Organizational Systems and Quality Leadership
The quality of care continues to occupy a center stage in the management of health care facilities as consumers focus shift from just seeking health care interventions to demand for safe and quality care. Nurses occupy an important position in healthcare interdisciplinary in which they play several roles in the delivery of patient care including the role of case managers and care takers among other clinical duties. In a move to promote effective integration of nurses into the interdisciplinary healthcare teams, the Institute of Healthcare Improvement (IHI) has exploited the current technological advancement including internet connectivity to nurses with easily accessible online education modules. Through such modules, nurse continue to be empowered to take up leadership roles during the functioning of such teams regardless of whether they occupy formal leadership positions or not. This paper discusses some of the strategies through which nurses can exert leadership influence on interdisciplinary teams, ways of assuming active roles in the teams and the creation of a safe environment.
Ways of Exerting Leadership When Outside the Formal Leadership Circles in Interdisciplinary Teams
In order for nurses to be able to exert their leadership influence on interdisciplinary teams despite falling outside the formal leadership position, they need empowerment through equipment with adequate leadership skills and knowledge. Without superior knowledge and necessary leadership skills, nurse may not have the much needed confidence to participate in interdisciplinary team’s decision making processes and control of situations (Leung & Bacon-Shone, 2006). Although in most cases formal leadership positions in interdisciplinary teams are occupied by senior physicians and doctors, nurses can exert leadership skills in such teams through cultivation of positive attitudes towards assumption of key responsibilities in the teams. Such attitudes would be crucial in motivating the nurses to intervene and provide leadership support in the process of delivering patient care. Cultivation of positive attitudes among nurses is in line with the school of thought purporting that leadership is an attitude as opposed to its view as a position (Frankel, 2008).
The other strategy through which nurses can exert leadership on interdisciplinary team including change of leadership perception in the team to ensure that every team member has an equal opportunity to contribute to teams activities regardless of their positions or ranks (Edmondson, 2003). Since nurses are well positioned in the evidence based care by virtue of having a direction and frequent interaction with patients, they can exploit such opportunities to evidence based facts capable of influencing the decisions arrives at by the interdisciplinary team. In this case, nurses need to have accurate observational and effective communication skills to enable them garner significant leadership influence on the interdisciplinary teams.
Active Involvement
Nurses often play different roles in the interdisciplinary teams including the role of case managers, care taker and even clinicians. In the event of carrying out such roles, they usually interact closely with patients giving them an opportunity to gather adequate evidence based information critical in the team’s decisions making processes (Page, 2004). As such, nurses are continuously consulted by other members of the team to provide with such information. For this reason, nurses are actively involved in the interdisciplinary team either through the different roles that they play in the provision of a patient care or as sources of evidence based information. However, the active involvement of nurse in the team is greatly influenced by different factors including interpersonal skills, attitude and knowledge about the situation under care or management by the interdisciplinary team (Page, 2004).
Contributing Position
As members of the interdisciplinary team, nurses need to position themselves strategically in order to contribute to the effectiveness of team and achievement of its goals. Other than execution of the various roles assigned to nurses within the interdisciplinary team, they can contribute significantly to other activities of the team such as the decision making process. However, this can only be achieved through increased knowledge about the situation at hand which empowers them to contribute effectively to the team’ goals and objectives (Page, 2004). Online educational modules provide nurses with adequate information to fill knowledge gaps that may hinder them from contributing effectively in the interdisciplinary teams. In this case, nurse can position themselves better to contribute to the team’s goals through acquiring of new skills and increased knowledge.
Other that attaining the contributing positions through acquiring of increased knowledge, nurses can also contributing effectively through development of the several attributes that contribute to the creation of effective teams such mutual respect, shared responsibility, effective communication skills, trust, conflict resolution skills and cooperation. Success development of these attributes greatly enhance nurses’ capability to actively contribute to the team’s activities through articulation of the various roles assigned to them in the interdisciplinary team as well as providing evidence based information to support the team’s decisions making process.
Creation of a Safe Environment
Creation of a culture of safety forms an important step towards provision of quality health care by the health care institutions. Creation of a safe environment requires articulation of four characteristics of the safety culture including psychological safety, active leadership, transparency and fairness.
Psychological Safety
Psychological safety plays an important role in assuring healthcare practitioners of a safe environment where they can freely exercise their skills and without fear of being reprimand whenever mistakes occur. The feeling of being psychologically safe facilitates effective sharing of information and contribution towards achievement quality health care through the interdisciplinary teams. According to Kanes (2010), people contribute more through information sharing and asking whenever in doubt when operating in an environment that afford the feeling of being secure. It is purported that psychologically safe environments allow workers to make mistakes but also encourage them to avoid such mistakes through ensure that the interests of the patients come first in their decisions.
Transparency
The issues of transparency is critical in ensuring teamwork in the process of health care delivery in which every members should feel free to disclose any information of interest to the team. In some cases, health practitioners may decide to withhold important information such as medical errors, skills or knowledge critical in the delivery of quality. In this case, healthcare practitioners must feel secure to share any information without fear of victimization from the hospital authorities. Transparency is particularly important in ensuring past mistakes are not repeated and all crucial information required in the delivery of quality care is shared among the staff members (Youngberg & Hatlie, 2004). For instance, a medical error committed by one of the practitioners if revealed can help other patients to avoid such errors by ensuring enhanced precaution when dealing with a similar scenario.
Active Leadership
The nature of operations within health care facilities requires an environment in which people are free to share their views and have them considered in the various decision making processes. This phenomenon is easily actualized through active leadership which is a type leadership that permits exchange of ideas among all staff members regardless of the leadership position held (Kanes, 2010). Working environments characterized by active leadership allows all people to air their views while at the same time allowing free exchange of information both downstream and upstream. The team leader in the interdisciplinary team should create an environment in which all team members are free to contribute to the teams’ decisions.
Fairness
A fair working environment encourages workers or stakeholders to account for their actions without the fear of unreasonable treatment by the organizations’ leadership. Promotion of fairness in the work environment encourages workers to be accountable and responsible in their roles thereby limiting risk behaviors, human errors and bad attitude among the workers (Wachter, n.d). The concept of fairness appreciates that anyone can make mistakes and encourages the need to exercise caution in the process of delivering patient care.
References
Edmondson, A. C. (2003). “Managing the risk of learning: Psychological safety in work teams.”
In: West M, ed. International Handbook of Organizational Teamwork. London, UK: Blackwell
Hartwig, M., & Landis, B. J. (1999). “The Arkansas AHEC Model of Community-Oriented Primary Care” Holistic Nursing Practice 13(4), 28-37.
Kanes, C. (2010). Elaborating professionalism: studies in practice and theory. London: Springer.
Leung, G & Bacon-Shone, J. (2006). Hong Kong's health system: Reflections, perspectives and visions. Hong Kong: Hong Kong University Press.
Page, A. (2004). Keeping patients safe: Transforming the work environment of nurses. New York, NY: National Academies Press.
Wachter R. “In Conversation with David Marx, JD.” AHRQ Web M&M: Perspectives on Safety. Retrieved on 28 September 2012 from < http://www.webmm.ahrq.gov/perspective.aspx?perspectiveID=49.>
Youngberg, B & Hatlie, M. (2004). The patient safety handbook. New York, NY: Jones & Bartlett Learning.
