Enhancing excellence care : working together

Sumolchat Duangbubpha1

What is teamwork ?• Teamwork refers to the way in which team members function

and coordinate to produce ‘synchronised’ output.

• Poor teamwork is a causal factor underlying critical incidents in the intensive care unit.

2

4 Key Team performance process

1. Team Communication

2. Team Leadership3. Team coordination4. Team decision-making

3

(Developing a team performance framework for the intensive care unit, 2009 )

1.Team Communication :- Team communication relates to the transfer of information, ideas

and opinions between the members of a team.

- 37% of communication errors was associated with communication between nurses and physicians.

-Team communication failures from written and verbal communications during routine care, hand-offs lead to patient harm.

- Critical incidents occurring due to a reluctance of nursing staff to report observed errors or patient care issues, a lack of communication between clinicians and nursing staff on treatment changes, inaccurate information transfer between different ICU care teams and poor information dissemination on newly admitted patients

4(Developing a team performance framework for the intensive care unit, 2009 )

2. Team Leadership :- Team leadership refers to the guidance of a team, and involves defining goals, setting expectations, organizing team resources and coordinating team activities.

- The leadership style of the team leader influences teamwork.

5(Developing a team performance framework for the intensive care unit, 2009 )

3. Team coordination :- Team coordination refers to the concerted and synchronous performance of work activities by team members, with each team member maintaining an awareness of one another’s work.- Team coordination is determined by factors such as team communication and team leadership. - Analyses of teams managing critical events during crisis management training has indicated errors to result from poor coordination (for example nurses being overloaded with requests, poor task delegation and a lack of prioritisation for care activities ).- Research with ICU staff has found positive perceptions ofteam coordination (e.g. timely information transfer, awareness of team member activities, team member role clarity) to be associated with lower error rates.

6(Developing a team performance framework for the intensive care unit, 2009 )

4. Team decision-making :-Team decision-making relates to decision-making (either by the leader on behalf of the team or amongst the members of a team) through integrating information and perceptions from the members of a team.

- Team decision-making is influenced by team communication and leadership.

- In the ICU, collaborative decision-making has been linked to improved patient outcomes.

-Poor decision-making processes, for example the application of inappropriate plans and the use of unsuitable techniques, have been shown to contribute to the occurrence of critical incidents.

7

(Developing a team performance framework for the intensive care unit, 2009 )

8(Developing a team performance framework for the intensive care unit, 2009 )

How do you improve your teamwork ?

9

Health care innovation

1. Clinical simulation2. Team based learning

10

1. Clinical simulation : - Clinical simulation—defined by the National Council of State Boards

of Nursing (NCSBN) as “an activity or event replicating clinical practice using scenarios, high-fidelity manikins, medium-fidelity manikins, standardized patients, role playing, skills stations, and computer-based critical thinking simulations”.

- Simulation training is not limited to students, and many programs exist to help practicing clinicians further their training or to assist hospitals to achieve such benchmarks as low infection rates and early identification and management of sepsis.

11( The Value of Simulation in Nursing Education, 2018).

2. Team based learning :- Team-Based Learning (TBL) is a teaching strategy designed

to promote problem solving, critical thinking and effective teamwork and communication skills; attributes essential for safe healthcare.

- Team-Based Learning creates conditions in which students will work together cooperatively to solve clinical problems and apply their learnings to real world practice situations.

- Team-Based Learning has been applied successfully in business programs and a number of medical courses used either as an alternative to problem-based learning (PBL) or to radically change a lecture-based teaching approach to improve learning outcomes.

(Nurse Education in Practice, 2015)

12

Step of TBL

13

Are you ready ?

14