Explain the healthcare core competency; work in interdisciplinary teams. Why this is important to address in healthcare education and what is its impact on practice?
Effective interdisciplinary teamwork is central to the delivery of safe and quality healthcare. Teamwork and collaboration within nursing and interdisciplinary teams promote open communication and mutual respect, shared decision-making and leadership skills, and cooperative learning and professional development. Collaborative work impacts nursing knowledge, attitude and behavior, and development of skills. Working within a team helps a nurse identify personal strengths and limitations and their value to the team. Team members have well-defined roles that translate into accountability and more efficient contribution to the delivery of health care, while providing an opportunity for recognizing the contribution of other members in the team, and learning from them. Working within a team offers a nurse the opportunity for self-directed and collaborative learning. Exposure to the specialized skills of other healthcare professionals allows for a deeper appreciation of the niche a nurse is to fill within the environment of the healthcare system (McCloskey & Maas, 1998). Teamwork emphasizes the responsibility of each member’s contribution to the delivery of healthcare, while stressing the contribution of each intra- and inter-disciplinary member of the team. Teamwork also shifts the focus of healthcare directly onto the patient. A team member is accountable to every other member in the healthcare team, promoting the delivery of high quality healthcare. To hold a team member accountable, other team members must understand each member’s scopes of professional responsibility. It is also easier to evaluate one’s skills and limitations within the framework of a team. A team also offers the opportunity for the development of new skills, while the better defined roles within a team allows for the refinement of skills already present. It also promotes leadership skills by providing an opportunity to delegate a task or to accept a new responsibility. Collaborative work translates into collaborative learning.
What is a team, and how does it function?
A team is a group of individuals who share a common goal. The team functions through active and ongoing communication among team members to maximize collaboration. To be efficient, a team must be highly organized and have well-established guidelines for cooperation, and for the allocation of tasks and responsibilities. The team must be managed as to integrate each member’s role into the matrix and coordinate efforts between and amongst members for optimal efficiency and delivery. Thus, the key elements to successful teamwork are coordination, communication, and shared responsibility (McCloskey & Maas, 1998). Within the context of the healthcare system, healthcare professionals have been segregated by their areas of discipline, and until recently have remained largely ignorant of the scope of the roles and responsibilities of each other’s professions. Thus, for a healthcare team to work effectively, any new member that is to join must first familiarize themselves with the roles and responsibilities of each of the other professionals in the team, and to recognize areas of overlapping skills and responsibilities, and thus be able to coordinate their individual roles for more efficient delivery of care. It is also necessary for team members to understand the roles and responsibilities of others who manage the non-health needs of the patient, like social workers and health plan administrators.
How does collaboration impact effectiveness?
Team collaboration is essential for effective communication. When communication fails, patients are placed at risk for a variety of reasons, including lack of vital information, misinterpretation of information, confusion, and overlooked information—the type of environment where medical errors can occur. Medical errors place the patient at higher risk of injury or death. The goal of any healthcare provider is to provide error-free medical care and there is a great deal of pressure from colleagues to make the right diagnosis and choose the right treatment.
Mistakes are perceived as failures. This creates an atmosphere where mistakes are not shared with others, which keeps learning from taking place, and the opportunity to prevent others from making the same mistake is lost. The value of teamwork is to provide an open and collaborative communication system where mistakes are acknowledged, analyzed, and prevented as a team. A team that keeps its channels of communication open and shares its failures as well as its success can evolve into a safer and more efficient healthcare delivery system. Studies have shown that a significant number of hospital deaths are due to medical error, and that lack of communication is one of the leading sources of medical error. Effective clinical practice relies on the accurate exchange of information between professionals from a wide variety of disciplines.
Why is collegiality and collaboration important for the professional growth of a nurse and the profession in general?
The truism that one learns from one’s mistakes has no greater significance than within the healthcare system. A true professional contributes to the professional development of others. It is an obligation that can be fulfilled when sharing of one’s knowledge and expertise. Teamwork offers a special opportunity to serve as a resource to others, provide positive feedback regarding professional contributions to the team, create an atmosphere where learning can be advanced, apply communication skills to resolve differences, assist colleagues in refining their skills, and develop one’s leadership skills.
