than face the problem head-on” *

– Avoidance (distracting from)

– Accommodation (giving in)

*Adler, et al, 2009, p. 342.

Personal Conflict Styles



Personal Conflict Styles cont.

⟩ Direct Aggression

– Character attacks

– Competence attacks

– Physical appearance attacks

– Wishing the other ill fortune (teasing, ridicule, threats, swearing, etc.)

⟩ Passive Aggression

“suppressed feelings of resentment, anger or rage they’re unable or unwilling to express directly”*

*Adler, et al, 2009, p. 344.



⟩ Indirect Communication

“conveying a message in a roundabout manner in order to save face for the recipient” *

⟩ Assertion

“message expresses the speaker’s needs, thoughts, and feelings clearly and directly without judging or dictating to others”**

*Adler, et al, 2009, p. 346.**Adler, et al, 2009, p. 347.

Personal Conflict Styles cont.



Choice of Conflict Style Depends on…

⟩ Relationship within the team (power dynamics)

⟩ Situation which team is addressing

⟩ Other people on team (how receivers respond)

⟩ Individual goals vs team goals



Getting to Win-Win

Consider…

⟩ Deferring to the other person

⟩ Compromising

⟩ Competing

⟩ Cooperating



Competency Statement:

Learners/practitioners

actively engage self and

others, including the patient/

client/family, in dealing

effectively with

interprofessional conflict.

Interprofessional Conflict Resolution



Interprofessional Conflict Resolution cont.

Practitioners actively engage in positively and constructively addressing disagreements as they arise including:

⟩ Valuing the potential positive nature of conflict

⟩ Recognizing the potential for conflict to occur and taking constructive steps to address it

⟩ Identifying common situations that are likely to lead to disagreements or conflicts

⟩ Knowing and understanding strategies to deal with conflict

⟩ Setting guidelines for addressing disagreements

⟩ Effectively working to address and resolve disagreements, including causes, and working to acceptable solutions

⟩ Establishing a safe environment in which to express diverse opinions

⟩ Developing a level of consensus among those with differing views



Resolution of Conflicts

⟩ Win-win conflict resolution is the goal

⟩ Getting to a solution that all can live with

⟩ NOT A COMPROMISE but a collaborative decision



How Can Teams Agree to Handle Conflicts?

⟩ Create openness to hear each other’s views

⟩ Consider all views within your own perspective

⟩ Consider biases that might exist in your viewpoint

⟩ Consider justification for your biases and how you can come to terms with other views

⟩ Weigh the alteration in your view, based on other views in the context of your patient’s safety

⟩ Share your thinking with the others

⟩ Hear each other’s viewpoints

⟩ Come to a shared agreement



⟩ You are a member of the Stroke Team in the regional hospital.

⟩ You receive an email from the local hospital 20km away, they are sending a patient who had a stroke two days ago and you reply asking what care has been provided thus far.

⟩ You find out that only stabilization of their blood pressure and basic assessment of swallowing, walking and speaking has occurred.

Case Scenario:



⟩ Using the Conflict Resolution Process, work in your group to determine how to handle this situation. Have one of the members of the group play the role of the referring health provider and the remaining participants as the Stroke Team.

⟩ Be prepared to share with the total group, how you work through this conflicting situation to come to a resolution.

Small Group Work



Reflection

⟩ What works well in our team?

⟩ What do you feel still needs attention to make your team more collaborative?

⟩ How well do we manage our team meetings?

⟩ Is the leadership of our team supportive of collaborative work?

⟩ How well do we move to win-win resolutions when disagreements occur in the team?



Next Workshop: Ideal Collaborative Team Functioning

Workshop #3 will

⟩ Reflect on Workshop #2 and the strengths the team already enjoys

⟩ Help set how your ‘dream team’ might function and exploring explore what changes are needed to move to this dream

⟩ Discuss how to be guided by a patient and/or family member in shaping how the team’s dream can reflect true patient and family member inclusion as full team members

⟩ Create the final dream for the best practices in interprofessional patient-centred collaborative team functioning by all members

Ahead of the next workshop:

⟩ Review work completed in Workshops #1 & #2

Workshop #3: Ideal Collaborative Team Functioning Next workshop is (date)

Documents

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y1© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Workshop 02 Our Teamwork