InstitutionLeadership Learning Experience Project
- The Need for Interdisciplinary Teams
Interdisciplinary teams are important in nursing as they improve the quality and safety of care offered to patients. Interdisciplinary teams consist of professionals from different disciplines who work together and share expertise, skills and knowledge (Gardner, 2005). Collaboration and teamwork are imperative in healthcare which requires professionals with varied expertise. Poor collaboration between health professionals and lack of teamwork influences quality and safety of care (Gardner, 2005). Research linked poor collaboration with poor patient outcome and increase in medical errors. This is because patients do not get appropriate and timely care. Poor communication between health professions also increases the rate of medical errors and affects patient outcome and quality of life (Gardner, 2005). Health professionals including nurses and physicians require accurate information to provide quality and safe care (Gardner, 2005). Interdisciplinary teams have proved effective in enhancing patient outcome in different patient populations. Interdisciplinary teams transform care offered to patients by reducing medical errors and improving the quality of care. Team members need to communicate effectively when providing care and this reduces medical errors resulting from poor communication between professionals (Gardner, 2005). In addition, team members make collective decisions concerning patient’s health and safety.
Wilens, Cripps, Wilson, Wolff and Rothman (2011) support interdisciplinary team care as it improves patient health outcomes and access to care. The researchers noted that diabetic patients, cared for by primary doctors, do not get quality care since they do not spend adequate time. This impairs the efforts to attain the treatment goals. Interdisciplinary team care is better in meeting the psychological and medical needs of diabetic patients. Thus, doctors, nurses and pharmacists should work as a team to care for this population. The aging population, huge number of patients with complex need and the chronic nature of the diseases have led to the need for interdisciplinary teams to meet diabetic patient’s needs. Complex skills and knowledge are needed to offer comprehensive care to patients with chronic diseases and hence professionals from diverse disciplines work together and share skills and knowledge (Nancarrow, Booth, Ariss, Smith, Enderby & Roots, 2013).
- Interdisciplinary Team Meetings Experience
I attended three interdisciplinary team meetings, each with different experiences. The first interdisciplinary team meeting was aimed at discussing care offered to diabetic patients. The team comprised of a physician, a registered nurse and a pharmacist. I had a positive experience because of the atmosphere. The team members created an atmosphere conducive for all members and made it easy for new members to adjust. The team members interacted and communicated freely. The members aired their views regarding care offered to diabetic patients and how they view the care provided. The members listened carefully as each spoke and avoided disruptions. The team leader chaired the meeting and all members were aware of the aims of the meeting, thus avoiding confusion.
The second interdisciplinary team comprised of a doctor, a wound care nurse and a pharmacist. The team members discussed care offered to patients with pressure ulcers. The health professionals discussed the best treatment option for the patients. I attended the meeting as an observer and I had a positive experience. The team members were welcoming and this made it easy for me to fit in the team. The team members encouraged open communication and interacted with each other freely. Each member contributed to the issues raised by the team leader as others listened. The agenda for the meetings were clear and hence members were aware of the purpose of the meetings. The third interdisciplinary team consisted of a therapist, a registered nurse and a psychiatrist. I attended the meeting as an observer and had a negative experience. The team members were unable to work as a team due to poor communication and conflicts. The team members did not interact freely or actively listen to other members as they spoke. Though the agenda for the meeting was well stated, the team leader was unable to control the team and chair the meeting. As a result, the team members did not attain the objectives of the meeting and they did not clearly discuss the issues raised concerning care to a schizophrenic patient.
C. Roles of Interdisciplinary Team Members
The interdisciplinary team members perform different roles. A psychiatrist provides care to patients with mental problems including schizophrenia. The psychiatrist diagnoses and determines the best treatment and intervention for patients with mental illnesses. The wound care nurse provides suitable wound care to patients after a surgical operation. In addition, the wound care nurse cares for patients with pressure ulcers and other types of wounds. Wound care nurses assess, treat and monitor client’s wounds and encourage health management practices to avoid recurrence. Therefore, wound care nurses minimize suffering, loss of function and complications. A registered nurse provides care to different patients. The registered nurse assesses and determines the best treatment for patients. A registered nurse works with other professionals to provide care to patients with different health conditions including chronic diseases. A physician promotes, maintains and restores human health via diagnosis and treatment of diseases. A pharmacist plays a critical role in the delivery of care as he dispenses prescription drugs to patients and provides expertise in safe usage of prescriptions. Pharmacists provide advice on how to live a healthy lifestyle, carry out screening and monitor patients. The therapist provided therapies including cognitive behavioral theraphy to patients with mental conditions including schizophrenic patients.