What has impeded collaboration and the interdisciplinary team approach to deliver care?
An interdisciplinary approach to healthcare raises the standard of healthcare, but collaboration among professionals with contrasting levels of skills and overlapping responsibilities can have its problems. Interdisciplinary teamwork is particularly difficult for physicians who traditionally have been trained to be self-sufficient and individually responsible for their actions (McCloskey & Maas, 1998). There are several barriers that must be overcome. The largest barrier is communication. When a well-established system of communication and practices is not in place, there may be breakdown in the consistency and continuity of care. Delivery of healthcare through teamwork has to be collaborative for it to succeed, and collaboration is not possible without communication. Another barrier to interdisciplinary teamwork is that some members in the team are not able to work together due to lack of understanding of the roles or appreciation of the contributions of other members. It is difficult to come together and solve any problems that might arise without mutual understanding and respect. The personalities of the individual team members can also play into the dynamics of the group; unfortunately, some individuals may feel that they are the most important member of the group and act without consideration of the team. Lack of respect may lead to lack of trust and severely impact collaborative care, and may ultimately harm the patient. A team is only as strong as its weakest link. It is critical for a team to have a strong leader that can monitor the efficiency and effectiveness of the team. A good leader understands the impact of personal dynamics on professional proficiency.
Discuss some skills that nurses must have to work effectively with other team members.
The fundamentals of collaboration are sharing, partnership, leadership, interdependency, and trust. Therefore any skills a nurse brings to an interdisciplinary team would fall within one of these categories. A good team member shares the goal of the other members and works in partnership with others to synchronize their skills in interdependent cooperation for effective delivery of care. There are two types of skills that impact interdisciplinary teamwork: technical, and non-technical skills. A professional that enters the team is first judged and accepted by the quality of their technical skills; knowledge is the first power. The other set of skills involve cognitive and interpersonal skills that involve abilities such as communication, leadership, cooperation, delegation, assertiveness, and decision-making skills. The strength of a team also rests on each team member’s ability to anticipate task needs, and that is highly dependant on internalized values and goals of the team; a common goal must exist. Thus, to work efficiently within an interdisciplinary team a nurse must have strong clinical skills, and strong social skills. Weakness in one will undermine the other.
Discuss some roles the nurse collaborator can have to its client and peers.
A nurse collaborator in an interdisciplinary team can play a variety of roles related to assessment, treatment and management, education, advocacy, and referrals (Nursing, 2004). A nurse is also the one healthcare professional in the team that interacts the most with the patient and as such serves as the representative and advocate of the team and of the patient. One of a nurse’s most important roles is to assess the needs of the patient and the family at each stage of the healthcare process. This includes a complete health evaluation, medical diagnoses, identification of factors that might impact the health and wellbeing of the patient, evaluation of the need for screening and diagnostic exams, interpretation of results, and assessment of patient’s concerns and preferences (Nursing, 2004). A nurse also manages the patient’s medical condition, monitors ongoing therapy, determines necessary changes in therapeutic protocols, uses evidence-based data to suggest alternate medications, and includes the patient’s views in the healthcare plan (Nursing, 2004). A nurse also provides health information for the patient, determines the need for secondary interventions, collaborates with the community, and identifies community resources applicable to the patient (Roux, G., & Halstead, 2008). Another important role for the nurse in an interdisciplinary team is to maintain open communication channels with the patient’s primary physician and refer patients to specialists where necessary (Roux, G., & Halstead, 2008).
Referrals are not limited to healthcare professionals, but also include non-healthcare professionals, ranging from social workers to spiritual advisors.
References
McCloskey J.C., & Maas M. (1998) Interdisciplinary team: the nursing perspective is
essential. Nurs Outlook. 46(4):157-163.
Nursing: Scope and Standard of Practice (American Nurses Association), Fifth Ed.
(2004). Amer Nurses Assn.
Roux, G., & Halstead, J.A. (2008). Issues and trends in nursing: Essential knowledge for
today and tomorrow. Burlington, MA: Jones & Bartlett Learning
