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Interprofessional Teams: Improving Patient Care Through Collaboration and Communication

Interprofessional Teams: Improving Patient Care Through Collaboration and Communication. Holly Taylor, BSN, RN, CNOR, RN-BC Lauren Taylor, BSN, RN, CPAN, PCCN. speakers. Holly Taylor Perioperative Educator. Lauren Taylor PeriAnesthesia Nurse Manager. Registered Nurse for 8 years

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Interprofessional Teams: Improving Patient Care Through Collaboration and Communication

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  1. Interprofessional Teams: Improving Patient Care Through Collaboration and Communication Holly Taylor, BSN, RN, CNOR, RN-BC Lauren Taylor, BSN, RN, CPAN, PCCN

  2. speakers Holly Taylor Perioperative Educator Lauren Taylor PeriAnesthesia Nurse Manager Registered Nurse for 8 years Double Board Certified LPN prior to becoming a RN 2018 Arkansas Center for Nursing 40 Under 40 honoree 2019 Arkansas Great 100 Nurses honoree Medical Missions to Honduras • Registered Nurse for 14 years • Double Board Certified • DNP student • 2016 Arkansas Center for Nursing 40 Under 40 honoree • 2018 Arkansas Great 100 Nurses honoree • Item Writer for the NCLEX exam

  3. CHI St. Vincent Infirmary • Faith-based, not-for-profit, acute care hospital in Little Rock, AR • Established in 1888 • Licensed for more than 600 beds • Consistently named by U.S. News and World Report as one of the state’s best hospitals, with high performance in Heart Care, Colorectal Surgery, and Joint Replacement • Current and two-time recipient of the highest recognition in nursing, ANCC Magnet designation.

  4. Get to know your Interprofessional Team

  5. Who is this guy? • Aristotle, • Greek Philosopher • The founder of formal logic. • A scientist, who was a pioneer in biology, botany, chemistry, and zoology. • He extensively studied psychology, philosophy, and ethics.

  6. How Does Aristotle affect modern teamwork? • “Knowing yourself is the beginning of all wisdom.” • “Pleasure in the job, puts perfection in the work.” • “We are what we repeatedly do. Excellence, then, is not an act, but a habit.”

  7. Personality Testing & self-Reflection • Myers-Briggs Test • Based upon the work of Carl Jung, psychiatrist and psychoanalyst. • Abbreviated exam here: http://www.humanmetrics.com/cgi-win/jtypes2.asp • Extravert vs. Intravert, Intuitive vs. Sensing, Feeling vs. Thinking, Judging vs. Perceiving • DiSC assessment • Published by Wiley, is a non-judgemental tool used for discussion of people’s behavioral differences. • Abbreviated exam here: https://discpersonalitytesting.com/free-disc-test/ • Dominant, Influential, Compliant, Steady • The Big Five • Based on the Five Factor Model of Personality by Lewis Goldberg. Validity confirmed by Costa and McRae, and termed “The Big Five.” • Abbreviated exam here: http://www.personal.psu.edu/~j5j/IPIP/ • Full Breakdown of the Big Five Factors: https://backend.fetzer.org/sites/default/files/images/stories/pdf/selfmeasures/Personality-BigFiveInventory.pdf • Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness to Experience • Lion-Beaver-Otter-Golden Retriever • Based upon the work of Gary Smalley, a family counselor. • The Smalley Animal Personality Test helps to understand strengths, weakness, and natural inclinations • Take the assessment here: http://thaoski.com/2013/04/02/5-minute-personality-test-lion-beaver-otter-golden-retriever/

  8. Myers-Briggs (MBTI):Extravert vs. Intravert, Intuitive vs. Sensing, Feeling vs. Thinking, Judging vs. Perceiving • Holly: ENTJ (The Commander) • Extrovert, Intuitive, Thinking, Judging • Analyst at heart • Motto: “find a way or make one” • Natural tendency to marshall and direct • Must collaborate and be democratic • Likes to plan • Salesman • Decisive • Struggles: Will “Die on the Cross” • Must choose battles that I can actually win • One of the rarest MBTI types, at about 1.8% of the US population. • Lauren: ISFJ (The Defender/Protector) • Introvert, Sensing, Feeling, Judging • Sentinel at heart • Motto: “protect and serve” • Natural tendency towards loyalty • Like to “be needed” by others and produces high-quality work • Family-centered • Struggles: Takes things personally and reluctant to change • Must avoid internalizing criticism and consider change for the better of the team • About 14% of Americans fall into this MBTI type.

