Abstract
Teamwork concept can be interpreted from various disciplines such as sociology, industrial relations, psychology, philosophy, theology, economics, politics, health sciences and the wide range of paradigms can be quite extensive. Each has a different criterion for defining what it is and the boundaries within which it functions. Sometimes due to these discrete variables encompassing its adaptations social scientists find it difficult to analyze what constitutes Teamwork. It is imperative, however, that industrial relations activists in the twenty-first century form common ground in deciphering how teamwork functions to provide an acceptable industrial relations climate and efficiency in execution of tasks. This is pertinent to the development of organizations; realizing goals and implementing changes in the work environment. Within, and without the workplace teamwork, inevitably, plays an important role in maintaining stability anywhere, while building healthy relationships.
It is with this conceptual framework that the author will utilize the following pages of this document to interpret a literature review of the concept; investigate and assess definitions offered about teamwork; link terms associated with it exploring their relevance; research available tools to measure this concept and advance an example of how it is applied in my job situation.
Introduction
The direct question then, is how different teamwork concept is in health care as against other disciplines? Can health care utilize teamwork concepts verbatim from other disciplines without making the necessary adjustments? In the course of analyzing this concept being a major health care intervention as any other, the author wishes to evaluate its present usefulness as it relates to the literature review presented as well as examine applications, which are made in my work environment.
Literature review of Teamwork –concept
This literature review represents a scientific research conducted by Andreas Xyrichis and Emma Ream (2008).Their aim was to provide a clarifying report after an analysis of the concept teamwork was undertaken. For them the investigation became necessary since there are limited research studies on teamwork as it relates to the health care industry. (Xyrichis & Ream, 2008).
It was discovered that while teamwork as a concept was utilized in many other disciplines and acknowledged as an instrument applied for improvement in the quality of health care delivery, many pertinent issues defining applications had to be revised for adequacy.
Importantly, the authors pointed out that ‘conceptual understanding’ (Xyrichis & Ream, 2008) was sadly lacking from the perspective of what it represents in health care settings. As such, the concept exhibited diminishing variables in defining its prevalence to health care practice and literature, generally. (Xyrichis & Ream, 2008).
Employing analytical approaches advanced by Walker and Avant (2005) they hypothesized that teamwork be considered a dynamic process involving two or more health care professionals. These professionals must articulate complementary skills for synchronicity. (Xyrichis & Ream, 2008).
In their introductory remarks the authors advanced arguments to show where ignorance of teamwork applications has been detrimental to health care interventions. Therefore, the urgency exists as twenty-first century health care professionals for ‘conceptual understanding’ (Xyrichis & Ream, 2007) to avoid errors in clinical management of patients; medication orders misinterpretations and chaos in staffing techniques itself. (American Nurses Association, 2005).
Further, the emphasis of this literature review shifted towards attempting ways of defining the concept utilizing a scientifically acceptable methodology. While adapting Walker and Avant’s (2005) approaches appeared relevant, the authors had to ensure that the requirement of identifying suitable variables within the concept was upheld.
Secondly, variables contained in the aims of the analysis itself also had to be clearly operationalized to obtain accuracy when empirical measurements are applied. The principal aim as outlined in this literature review encompassed the provision of a definition of teamwork which contributed towards an understanding of how it is utilized in health care presently as well as instituting an operational definition for future interventions. (Xyrichis & Ream, 2008).
The researchers in their quest for clarity have also proposed a deliberate concept analysis approach embodying distinct formats engaging rigorous processes through which a selected concept is perceived in the abstract, but is subsequently explored utilizing scientific principles to justify its relevance to the discipline. (Xyrichis & Ream, 2008).
This embodied eight definite steps burrowed from Wilson’s (1963) typology of concept analysis adapted by Walker and Avant (2005). It involved first selection of the concept through screening implying literature review; then, indicating a purpose or aims; identifying all its uses; determining its attributes; designing cases for its application; defining predisposing factors; establishing empirical relevance and forging theoretical commitment.( Walker & Avant, 2005).
