Lecture 1 - Work Team Characteristics

Question 1

What has been the paradigm shift regarding teamwork and patient outcome?

Answer 1

Moving away from the idea that outcomes are the result of individual efforts

Question 2

Why has the acceptance of team-based healthcare been slow: (3)

Answer 2

1. In training clinicians are given the idea that they are individually responsible for what happens
2. Members of the healthcare system are isolated alone.
3. Interpersonal training is uncommon

Question 3

Describe:

To Err is Human

Answer 3

It was as Institute of Medicine Report that brought a focus group onto patient safety and look at the effectiveness of team-based healthcare

Question 4

What does the term “team” mean in healthcare?

Answer 4

Refers to groups of people that can provide team-based healthcare and can make decisions in healthcare organizations

Question 5

Work group vs. Work Team

Answer 5

Work group - is much more vague and is defined as a collection of individuals who work together in some way.

Work team - Teams that provide team-based healthcare ad can make decisions in a healthcare organization

(In a bubble work teams is within work group)

Question 6

Defining characteristics of work team

Answer 6

• Shared team goal
• Shared responsibility for achieving said goal
• Defined membership
• Authority for taking action to achieve the goal
• Interdependency of team members
• Absence of larger sub-groups
• Accountability to a larger organization

Question 7

Explain:
Work Team
Shared Team Goal

Answer 7

• Not pursuing individual goals while working in same vicinity
• Working together for the same outcomes
• Each individual task is focused towards the same overarching goal

Question 8

Explain:
Work Team
Shared responsibilty for achieving the goal

Answer 8

• Success and failures are shared
• Each individual has a responsibiltity and can contribute
• Sum of moving parts

Question 9

Explain:
Work Team
Defined Membership

Answer 9

• Clearly established and understood who the team members are

– Composition may change overtime, but at any given time it is clear who the members are

– Family Medicine Example: There are 11 people responsible for patient care and interacting with families
• These members make the healthcare decisions

Question 10

Explain:
Work Team
Authority for taking action to achieve the goal

Answer 10

– Team members do not have to seek approval to take action

– Since the team is responsible for achieving its goals, it has the authority to take independent action, but is responsible for the ramifications of those actions

Question 11

Explain:
Work Team
Interdependency of members

Answer 11

– Depend on each other to carry out different tasks
• Usually specialized tasks within the realm of healthcare

– Red Family Med: doctors can only do their work if medical assistants
(MA) take vitals

– Interdependency is a result of specialization as members are not interchangeable

Question 12

Explain:
Work Team
Absence of Independent Sub-Groups

Answer 12

– Work teams do not have sub-groups operating separately nor an
internal structure
• Work teams will sometimes have sub-groups that form within the same membership to make certain decisions, but they are not autonomous in this as it effects the entire group

Question 13

Explain:
Work Team
Accountability to the Larger Organizationl

Answer 13

– By definition work teams are a subset of work groups that are a part
of a larger organization
– In the Red family med example, the work teams on any given day are ultimately accountable to the practice owner, Dr. Kimpbell

Question 14

Risk of Teams

Answer 14

• Social loafing
• Degrading of decision making (hierarchy or personality)
• Diminished creativity if the team is not managed well

Question 15

Benefits of Teams

Answer 15

• Perform task faster
• Enable individuals and organizations to learn
• Enable organizations to retain lessons learned despite turnover of individuals
• Enable innovation

Question 16

Explain:
Benefits of Teams
Perform task faster

Answer 16

– Minimizing bureaucracy
– Rapid interaction saves time and money

(Ex: positive depression screening could see a psychologist in the same day because the proximity of teams)

Question 17

Explain:
Benefits of Teams
Enable individuals and organizations to learn

Answer 17

• Teams enable individuals and organizations to learn

In the Bay example, the different providers in different specialties learn from each other

Question 18

Explain:
Benefits of Teams:
Enable organizations to retain lessons learned despite turnover of individuals

Answer 18

Organizations able to retain lessons learned despite turn-over of individuals

• Practices become codified within the operation of the organization
• When members move away or retire they lessons they learned remain because the team itself is a repository of knowledge

Question 19

Explain:
Benefits of Teams:
Enable Innovation

Answer 19

– With time, efficiency and accuracy is built
– The team becomes better equipped to function

(With respect to the Bay Medical example, innovations were made to schedule more slack time for the psychologists so that the other providers would have time to drop in for consults and assistance)

Question 20

Explain:
Risk of Teams:
Social loafing

Answer 20

– Teams often have more than one member who can perform a certain task, so it can be tempting for some members to simply allow other members to do the work
– This can stifle motivation
– Risk is higher with larger teams

Question 21

Explain:
Risk of Teams:
Degradation of decision making and action by individuals

Answer 21

– Domination by strong personalities and development of internal hierarchy can cause others to not voice their opinions/ideas in order to do what is expected of them by those they perceive to have power

(Think about the OR, people are highly unlikely to disagree with the physician they perceive to be the head of the surgical team)

Question 22

Explain:
Risk of Teams:
Possible diminished creativity

Answer 22

– Offering novel ideas in a group setting runs a risk of ridicule because
the new idea is unfamiliar and can seem implausible

– Production Blocking: a phenomenon that refers to the diminished capacity for higher level thought when multi-tasking
(Ex: The production of new ideas gets blocked due to attention that is required to other matters)

Question 23

Evidence for the Effectiveness of Teams (3)

Answer 23

1. Enhanced Clinical Expertise
2. Improved coordination of care
3. Enhanced Expertise and Coordination

Question 24

Define:

Red Family Med

Answer 24

Doctors can only do their work if medical assistants (MA) take vitals