  9. DiSC Assessment: • Holly: Compliant/Influencer • C’s are accurate, analytical, systematic fact-finders with high standards. Likes organization and rules. Dislikes criticism. • Described as the “anchor of reality.” • Weaknesses: needs clear boundaries. • I’s are enthusiastic, optimistic, persuasive, talkative, and emotional. Likes praise, friendly environments, and motivating others. Dislikes rejection. • Described as the “creative problem solver.” • Weaknesses: overuses gestures and facial expressions. • Lauren: Steadiness/Dominant • S’s are good listeners, team players, predictable, and friendly. Likes loyalty and safety. Dislikes loss of security and sudden changes. • Described as the “reliable team worker.” • Weaknesses: resists change. • D’s are direct, decisive, have ego strength, and take risks. Likes challenges. Dislikes being taken advantage of. • Described as the “innovative, bottom-line organizer.” • Weaknesses: perceived as argumentative and attempts too much at once.

  10. The Big Five: • Holly: • Extraversion vs. Introversion – 89 (high) • Highest – Assertiveness • Lowest – Cheerfulness • Agreeableness vs. Antagonism – 11 (Low) • Highest – Sympathy • Lowest – Trust • Conscientiousness vs. Lack of Direction – 48 (average) • Highest – Self-Efficacy & Achievement-Striving • Lowest – Orderliness (I got a 1 ) • Neuroticism vs. Emotional Stability – 34 (average) • Highest – Anger/Frustration • Lowest – Depression • Openness to Experience vs. Closedness – 55 (average) • Highest – Intellect • Lowest – Liberalism • Lauren: • Extraversion vs. Introversion– 76 (high) • Highest – Friendliness • Lowest – Excitement-Seeking • Agreeableness vs. Antagonism– 53 (average) • Highest – Altruism • Lowest – Modesty • Conscientiousness vs. Lack of Direction– 53 (average) • Highest – Dutifulness • Lowest – Orderliness • Neuroticism vs. Emotional Stability– 51 (average) • Highest – Immoderation • Lowest – Depression • Openness to Experience vs. Closedness– 29 (low) • Highest – Emotionality • Lowest – Liberalism

  11. Lion – Beaver – Otter – golden Retriever : • Holly: • Lion – 34 • Leader, goal-oriented, competitive • May be dictatorial or directness may hurt the feelings of others. • Otter – 29 • Social creature, influences and motivates others. • Talks too much • Golden Retriever – 10 • Beaver – 26 • Has high standards, and likes order and respect. • Has unrealistic expectations of self and others, often misses the optimistic side of things. • Lauren: • Lion – 20 • Otter – 21 • Golden Retriever – 30 • Deep relationships but usually with only a few close friends. Loyal, accommodating, affirming. • Dislikes big changes • Struggles to hold others accountable and may be indecisive or indifferent. • Beaver – 29 • Has high standards, and likes order and respect. • Has unrealistic expectations of self and others, often misses the optimistic side of things.

  12. Facts about Communication • Poor communication and communication overload are shown to have a direct correlation with • Poor patient outcomes • Adverse events • Decreased RN job satisfaction • Transfer delays • Increased length of stay • According to healthcare providers, 1 out of 6 patients are described as “difficult.” • People who are Caucasian or College-educated report higher levels of satisfaction with physician and nurse communication than other populations.

  13. How does the Art of Communication affect the science of Healthcare? • At any given time, 1 in every 20 patients has an infection related to their hospital care. (CAUTI, CLABSI, SSI) • A CAUTI costs over $1000 per patient • A CLABSI costs over $35,000 per patient • A SSI costs over $7000 (superficial) and over $25,000 (deep organ space) • 1 in 7 Medicare beneficiaries is harmed during the course of their care. (infections, falls, wounds, etc.)

  14. Interprofessional Teamwork • Chemotherapy Administration in the Perioperative/PeriAnesthesia Setting • Malignant Hyperthermia Response and Supply Cart Standardization • Colorectal Surgical Site Infection Quality Improvement Team • Surgical Consent Documentation • Bereavement Program Coordination and Documentation

  15. Who is this Guy? • Mike Krzyzewski, • Duke University Men’s Head Basketball Coach • 80% winning percentage over 39 years • Most wins as a college coach in history (over 1000 and counting) • Coached 5 national championship teams • Coached 3 Olympic gold medal winning teams • Duke’s Fuqua School of Business has a Coach K Center on Leadership and Ethics

  16. Coach K on Teamwork: The “fist” Analogy • The “fist” describes effective teamwork. Each finger represents a member of the team. To make the greatest impact, each member of the team must come together like a fist, to unify the mind and body towards a single goal. If the goals are not aligned, teamwork fails and so does the ability to achieve your objective.