In concluding they advanced prepositions to embrace teamwork as being a concept denoting a dynamic process engaging two or more professionals with complimentary backgrounds; it was accomplished through interdependent collaboration through open communication; common goals were necessary for successful outcomes and effort through shared decision making were direct attributes to be implemented.
Definitions of the Teamwork- concept
When applying the eight steps of concept analysis in arriving at relative definitions within a discipline, it can be deducted that the authors provided the reading audience with a definition of teamwork utilizing a distinct concept analysis approach. The definition embraced eight discrete variables necessary for implementation in health care delivery process.
Xyrichis and Ream defined teamwork initially, as a dynamic process, which means that it has the propensity to change depending on prevailing circumstances or desired outcomes. Major intervening variables in the exploration for clarity were espoused as ‘health care professionals;’ ‘complimentary background and skills;’ ‘sharing common health goals;’ ‘exercising concerted physical and mental efforts;’ ‘interdependent collaboration;’ opened and shared decision making;’ ‘common goals’ and’ ‘understanding professional goals.’ (Xyrichis & Ream, 2008).
In defining teamwork concept it is speculated that the authors incorporated these foregoing variables as an explanatory device since health care intervention seems to be inconclusive regarding the elements informing teamwork within the science.
Further clarifying conclusions regarding a precise definition of teamwork from a concept analysis paradigm is indicative that while the present assumptions are limited in expressing what constitutes valuable teamwork in health science, it forms a platform from which nurses, doctors and allied health workers can pivot in efficient execution of task oriented duties. (Xyrichis & Ream, 2008).
It is my humble assumption based on the definition of teamwork offered through concept analysis in this literature review, that there is still much more work to be done in providing integration among health care professionals especially, when functioning as service agents interfacing with the public. Is conceptual understanding the resolution? We will have to wait and see!
Terms associated with Teamwork- concept and differences.
Based on the authors’ perspective in this literature review “Teamwork: A concept analysis, ’’ there was mention of six keywords, which could be the associated terms infiltrating this study. They are collaboration, communication, concept analysis, health care, nursing and teamwork. (Xyrichis & Ream, 2008). In my analysis it would be appropriate to exclude teamwork and concept analysis as associated terms. Actually, they are the active ingredients of this study and therefore, cannot be associated terms, but independent variables.
Alternatively, referring to results explained in the definition, associated terms could include ‘health care professionals;’ ‘complimentary background and skills;’ ‘sharing common health goals;’ ‘exercising concerted physical and mental efforts;’ ‘interdependent collaboration;’ opened and shared decision making;’ ‘common goals’ and’ ‘understanding professional goals which are all dependant variables of teamwork/ concept analysis.
My assumption is based on the premise that if these variables define the concept then they are positively related and can be ascribed the terminology of being associated with teamwork regarding healthcare innovations.
The principal terminology describing teamwork is ‘dynamic process.’ Associated with this dynamic process are the variables mentioned in explaining how this functions. Precisely, it involves health care professionals who activate the dynamic process. Then there is the qualifying ‘complimentary background and skills;’ ‘sharing common health goals;’ ‘exercising concerted physical and mental efforts;’ ‘interdependent collaboration;’ opened and shared decision making;’ ‘common goals’ and’ ‘understanding professional goals in completing the process’ appropriateness while refining the concept.
How do they differ? It is simple! Teamwork as a concept has no meaning in itself when left alone. According to Xyrichis & Ream (2008) it is merely a “dynamic process” What is a dynamic process? The intervening dependant variables add meaning to dynamic process and teamwork individually and collectively in explaining the innovators, their roles, responsibilities and the desired outcome.
Tools available to measure Teamwork- concept and propositions if none is identified
Xyrichis and Realm (2008) offered other perspectives in measurement by proposing that this rigorous process of concept analysis inevitably, requires exploration of an abstract concept; clarification; validation, definition, differentiation and theorization.
