building effective work groups
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A team is any group that works togethertoward a common goal.
Reaching the goal requires teamworkand a clear, shared vision of the future.
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Team building isnt just magic, its justplain hard work.
Challenge and Motivation
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1. Mission
The team must know the organization
mission and then establish goals thatcontribute to that mission. And the teammust be clear about its own mission.
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2. Assessment
The team must identify the criteria that
ensure their effectiveness and assesshow well they fulfill each of the criteria.
Identifying strengths and weaknesses.
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3. Goal Setting
Team members must identify ways to
improve team effectiveness, workingtogether to develop common goals,learning the benefits of cooperation.
4. Communication
The team must learn to communicate
about ideas, problems, opportunitiesand concerns both within the groupand up and down the organization.
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5. Leadership
Good teams need good leaders. And
learning to share leadership can maketheteam even more effective.
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Predetermining a carefully detailedcourse of action that will enable theorganization, unit, or individual to
achieve specific objectives or goals. Requires ability to think, to analyze data,
to envision alternatives and to makedecisions.
A decision making process.
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Organizing the work of nursing carewithin each shift, between shifts, and
between nurses and other healthprofessionals throughout the health caredeliver system.
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A complementary function of direction.
Effective delegation implies that a nurse
shares a segment of correspondingauthority, and demands accountability.
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Is an inherent part of all organizations,units and work groups.
Within a health care organization,conflict may result from divergence ofopinion, incompatibility, transmission oferroneous information, or competition forscarce resources.
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Nurses are employed in diverse settings:hospitals, community agencies, long
term care, private practice, physicianoffices, faith communities andambulatory clinics, which have animpact on the design of work groups.
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In the hospital setting, it is assumed thatthe majority of all care must be
performed by the employees.
Anne Rowe
She developed a workshop for self
management of multidisciplinary primaryhealth care teams.
The theory and research on teamwork
and adult learning principles andfocuses on values, trust building and theequality of all to encourage interactionand risk taking.
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Organization of the hospital and its largersystem
Cost of health services Nurse Characteristics
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Bureaucratic structure shifted to alearning organization structure
characterized by an integratedapproach to organizationaleffectiveness, systems orientation,horizontal communications and
professional growth and empowerment.
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This trend has led to the fact that healthprofessionals must be prepared topractice in settings that are more
intensively managed and integrated.
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The cost of hospital services isincreasingly emphasized.
Singleton and Nail explained hospitalstructure, organization, and relationshipsfrom a financial perspective.
Doctor (responsible)nurse(implementing)-payers (governmentagencies)
Patient (consumers)
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Therefore, the quantity and quality of theservices provided to patients isinfluenced and monitored by anotherbody outside the hospital environment.
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1. Nurses sphere authority has notchanged since World War II.
2. Physicians work fewer hours and areavailable less for consultation in thehospital.
3.Nurses are have not been recognizedfor their new level of clinical decisionmaking.
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4. The role of the nurse to synthesize andmonitor multiple diagnostic and
treatment regimens has not beenrecognized.
5. Nurses are the coordinators of all thesupport service involved with the care
and safety of a patient, yet they haveno authority to deploy or redirect theseservices to carry out responsibilities.
6. Nurses, mostly women who are nowlooking at many professional careeroptions, do not find working conditionsin hospitals professionally satisfying.
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Magnet Hospitals
Hospitals that were judged to have
outstanding records of nurse recruitmentand retention.
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A visible, accessible, and participatoryadministration.
Knowledgeable and strong leaders whosupport their work and care about theirworking conditions.
A collaborative organizational structure
with mutual goal setting Staffing patterns that recognize the
need for adequate quantity, quality,and mix of expertise of staff.
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Personnel programs and policies withflexible work schedules, competitivesalaries, and benefits.
Active recruitment and retentionprograms,
Professional practice support nurseautonomy, constructive feedback onthe quality of care, and knowledgeable
nursing consultants available.
