geriatric inter-professional team dynamics. geriatric leadership
TRANSCRIPT
INTER-PROFESSIONALITY
Process that professionals
develop ways of practicingOrganized to solve, explore a
variety of issues
Optimize client participation
Inter-professional practice
unique characteristics:
codes of conduct, values
ways of working
D’Amour, D. and Oandasan, I. (2005).
Nurse
Nurse Practitioner
Physician
Geriatrician
Physician Assistant
Social Worker
Psychologist
Psychiatrist
Pharmacist
Occupational Therapist
Physical Therapist
Speech Therapist
Chaplain
Dietitian
INTER-PROFESSIONAL GERIATRIC TEAM
INTER-PROFESSIONAL COLLABORATION In the field of healthcare
effective collaboration and
interaction can have direct
ramifications for patient care
Poor teamwork skills in
healthcare have been found to be
a contributing cause of negative
incidents in patient care
A. It increases readmission rates to hospital.
B. It is physician-centered care.
C. It increases the cost of healthcare.
D. It improves the health of populations.
Which statement about inter-professional
collaboration is true?
D. It improves the health of populations.
Forming• Members are positive and polite, excitement• Discussions about how the team will work• Anticipation and optimism • Pride in being chosen for the project • Suspicion and anxiety about the job • Tentative attachment to the team
• Leadership Style: DIRECTING
Storming• Stage when many teams fail• Try to focus on the job without support of
established processes • Defensiveness, competitiveness, disunity, and
increased tension or jealousy • Sharp fluctuations in attitude about the team and
the team’s chance of success • Questioning decisions and decision-makers
• Leadership Style: COACHING
Norming• Hierarchy established• Team members know each other better, may be
socializing, ask each other for help and provide constructive criticism
• Friendliness and trust towards other team members, confidence in the team goals, team cohesion and spirit, pride and sense of belonging to the team
• Leadership Style: PARTICIPATING
Performing• Hard work leads directly to progress towards
shared vision of goal• Being part of the team at this stage feels "easy"• Constructive self-change, sense of belonging• Understanding of each others strengths and
weaknesses• Self-organization of work
• Leadership Style: DELEGATING
Adjourning
• Termination of roles• Completion of tasks • Reduction of dependency • Process can be stressful • Perspective of the functioning group - this
fifth 'stage' takes us beyond that
5.
Inattention
to Results
4. Avoidance of
Accountability
3. Lack of Commitment
2. Fear of Conflict
1. Absence of Trust
Lencioni, P. (2002).
ABSENCE OF TRUST
Trust is the foundation
The absence of trust stems from team members’
unwillingness to be vulnerable in the group
For a high performing team to operate members
share successes and failures
share strengths and weaknesses
Lencioni, P. (2002).
About disclosure and not about confession
Overcoming the absence of trust requires:
Team members sharing experiences over time
Multiple instances of follow-through
In-depth understanding of unique attributes of
each team member
In building trust leader is most important
The leader must first demonstrate vulnerability
ABSENCE OF TRUST
Lencioni, P. (2002).
Team members must constructively
engage in conflict
Express themselves, know that they
have been heard, respected for their
thoughts and beliefs
Heart of how buy-in happens, when
skillfully handled conflict leads to
powerful commitments
The role of the leader: to surface
issues, perspectives, and opinions
FEAR OF CONFLICT
Lencioni, P. (2002).
Commitment is a function of two things:
CLARITY = removal of assumptions and ambiguity
BUY-IN = achievement of honest emotional support
Great teams make clear and timely decisions
Leave meetings confident no one harboring doubts
Achieve commitment engaging constructive conflict
Focus on problems not on personalized agendas
LACK OF COMMITMENT
Lencioni, P. (2002).
Dealing with objective issues precedence over ego conflict
Members express thoughts, beliefs creating buy-in & clarity
Once there is alignment and buy-in leadership teams drive clarity
Facilitated by the process of cascading communication:
taking key decisions and action items, ensuring a roll out that includes “why they are important”
LACK OF COMMITMENT
P. Lencioni, P. (2002).
Accountability
Leader holding their direct reports accountable
Peers holding each other accountable
Reminding each other
Commitments
Real or perceived breaches of performance
Behavioral agreements
AVOIDANCE OF ACCOUNTABILITY
P. Lencioni, P. (2002).
Leaders need to model accountability in a different way
Many shy away from dealing with inappropriate
behavioral problems
When leaders confront inappropriate behaviors they are
role-modeling accountability *sets the stage for peer-to-
peer engagement
AVOIDANCE OF ACCOUNTABILITY
P. Lencioni, P. (2002).
Two things get in the way of achieving results:
Self-interest
Self-preservation
Team members who put their individual needs or the
needs of their department above the collective goals
make it difficult to achieve better overall results
Overall team performance should come first
Need connection between self-interest & getting results
INATTENTION TO RESULTS
P. Lencioni, P. (2002).
The distractions from collective results are:
1. Personal ego
2. Career development
3. Compensation
4. “My department”
INATTENTION TO RESULTS
P. Lencioni, P. (2002).
The role of the leader sets
tone for the focus on results
If team members sense that
the leader values anything
other than results, they will
take that as permission to do
the same for themselves
INATTENTION TO RESULTS
Lencioni, P. (2002).
There are five common pitfalls make up team dysfunction
Interrelate and build off one another
Either significantly hamper the success of a team or
paradoxically become foundation for crystallizing to
achieve great results
INTER-PROFESSIONAL TEAM DYSFUNCTION
Testing and Developing
Understanding one’s professional identity
Likely role within a team
Ideas about related health professionals
INTER-PROFESSIONAL TEAM CHALLENGES
Invalid assumptions:
May lead to breakdown in
communication + teamwork
May constitute barrier to effective
care
Research suggests:
Students rate communication +
teamwork skills positively
Were favorable about inter-
professional learning
INTER-PROFESSIONAL TEAM CHALLENGES
SUMMARY
When teams build trust and engage in
constructive conflict then there is the
potential for building commitment and
accountability
Then the team can focus on meeting
and exceeding the goals and mission
Lencioni, P. (2002).
REFERENCES
P. Lencioni, The Five Dysfunctions of a Team- A
Leadership Fable (Jossey Bass, San Francisco, 2002).
D’Amour D & Oandasan I. (2005). Interprofessionality as
the field of interprofessional practice and
interprofessional education: An emerging concept.
Journal of Interprofessional Care. 19 (Supplement 1):8-
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http://www.youtube.com/watch?v=IqpT95TKum
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