Nurses play a vital role in interdisciplinary team interactions as they facilitate interaction between members. Nurses eliminate barriers to interaction in a team and encourage effective communication between team members to improve interactions (Weller, Janssen, Merry & Robinson, 2008). Ineffective communication hinders team members from interacting with each other and attaining team goals. Nurses promote effective communication in a team to improve interactions. For instance, they encourage active listening, which is important in communication. They ensure team members actively listen to each other when communicating. In addition, nurses eliminate conflicts as they affect interactions in a team (Weller, Janssen, Merry & Robinson, 2008). Nurses identify causes of conflicts among team members and solve them using conflict resolution and management techniques to enhance interaction. Conflicts cause tension and distrust group members interactions.
D. Interdisciplinary Team Interactions
1. Effective Leadership
Effective leadership is important in ensuring smooth functioning of any team including an interdisciplinary team. Leaders should have appropriate skills to lead team members and ensure members attain team goals. Leaders should develop a shared vision and guide team members in achieving the vision (Weller, Janssen, Merry & Robinson, 2008). Leaders should effectively identify and manage conflicts to promote cohesion. Besides, leaders should encourage effective communication between and among team members (Weller, Janssen, Merry & Robinson, 2008). They foster understanding and trust among members to enhance team effectiveness. Only two interdisciplinary teams I attended had effective leadership. The diabetic care and the pressure ulcers interdisciplinary teams had effective leadership, as leaders were able to lead team members to discuss care offered to diabetic and pressure ulcers patients. The leaders effectively managed team interactions by eliminating barriers to effective interactions (Weller, Janssen, Merry & Robinson, 2008). They ensured no conflicts were evident among team members and this created a favorable environment for members to discuss the agenda. In addition, the leaders identified the agenda and guided members in finding solutions to the issues raised. They ensured team members communicated effectively and employed active listening skills. The team members understood and acknowledged the differences and similarities between members making it easy for them to work together.
On the other hand, the third team did not have effective leadership as evidenced by the poor interaction between members. The team leader was unable to effectively identify conflicts and resolutely manage. Thus, conflicts between different members of the team affected team cohesion and functioning (Weller, Janssen, Merry & Robinson, 2008). Team members were reluctant to work together due to distrust and fear. The team leader did not promote effective communication among members or control members (Weller, Janssen, Merry & Robinson, 2008). The members did not employ active listening skills and constantly interrupted other members as they presented their views. Therefore, poor leadership hindered the team from achieving team goals.
2. Goals
The interdisciplinary teams had different goals. One of the goals was to improve care offered to patients with pressure ulcers and hence enhance quality of life and outcome. The team members identified different ways of enhancing care offered to patients with pressure ulcers. The team members agreed to implement risk assessment, nutrition interventions and use pressure relieving devices to avoid ulceration. The second goal identified was transforming care offered to diabetic patients by improving information monitoring and drug adherence. The group members believed monitoring is important in improving the outcome of diabetic patients and quality of life. The health professionals noted poor medication adherence affected patient outcome and quality of life. Therefore, they agreed to monitor the patient and offer comprehensive follow up care to improve adherence and outcome. I could have participated in enhancing care offered to patients with mental conditions by suggesting suitable interventions in this population.
