NSG3 Collaborative Nursing

Introduction:

Inter-professional team is a necessary requirement in today’s health care environment due to the emphasis on improving quality of care and patients outcomes. Collaboration between different levels of health care professionals helps in providing integrated care and fulfilling expectation of patients in care delivery (Babiker et al., 2014). In response to the scenario of developing a new health care professional team, this paper gives an insight into the methods and strategies needed to develop an effective inter-professional team and facilitate effective collaboration between the team.

Team Charter recommendation:

When a new inter-professional team is being launched, with professionals coming from different field or specialization, it is necessary that certain rules and expectations are set for the team. This is necessary to ensure that everyone is on the same page and work towards a common goal. This is also essential for the smooth running of the team (Babiker et al., 2014). Such ground rules and expectation for the inter-professional team needs to be developed by the leader of the team. The Team Charter recommendation regarding methods for establishing ground rules and expectations for the inter-professional team includes the following:

• Firstly, the team allocation process is important so that each member get to know their role in health care delivery and the expectation from them regarding patient safety.
• Secondly, for the efficiency of the inter-professional team, the leader can define certain performance standards and key actions that is necessary for proper collaboration between the team.
• As quality of care and optimum health of patient is a priority, guidelines for patient safety can be provided. The leader can instruct team members regarding negotiation of task work so that timely care is provided.
• In addition, making the team aware about professional and role boundaries is also important so that no conflict arise between the team (MacNaughton, Chreim & Bourgeault, 2013). All this will ensure that each team member are aware about grounds rule and expectation for good team work.

In a new inter-professional team, different types of members will be present. Some will be highly experienced in their job and other will be newly placed staff in health care. When such diverse team members are present, the common barrier in the initial phase will be the difference in opinion and expectations of team members. Such difference in power, authority and opinion of different team members can have an impact on the collaboration process and lack of negotiation may lead to delayed delivery care or medical errors (Almost et al., 2016). This is common issue in inter-professional team when the members are not accustomed to work collaboratively with a shared goal. To resolve such kind of conflict, the strategy is to educate team members about the purpose of making a inter-professional team. The team leader should inculcate in them the philosophy of optimal care for patient and developing a commitment to work collaboratively. If conflict arises even after this education, then the team leader should establish a forum where members can report about conflict issue. The mechanism for negotiation and renegotiations can be set in such forum (Brown et al., 2011). Such steps will also develop trust with the leadership as team members will develop feeling of belongingness.

While launching a new multi-professional health care team, issues related to team leadership may also arise. For example, when team leaders with positive leadership and management attributes are not present, then the unity and harmony of the team is affected. The team leader is the person who plays a vital role in the continuity of care and motivating inter-professional team to deliver health care (Kaini, 2015). However, inappropriate leadership style and ambiguity in leadership role may threaten the performance of the whole team. Such issue can be resolved by giving leadership training to the selected team leader and giving them some training regarding the essence of effective leadership. While taking the decision to choose the team leader, assessment of knowledge related to clinical expertise, decision making capability and managements attributes should also be done. This will help to ensure that the team leader has all the desired leadership behavior to effectively lead the team (West et al., 2015). If after few days, the team leader is found to be ineffective, then mentoring and coaching arrangement should be made by the health care provider so that leadership performance of the person can be improved.

Communication and Collaboration strategies:

The above recommendation gave idea about ways to establish ground rules and resolve leadership issue in a new inter-professional team. However, to promote the efficiency of the team in delivering high quality care, it is necessary to set best practice standards for effective inter-professional collaboration. The recommendation for best practices related to effective collaboration includes the following:

• One of best practice for inter-professional team collaboration is regularly holding team huddle or team meeting each day or whenever required. This will inform all members about work priorities for the day and ways to handle complex cases. Such meeting also provides the opportunity to solicit concerns and ask questions on goals for care. This can help to reach a final consensus on goals for care of patient, which is a necessary element of team based care (Reiss-Brennan et al., 2016).
• Certain protocols for communication and collaboration between team members can be set. This will ensure that each member have common procedure to relay information about patient and give handout information about patient to all involved team members. Certain health care tools like SBAR and electronic health record may also help in collaboration between team members (Chase et al., 2014).