In essence they did not establish any distinct empirical measurements of testing a hypothesis statistically to verify if the null or prevailing other could be validated. Perhaps, a chi- square test of significance could have been appropriated for a more scientific evaluation of this concept teamwork.
There are many variables within the concept teamwork and no one knows whether they are really relevant or not in producing the desired outcome of ‘conceptual understanding’ in health care delivery through teamwork intervention. This is still to be measured in reality settings.
A 10 month old child has been admitted to the pediatric ward with temperature of 105 degrees Fahrenheit. The toddler has had two seizures prior to arriving at the emergency. She appears comatose; reflexes are limp; pupils dilated but shows signs of restlessness.
The team of health care professionals is summoned to manage this patient. It consists of a pediatrician, registered nurse trained in pediatrics; licensed practical nurse; pharmacist laboratory and X-ray technicians. These are the complimentary background and skills engaged in the intervention.
Sharing common health goals are incorporated in the aim to reduce fever; arrest seizers, monitor pupilary reaction and temperature, dispense and administer medication; ensure safety of patient during a seizure; assess blood and X-ray head. With concerted physical and mental efforts, the registered nurse monitors results of vital signs taken by the LPN. Reports are made to the pediatrician who diagnoses after laboratory reports and X-ray findings are revealed.
Repeated interdependent collaboration among team workers consequently initiates open and shared decision making as to how common goals could be reached and maintained. Each member of the team functions in accordance to protocol within designated roles and responsibilities.
The registered nurse documents a schedule of activities within the framework of understanding professional goals for each team worker and his/her contribution towards a successful outcome. Understanding the application of these diverse professional goals within the team is crucial to the outcome of this 10 month old leaving the pediatric unit without any brain damage. Team members were successful in resolving this health issue. The toddler regained full consciousness and was discharged within 24 hours.
Conclusion
In the foregoing pages of this scholarly presentation it was the author’s desire to evaluate the usefulness of variables espoused by Xyrichis and Realm (2008) in the literature review, Teamwork: Concept analysis.’ Theories, concepts, variables, hypotheses, assumptions and propositions serve the science no purpose if they cannot be applied to real life experiences.
My application of Teamwork in the preceding case study while appropriately applicable still shows that there could be room for improvement. True! Communication is the key to successful team management. But how much transparency of communication really exists in the everyday work environment on clinical areas? Just personally evaluate the routine of contemporary clinical management daily!
In the quest for relevancy of teamwork in health care practice Sewell (2005) admonishes administrators to look beyond concepts pertaining only to health care and apply strategies from a human resource perspective. Actually, it is believed to be ‘the best way of tapping into the expertise and skills of the workforce. (Sewell, 2005).
Therefore, when Xyrichis and Realm (2007) argue that there are limited research studies on teamwork as it relates to the health care industry, perhaps there are other variables affecting health care practice, which are overlooked when designing a conceptual framework for teamwork within the discipline.
Conclusively, these authors advanced, that the assumptions derived from their limited scientific research is merely a glimpse at what the true picture entails. As such, nurses, doctors, and healthcare providers in human resource management ought to take an in-depth view of teamwork with the aim of addressing dysfunctions and thereby resolving them.
References
American Association of Critical Nurses Care (2005) Standards for Establishing and
Maintaining Healthy Work Environments. ANNC, Columbia.
Sewell, G. (2005) Doing what comes natrurally.Why we need practical ethics of teamwork?
International Journal of Human resource management.16 (2), 202-218
Walker, L & Avant, K. (2005) Strategies for theory construction in Nursing (4th ed.) Upper
Saddle River, New Jersey: Prentice Hall
Xyrichis, A & Realm, E (2008) Teamwork: A concept analysis. Journal of Advanced Nursing
6(12), 232-241