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The Secretarys Commission on NursingReport contained 8 of 16
recommendations addressingreorganization of the work place.
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Health care delivery should preservenurses time for direct patient care byproviding adequate staffing levels for
clinical and non-clinical support services. Innovative staffing patterns should use
nurses different levels of education,
competence, and experience. Automated information systems and
other new laborsaving technologiesshould be developed.
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Methods for costing, budgeting andtracking nursing resource use should be
developed.
Involvement of nurses at all policy anddecision making levels must occur
The decision making level of the nurse incooperation with medicine should berecognized.
Positive and accurate images of nurseswork should be promoted.
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The effects of nurse compensation,staffing patterns, decision making
authority and career development onnurse supply and demand and healthcare cost and quality should beresearched.
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Is used as an indicator of the hospitalsand units status.
(Alexander) voluntary turnover rate of1,726 RN and licensed vocational nurseson 146 units within 17 hospitals.
Correlated into 4 varialbles.
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Staff integration
Centralization
Communication/coordination Evaluation
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Defined as the ratio of RNs assigned tothe unit to total patient care staff
assigned to unit, extent of RN rotationand among shifts, and ratio of full-timestaff to all staff.
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Defined as RN influence in unit relateddecisions and decision-making authority
of the head nurse.
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Defined as the frequency of contactand communication among nurses
during the shift, frequency of patientcare conferences, explicitness of unitpolicies and procedures.
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Defined as perceive accuracy of headnurse performance evaluation and the
number of patients care hoursperformed by head nurse per week.
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Yocom
He conducted a test on 4,500 newly
licensed nurses who responded toquestions about nursing activities andclient needs.
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Nurses in medical/surgical clinical unitscored high in performing routine nursing
measures, monitoring clients at risk,preparing clients for procedures, andcontrolling pain.
low: emotional/behavioral needs, staff
development, management, andcollaboration and quality assurance andsafety.
Very low: parenting skills associated withteaching mothers and fathers how tocare for new infant and immunizations.
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The hay group conducted over 850hospitals about nurses working on
medical-surgical units. They found : 26% of RNs time = Professional Nursing
22% = Support Functions
52% = Housekeeping
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The investigators reported the reasonthese nurses stayed or left an institutionwas based on reasons directly andindirectly related to environment, job,perceived opportunity for personal and
professional growth.
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Has been described using words such asknowing, caring, intuitive, the
essence of nursing, or hidden work. The knowledgeable nurse and
technically competent nursedistinguishes between what is nice and
what is necessary for the clients careand not only cares about the assignedclients but also cares for them.
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Platt says a team requires:
A group of 2 or more
A shared sense of purpose among thegroup members
Interactions among the members that
make them able to accomplish workingindividually toward the shared purpose.
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Team building is an essential leadershipcompetency and according to
Schaffner and Berningham it is amethod of participative managementthat encourages staff commitment tothe unit and the organization.
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The team or work group culture is animportant ingredient when facilitating a
team building. A group that knows what it stands for
and where it wants to go is in a betterposition to move forward than a groupthat lacks an identity and is aimless.
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Competing Values Model by Quinn
This model appeared meaningful in
understanding the complex andcompeting dynamics on a hospital.
Quinn was concerned about howexperts think about effectiveorganizations and tried to understandunderlying assumptions causing thebehavior.
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Vertical axisflexibility to control
Horizontal axisinternal to external focus
Human relationsinternal focus withcriteria as cohesion and morale, andvalues human resources training.
Rational goalvalues output,productivity and efficiency withplanning and goal setting.
Open systemprovides an externalorientation, values expansion andadaptation, readiness, growth,competition and resource acquisition.
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Internal orientationis the internalprocess model that values continuity
and consolidation with stability andcontrol, information management, andcommunication.
The model can be used to diagnoseand intervene in actual organizations.
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The END
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