3. Benefits of having Cohesive Interdisciplinary Teams
Team cohesion is one of the most essential outcomes among teams. Cohesion arises in different ways in a team including communication. Effective and open communication leads to team cohesion and enables members work towards group goals. A cohesive interdisciplinary team is beneficial to the healthcare organization, nursing staff, patient and group dynamics. A cohesive interdisciplinary team improves care offered to patients as team members are able to work together to transform patient care (Purvis, Bernhardt, Indredavik & Cadilhac, 2014). Team members work as a team to determine the best treatment and interventions for the patient. Thus, a cohesive interdisciplinary team leads to better patient outcome and enhances quality of care. Patients with chronic diseases and elderly patients need comprehensive and skilled care. Hence, a cohesive interdisciplinary team ensures members offer comprehensive and skilled care to this population (Purvis, Bernhardt, Indredavik & Cadilhac, 2014). Additionally, a cohesive interdisciplinary team is beneficial to the healthcare organization as the organization is able to attain its goals and objectives. Healthcare organizations focus on providing quality and safe care to patients and health professionals are supposed to collaborate and work as a team to transform patient care. Therefore, a cohesive interdisciplinary team makes it easy for the healthcare organization to meet patient needs and meet its goals ( DiMeglio et al, 2005). The nursing staff also benefits from a cohesive interdisciplinary team. Nurses are supposed to collaborate and work with other healthcare professionals when providing care to patients.
Cohesive interdisciplinary teams improve collaboration and teamwork and reduce stress associated with teamwork. Cohesive interdisciplinary teams reduce nurse turnover by improving job satisfaction and reducing stress levels ( DiMeglio et al, 2005). Cohesive interdisciplinary teams influence group dynamics including relationship between members, perception and behaviors towards other members. Cohesive interdisciplinary teams eliminate conflicts between group members and members are able to work as a team. Team members view each other positively and understanding the differences between members. Cohesive interdisciplinary teams reduce the perception of differences between group members through understanding ( DiMeglio et al, 2005).
4. Group Dynamics for the Interdisciplinary Diabetic Care Team
The group dynamics were evaluated by observing the interactions among the team members. The interdisciplinary team operated efficiently and was able to attain the team goals. Additionally, the team members identified conflicts and resolved them before they escalated and affected the functioning of the team. Professional conflicts did not arise during the meeting as the roles of each member were clearly stated. Personal conflicts were evident, but the members managed to resolve them. Thus, the group members trusted each other and were motivated to work as a team (Weller, Janssen, Merry & Robinson, 2008). The team leadership played a big role in increasing team efficiency as the team leader led the team effectively (Weller, Janssen, Merry & Robinson, 2008). The team leader identified conflicts, resolved them, and set clear goals. Other members in the team also assumed leadership roles and performed different tasks. The group members interacted freely and actively participated in-group activities. Effective communication and cohesion enhanced group interaction and effectiveness (Weller, Janssen, Merry & Robinson, 2008). The group members communicated effectively and openly hence eliminating misunderstandings. Further, team cohesion contributed to team efficiency by eliminating conflicts and negative attitudes. Members had a positive attitude towards each other despite having come from different disciplines. Team cohesion improved member’s perception of each other and improved the functioning of the team.
E. Potential Problems that May Arise
1. Methods
Conflicts and communication problems may arise in future in diabetic team due to professional and personal differences. Two methods can be used to deal with difficult group dynamics. The methods include negotiation and conflict management. Conflict management is important in managing conflicts and increasing team efficiency (Johansen, 2012). The group leader should be able to identify conflicts including the main causes. Then use appropriate conflict management technique to resolve the conflicts. Some of the conflict management techniques are avoidance, negotiation, compromise among others. Leaders can use compromise to resolve conflicts, as it has proved effective (Johansen, 2012). In negotiation, leaders find a win-win solution when resolving conflicts. Conflict management will be implemented to resolve conflicts that might arise in the future. Compromise method will be useful in resolving conflicts, unlike avoidance. Compromise helps nurse leaders attain a solution that partially satisfies the needs of parties involved (Johansen, 2012).
2. How Individual Members Affect the Functioning of an Interdisciplinary Team
Individual members affect the functioning of a team with their actions, attitude, beliefs, perceptions and behaviors. Individual members can have certain characters that make it hard to work with other members of the team. The functioning of the team is affected if members do not accept diversity and divergent views (Weller, Janssen, Merry & Robinson, 2008). In addition, individual members can affect the functioning of the team if they do not have effective communication skills and are unable to manage and resolve conflicts (Weller, Janssen, Merry & Robinson, 2008).