  17. Coach K on Teamwork: Five Word Emphasis • Communication – Trust – Care – Collective Responsibility – Pride • Effective leaders are effective communicators. • Without trust, teams can fall into the trap of one person micromanaging the entire operation, thus disrupting group synergy. • Care is the equivalent of giving your best effort and minimizing errors. • Every member of a team is accountable for the desired outcome. • Develop an environment of encouragement and support, where big and small accomplishments are celebrated.

  18. Questions?

  19. Resources • Academy of Communication in Healthcare. (2019). Welcome to the academy of communication in healthcare (ACH). Retrieved from https://www.achonline.org/ • Agency for Healthcare Research and Quality [AHRQ]. (2013). Eliminating CLABSI, a national patient safety imperative: Final report companion guide. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/cusp/clabsi-final-companion/clabsicomp4c.html • Agency for Healthcare Research and Quality [AHRQ]. (2015). Toolkit for reducing catheter-associated urinary tract infections in hospital units: Implementation guide. Retrieved from https://www.ahrq.gov/sites/default/files/publications/files/implementation-guide_0.pdf • Curtis, K., Tzannes, A., & rudge, T. (2011). How to talk to doctors – a guide for effective communication. International Nursing Review, 58, 13-20. 10.1111/j.1466-7657.2010.00847.x • Duke University Masters of Business Blog. (2014). From the court to the classroom: The “fist” team analogy. Retrieved from https://blogs.fuqua.duke.edu/duke-mms/2014/02/14/patron/from-the-court-to-the-classroom-the-fist-team-analogy?category=about-mms#.XGWW6dGWyUk • Edgoose, J., Regner, C., & Zakletskaia, L. (2015). Breathe out: A randomized controlled trial of a structured intervention to improve clinician satisfaction with “difficult” visits. Journal of the American Board of Family Medicine, 28(1), 13-20. 10.3122/jabfm.2015.01.130323 • Ellison, R. (2014). The cost of surgical site infections. NEJM Journal Watch. Infectious Diseases. 10.1056/mejm-jw.NA34755 • EncyclopaediaBrittanica. (2019). Aristotle: Greek philosopher. Retrieved from https://www.britannica.com/biography/Aristotle • Istockphoto.com. (n.d.). Image. Retrieved from http://media.istockphoto.com/vectors/medical-team-vector-illustration-vector-d533858370?k=6&m=533858370&s=612x612&w=0&h=JdHqkiXnr_uOnQowV8nXMzrRlO-9832nozeQpOqiOME=

  20. Resources • John, O.P. & Srivastava, S. (1999). The Big-Five trait taxonomy: History, measurement, and theoretical perspectives. In L.A. Pervin & O.P John (Eds.), Handbook of personality: Theory and research (Volume 2, pp. 102-138). New York: Guilford Press. • Kowalsi, K. (2018). Creating interprofessional teams. Journal of Continuing Nursing Education, 49(7), 297-298. 10.3928/00220124-20180613-04 • McFarland, D., Shen, M., & Holcombe, R. (2017). Predictors of satisfaction with doctor and nurse communication: A national study. Health communication, 32(10< 1217-1224. 10.1080/10410236.2016.1215001 • O’Malley, A.S., Gourevitch, R., Draper, K., Bond, A., & Manasi, T. (2014). Overcoming challenges to teamwork in patient-centered medical homes: A qualitative study. Journal of General Internal Medicine, 30(2), 183-182. 10.1007/s11606-014-3065-9 • PeopleKeys, Inc. (2019). DISC insights. Retrieved from https://discinsights.com/disc-theory • Poll Everywhere. (n.d.). Live interactive audience participation. Retrieved from https://www.polleverywhere.com/ • Robert Wood Johnson foundation. (2011). What can be done to encourage more interprofessional collaboration in health care? Retrieved from https://www.rwjf.org/en/library/research/2011/09/what-can-be-done-to-encourage-more-interprofessional-collaborati.html • Smalley Institute. (2019). Welcome: let us help you build a better relationship. Retrieved from https://www.smalleyinstitute.com/ • The Myers & Briggs Foundation. (2019). How frequent is my type. Retrieved from https://www.myersbriggs.org/my-mbti-personality-type/my-mbti-results/how-frequent-is-my-type.htm?bhcp=1

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