Team Work

1. Team Work Working together for enhanced patient care.

2. Goal • The goal of this course is promote the practice of Teamwork in the working environment

3. Objectives At the completion of this course, the student will be able to: • State two examples of Teamwork • Verbalize one barrier to Teamwork • Name 2 advantages of Teamwork

4. What’s a Team Defined as a group of two or more individuals who: • perform some work related task • interact with one another dynamically • have a shared past • have a foreseeable shared future • share a common fate

5. Types of Teams • Work Teams-those that form natural work units, doing the day-to-day work of the organization such as a group of staff on a given patient care unit.

6. Types of Teams • Task Teams-those that address a specific problem such as quality improvement team, policy and procedures teams or a SWAT team.

7. Types of Teams • Management Teams- teams drawn from people who direct operational or organizational units such as nursing directors.

8. Definition of Teamwork • In health care, one definition of teamwork is "those behaviors that facilitate effective team member interaction, with “team" defined as "a group of two or more individuals who perform some work related task, interact with one another dynamically, have a shared past, have a foreseeable shared future, and share a common fate."(Wikipedia)

9. Examples In the hospital: • The physician orders necessary interventions • The nurse or therapist is responsible for carrying the orders out • It is crucial that all team members work together and communicate effectively.

10. Examples • The Respiratory Therapist(RT) works with the physician and the patient’s assigned nurse. • The RT makes recommendations for ventilator settings for weaning the patient. • The RT and the patient’s assigned nurse work together to wean the patient. • When patient’s are managed by a multi-disciplinary team that proactively oversees the weaning process, the patient is consistently extubated in 2 days less time.

11. Examples Shower time for the resident • CNA and the LVN work together to shower the resident. • CNA communicates to the LVN what residents are scheduled for showers • CNA and LVN decide on a good time • The CNA gives the bath and the LVN ventilates the resident.

12. High performing teams have been credited with: • Meeting the complex needs • of patients • Improving patient care • Increasing staff satisfaction • Enhancing organizational • effectiveness • Strengthening overall • healthcare delivery

13. Barriers to Teamwork • Large team size. • Lack of familiarity. • Instability of the work • force and assignments. • Absence of common • purpose and destiny. • Inhibiting physical • environment.

14. Barriers to Teamwork • Large team size-this is the number of people you interact with: RN-LVN, CNA, CP, EVS, DON, House Supp & more LVN-RN, CNA, CP, EVS & more CNA-RN, LVN, CP, EVS & more The more staff you need to communicate with the more difficult it is to communicate.

15. Barriers to Teamwork • Lack of familiarity-knowing the strengths, vulnerabilities and idiosyncrasies of all the other team members Become familiar with each staff member so you know each one’s strength and weaknesses.

16. Barriers to Teamwork Instability of the work force and assignments-Staff works different days of the week, different shifts and varying amounts. Examples: Some staff work 8 hour shifts and others work 12 hours Some staff only work weekends and others every other weekend

17. Barriers to Teamwork • Inhibiting physical environment: • The structure and layout of some • patient care units can decrease • or increase the likelihood of • team work

18. Why use Team Work Faulty Transfer: Nursing Home Pays Settlement To Patient. T he sixty-five year-old nursing home patient was unable to stand and could not bear her own weight. The patient was assessed as requiring two persons to transfer her. A sign was posted above her bed to alert staff that two-person transfer was mandatory. One nurse alone tried to move her and dropped her on the floor, resulting in an ankle fracture. The fracture required surgery. The surgery marked the beginning a slow de-cline in the patient’s health which led to her death eight months later. The nursing home paid the family $200,000 to settle their lawsuit filed in the Superior Court, Pierce County, Washington.

19. Faulty Transfer: Patient’s Suit Dismissed. The seventy-three year-old patient was admitted to an extended care facility after surgical revision of her total-hip re-placement. A Minimum Data Set was prepared upon admission. Her assessment indicated, among other things, that she was totally dependent on staff assistance and required two persons to transfer her. While one nursing assistant alone was transferring her from her wheelchair to her bed in violation of her treatment plan, a cracking noise was heard that was later identified as a femur fracture. The Court of Appeals of Texas dismissed her lawsuit against the nursing facility. To succeed with a negligence lawsuit like this a patient needs expert testimony proving precisely how a one-person transfer caused an injury which would not have occurred with a two-person transfer. A bad outcome, in and of itself, does not prove a patient’s caregivers committed negligence.

20. Advantages of Teamwork The quality of teamwork may be measured by analyzing the following six components of collaboration among team members: • communication • coordination • balance of member contributions • mutual support • effort • cohesion

21. Communication • Communication is one of the most difficult things to do in a work place. • Miscommunication make work twice as hard. • Good communication with all team members improves resident care.

22. Coordination • Defined as a harmonious combination or interaction, as of functions or parts. • Without coordination, everyone is doing things at a different times and in a different way. • Coordination of resident care saves time and energy of all of the team members.

23. Balance of member contributions If everyone does their job equally, the job gets done quicker and in a more timely manner. One person should not have to carry a heavier load.

24. Mutual support Everyone helps out and supports all team members. It improves resident care and satisfaction.

25. Effort Equal effort by all team members helps to get the job done.

26. Cohesion Stick together. Work as a unit and the day will be easier.

27. Coordination Activity Imagine yourself bouncing a single balloon in the air. It’s easy. Now add another balloon, juggling 2 balloons at once. A little more difficult but manageable. Now add a 3rd balloon. This is difficult. You have to work a lot harder keeping those 3 balloons in the air. What a relief one someone steps ups and says “l’ll help you out!” This is how it can be with caring for the residents. Sometimes you are balancing “3 balloons” at once and really can use some help. Part of being a good team player is helping out those who seem to be trying to juggle too many balloons.

28. Conclusion • Teamwork produces quality care • Teamwork promotes patient safety • Coordination makes the day easier • Sharing the load keeps staff safe

29. Quiz Time