3. Factors that Hinder Change
Different factors could make it hard for change to happen. Poor communication between team members and leaders could hinder change process. Effective communication is essential when bringing change in the organization. Effective communication prevents resistance as leaders communicate the vision to employees (Salmela, Eriksson & Fagerstrom, 2012). Poor communication cause misunderstanding between members and impairs change. Poor leadership could also prevent the implementation of change, as effective leadership is needed to bring change. Leaders should have appropriate skills and be able to influence workers to support the change (Salmela, Eriksson & Fagerstrom, 2012).
Nurses as leaders are important in leading change as they can influence other professionals to accept and support change. Nurse leaders play diverse roles when leading change in the organization (Salmela, Eriksson & Fagerstrom, 2012). They direct, guide, motivate, support and communicate the proposed change. Nurse’s leaders are supposed to support and motivate employees to support the change by providing training. They should effectively communicate the change process to employees to enable them understand the need for change. Nurse leaders are role models in the organization and they can facilitate or impair change (Salmela, Eriksson & Fagerstrom, 2012).
F. How Meeting Outcomes are Communicated
The diabetic team used different methods to communicate the meeting outcomes to other professionals (Gardner, 2005). Face to face communication was used to communicate the meeting outcomes to other workers. The interdisciplinary team recommendations and action items were implemented to improve diabetic care (Gardner, 2005). The recommendations included regular monitoring of patients and provision of comprehensive follow-up care to patients to improve drug adherence. The hospital developed a comprehensive diabetic care program to enhance care offered to diabetic patients (Gardner, 2005). The interdisciplinary team members were required to monitor their patients regularly to ensure they adhered to drugs. In addition, team members provided follow-up care to patients to motivate them to adhere to medications and determine their progress. Data obtained from the monitoring process and follow up care was used to make changes to care offered to patients.
G. Reflection
My observation and participation in the interdisciplinary meetings shaped my views regarding the role of nurses in an interdisciplinary team. I learned a lot about the importance of nursing leadership in interdisciplinary teams. Leadership is important in improving the functioning of teams. Nurse leaders play an active role in leading teams and improving their functioning. Nurses should effectively lead groups and have skills required to manage problems evident in groups such as conflicts, cohesion issues, setting goals, attaining goals and poor communication. In addition, I learned that all members of a team could assume leadership functions and enhance team effectiveness.
As a nurse, I will assume leadership roles in my clinical setting. I will lead interdisciplinary and other teams in the organization. I will effectively lead the teams to improve their performance. In addition, I will select the best leadership style as poor leadership negatively influences the team performance and the organizational performance.
References
DiMeglio,K et al.(2005).Group cohesion and nurse satisfaction: examination of a team-building approach. J nurs Adm,35(3),110-20
Gardner, D. (2005). Ten Lessons in Collaboration. OJIN,10(1)
Johansen, M. L. (2012).Keeping the peace: Conflict management strategies for nurse managers. Nursing management,43(2),50-54
Nancarrow,S.A.,Booth,A.,Ariss,S.,Smith,T.,Enderby,P.,&Roots,A.(2013).Ten principles of good interdisciplinary team work. Human resource for health,11:19
Purvis, T., Bernhardt, J., Indredavik, B.,& Cadilhac, D.A (2014). Interdisciplinary Team Interactions in Stroke Units: Can Team Dynamics Influence Patient Outcomes from a Clinician’s Perspective. Int J Phys Med Rehabil
Salmela, S., Eriksson, K., & Fagerstrom, L (2012). Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process. J Adv Nurs,68(2),423-33
Weller,J.M.,Janssen,A.L.,Merry,A.F.,&Robinson,B.(2008).Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises. Med Educ,42(4),382-8
Wilens,D.,Cripps,R.,Wilson,A.,Wolff,K.,Rothman,R.(2011).Interdisciplinary Team Care for Diabetic Patients by Primary Care Physicians, Advanced Practice Nurses, and Clinical Pharmacists. Clinical Diabetes,29(2),60-68