Health information technology tools like electronic health records and electronic medical records system can also support the team in inter-professional collaboration. Such tools promote inter-professional collaboration as well as integrated delivery of care (Troseth, 2017). Apart from health information technology, communication between inter-professional team members is also easy today because of the presence of various communication tools like emails, text message, voice mail and face-to-communication. However, the utility of each tool will differ in different situation. The benefits and limitations and appropriate time to use these communication tools are as follows:

• Email is one of the formal means of communication by which important details about patient or necessary arrangements for treatment can be provided to health care team. The advantage of emails for clinical communication is that it can easily inform all members about necessary clinical task. However, one disadvantage is that emails are not convenient method for interaction between team members. There is less chance of clarifying or asking questions in emails. Hence, email is useful for patient referrals and getting outside opinion but not for collaboration between team (Pappas et al., 2012).
• Face-to-face communication is the most effective strategy for interprofessional communication. The advantage of face-to-face communication is that leaders can directly interact with team members and there are chances of questioning and inquiry too. It gives members the opportunity to voice concerns and take advice regarding any challenges in practice. The limitation of face-to-face communication is that it is not effective when a large group is present (Gucciardi et al., 2016).
• Text message and voice mails are useful only to provide short messages related to clinical practice. However, the limitation is that there is little scope for interaction in this type of communication. Very short message is given by text message and voice mail and this is not useful for inter-professional collaboration within health care environment.

Conclusion:

The paper gave the recommendation to establish ground rules for inter-professional team and strategies to resolve conflict between team members. Such strategy is likely to promote cohesion in the team and work towards shared goals. In addition, adapting the best practices for inter-professional collaboration along with the use of technology will be useful in improving the performance of the team.

References:

Almost, J., Wolff, A. C., Stewart?Pyne, A., McCormick, L. G., Strachan, D., & D’souza, C. (2016). Managing and mitigating conflict in healthcare teams: an integrative review. Journal of advanced nursing, 72(7), 1490-1505.

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., … & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese journal of paediatrics, 14(2), 9.

Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T. R., & Kasperski, M. J. (2011). Conflict on interprofessional primary health care teams–can it be resolved?. Journal of interprofessional care, 25(1), 4-10.

Chase, D. A., Ash, J. S., Cohen, D. J., Hall, J., Olson, G. M., & Dorr, D. A. (2014). The EHR’s roles in collaboration between providers: A qualitative study. In AMIA Annual Symposium Proceedings (Vol. 2014, p. 1718). American Medical Informatics Association.

Gucciardi, E., Espin, S., Morganti, A., & Dorado, L. (2016). Exploring interprofessional collaboration during the integration of diabetes teams into primary care. BMC family practice, 17(1), 12.

Kaini, B. K. (2015). Interprofessional Care and Role of Team Leaders. Journal of the Nepal Medical Association, 53(197).

MacNaughton, K., Chreim, S., & Bourgeault, I. L. (2013). Role construction and boundaries in interprofessional primary health care teams: a qualitative study. BMC Health services research, 13(1), 486.

Pappas, Y., Atherton, H., Sawmynaden, P., & Car, J. (2012). Email for clinical communication between healthcare professionals. Cochrane Database Syst Rev, 9.

Reiss-Brennan, B., Brunisholz, K. D., Dredge, C., Briot, P., Grazier, K., Wilcox, A., … & James, B. (2016). Association of integrated team-based care with health care quality, utilization, and cost. Jama, 316(8), 826-834.

Troseth, M. R. (2017). Interprofessional collaboration through technology. Nursing management, 48(8), 15-17.

West, M., Armit, K., Loewenthal, L., Eckert, R., West, T., & Lee, A. (2015). Leadership and leadership development in healthcare: the evidence base. London: Faculty of medical leadership and management.