414 Lec 8-9

What is a team

a distinguishable set of two or more people who interact dynamically, **interdependently**, and **adaptively** towards a common and valued goal/objective/mission who have each been assigned **specific roles** or functions to perform

What is a healthcare team

2 or more health care professionals who work collaboratively with patients and their caregivers to accomplish shared goals 

What is a core team

•Formed to accomplish a specific goal

•Typically team remains active for a longer period of time than a contingency team

→care team during a hospital admission

→outpatient primary care team

What is a Contingency team

•Formed for emergent ot specific events

•Time-limited events

→EX: disaster response team

•Composed of team members drawn from a  variety of core teams 

Describe the team-based model of care. Identify team-based care members and the

relationships between team members.

•Strives to meet patient needs and preferences
AKA: Interprofessional team, multidisciplinary team, teamwork


1. Patients- center of decision making & always apart of the healthcare team
2. Other team members- membership on team is fluid & may change as patient care needs change

Explain the features that facilitate team-based care

•Role awareness

•Trust between team members

•Interprofessional Education

•Organizational support

•Belief that interprofessional collaboration improvers care

six characteristics of effective team based care

•Shared goals

•Clear roles

•Mutual trust

•Effective communication

•Measureable processes & outcomes

•Support

Impacts of Effective Team Based Care on providers, teams, patients, and

Organizations.

•Providers: enhanced job satisfaction, enhanced well being

•Teams: Acceptance of treatment, improved coordination of care

•Patients: enhanced satusfaction, reduced error , improved health outcomes

•Organizations: Reduced hospitalization time and costs, efficient use of health care services, enhanced community & professional diversity 

Describe each of the five dysfunctions of a team.

**1)Absence of trust** among team members

2)Fear of conflict

3)Lack of commitment

4)Avoidance of accountability

5)Inattention to results

4 Stages of team formation

1. Forming
2. Storming
3. Norming
4. Performing

Forming

•Ambiguity and confusion at first

•Team members may not want to work together

•Guarded, superficial, impersonal communication

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Role of a leader: Encourage talking, discussion, sharing, etc

Storming

•Conflict and rebellion about tasks assigned

•Power plays, frustration at lack of progress

**Most difficult stage**

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•Role of a leader: manage differences of opinion, promote collaboration

→ Resolve power issues & authority, allow team members to play multiple different roles

Norming

•Accept team & individuality of members

•Open communication, begin confronting task

•Establish procedures and communication patterns

•Team cohesion, common spirit and goals, acceptance, relief to be moving forward

**Shared leadership emerges**

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•Role of leader: Encourage continued open communication and collaboration

Performing

•Focus on achieving goals

•Perform consistently

•Understand people’s strengths/weaknesses

**Path not linear**

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•Role of leader:assess teamwork, diagnose and solve team problems

characteristics of traditional leaders

•Top down

•Few make decisions

•Unilateral action

•Win or shift power

•Linear thinking

•Programs and products

•Charisma

•Persuasive

•Group falls apart if leader leaves

characteristics of collaborative leaders

•Self governing

•Broad participation

•Guide and coordinate process

•Build relationships

•Systems thinking

•Process

•Vision

•Empathetic 

•Group continues when leader leaves

Collaborative leadership roles:

•Assess the environment for collaboration

•Create clarity of model and agendas

•Build trust, transparency, and predictability

•Share power and influence

•Develop people and organizations

•Encourage self reflection

•Build and share common knowledge

Describe the collaborative working relationship

Stage 0: Acknowledging

→ “You stay on your turk and ill stay on mine”

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Stage 1: Professional Recognition

→”Il lend you a hand when my work is done”

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Stage 2: Exploration and Trial

→ “We need to adjust what we do to avoid confusion and overlap”

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Stage 3: Professional Relationship Expansion

→”Let’s all work on this together”

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Stage 4: Commitment to the collaborative working relationship

→ “We all feel totally responsible”

Discuss leadership behavior and its impact on healthcare worker wellbeing

•Leadership is a key driver of HCW well-being/engagement and its associated with:

→ Burnout/emotional exhaustion

→Concerns of safety culture/climate

→High workloads

→Employee engagement/turnober

→ Healthcare work well-being

Explain the term "Stresscalation" and how it affects leadership and pharmacy teams

Domino effect; your stress becomes someone else’s stress, and this becomes someone else’s stress

Describe occupational fatigue and the factors that contribute to occupational fatigue

•Multidimensional state that arises in workers who are exposed to excessive demands that can interfere with workers’ physical and cognitive abilities and their ability to function at their normal capacity

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→ Excessive demands in the workplace

→Multidimensional state

→Impairs ability to function at normal capacity

List the three domains of the Maslach Burnout Inventory

1)Emotional exhaustion

2)Diminished feeling of accomplishment

3)Depersonalization

→ Development of heartlessness or even dehumanized perceptions of others

Describe the three components of professional fulfillment

•Satisfaction from work

•Feeling engaged in work

•Feeling worthwhile at work

→ sense of self efficacy

individual factors that influence professional wellbeing and burnout

•Personal characteristics

•Personal health

•Responsibilities outside of academic work

•Engagement outside of academic work

List the educational/institutional system factors that influence professional wellbeing and burnout

•Perceived institutional values

•Nature of pharmacy education

•Faculty behaviors

•Sense of community

•Resources

List the healthcare & workplace system factors that influence professional wellbeing and burnout

•Equity

•Patient safety

•Patient care, task efficiency 

•Interdisciplinary care

Assess how fatigue impact healthcare

• Delayed response time

• Delayed diagnostic ability

• More likely to sustain needle stick injuries

• More likely to make errors

• Increased risk of road traffic accidents after shift

Assess how burnout impact healthcare

•Burnout associated with reduced quality of patient care

•Burnout associated with staff turnover