Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y1© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Workshop 02 Our Teamwork Effectiveness

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y2© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Goals 〉To reflect on Workshop #1 goals for team care 〉To consider how teamwork principles support strengths in functioning of the team 〉To consider how the team’s communication structures enhance communication amongst team members 〉To review what works well in leading the team 〉To review what works well in managing team meetings 〉To review what helps to address conflicts in the team

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y3© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Workshop Agenda [ ]Review goals, principles for working together, strengths, enhancements, areas not being used as effectively as they could be (reached in Workshop #1) [ ]Communicating with each other – what is and what could be [ ] Leading in the team [ ] Making the most out of our team meetings [ ] Finding a win-win during disagreements [ ] Reflection/summary/orientation to next session

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y4© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Goals 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y5© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Principles for Teamwork 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y6© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Strengths 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y7© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Relationship Enhancers 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y8© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Interpersonal Communication “… is a continuous transactional process involving participants who occupy different but overlapping environments and create relationships through the exchange of messages, many of which are affected by external, physiological and psychological noise.” * *Adler, Rolls, Proctor III & Towne, Looking Out/Looking In, 2009, p. 11

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y9© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Effective Team Communication “… successful communication always involves shared understanding.” * *Adler et al, 2009, p. 15

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y10© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Effective Communication Communication has two dimensions: (1) Content What is to be discussed (2) Relational..... How we feel about each other Affinity: sense of connection to another Immediacy: interest and attention to what is being said Respect: amount of respect shared between parties Control: degree of control exercised over the other

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y11© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Interprofessional Communication Competency Statement Learners/practitioners from different professions communicate with each other in a collaborative, responsive and responsible manner.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y12© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Explanation/Rationale 〉 Communication skills are essential 〉 Involve ability to communicate effectively with others – Professions – Patients/clients/families 〉 Communication should be collaborative, responsive and responsible

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y13© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Interprofessional Communication Competency* means that: … practitioners from different professions communicate with each other in a collaborative, responsive and responsible manner and should: 〉 Establish team work communication principles 〉 Actively listen to other team members including patients/clients/families 〉 Communicate to ensure common understanding of care decisions 〉 Develop trusting relationships with patients/clients/families and other team members 〉 Effectively use information and communication technology to improve interprofessional patient/client/community-centred care * Canadian Interprofessional Healthcare Collaborative, National Interprofessional Collaborative Competency Framework, Vancouver, B.C., CIHC, 2010, p. 16.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y14© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Guidelines for Communicating with Each Other 〉 Jot down on post-it notes how team members should communicate with each other: e.g. means (how to) content (what to) timing (when to) 〉 Place these on the flip charts and review, eliminate duplications

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y15© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Communication Means 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y16© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Communication Content 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y17© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Communication Timing 〉 (to be completed)

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y18© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Functioning at Meetings Effective meetings have a number of key features: 〉 Their frequency and duration 〉 There is group input into the agenda 〉 Required attendance is established 〉 Who chairs team meetings is established 〉 Who takes notes and who summarizes what has been agreed upon 〉 Who keeps meetings on agenda items 〉 Who follows up on items agreed upon

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y19© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Set ‘RULES’ for Organizing and Running Team Meetings 〉 Working in small groups, review the checklist questions in Worksheet #6 〉 Consider each question and how your group wishes each aspect of a team meeting to be managed 〉 Discuss and come to a consensus and complete a clear Worksheet #10 for your final choices of the group 〉 Share choices with all participants

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y20© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Functioning Competency Competency means: Practitioners understand the principles of team work dynamics and group/team processes to enable effective interprofessional collaboration.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y21© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Team Functioning Descriptors 〉Understand the process of team development 〉Develop a set of principles for working together; respects the ethical values of members 〉Effectively facilitate discussions/interactions among team members 〉Participate and be respectful of all members’ participation in collaborative decision-making 〉Reflect, at regular intervals, their functioning with team practitioners and patients/clients/families 〉Establish and Maintain effective and healthy working relationships with practitioners, patients/clients and families 〉Respect team ethics, including confidentiality, resource allocation and professionalism

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y22© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Leadership in the Team How is leadership determined? 〉 One designated person 〉 Rotational person 〉 Depends on the needs of the patient AND How will the team continue to decide on who is the leader?

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y23© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Collaborative Leadership * Linden, R., The Discipline of Collaboration. Leader to Leader (Summer), 2003, p. 42. “… the art of pulling people together from different [perspectives] … to accomplish a task that none of them could accomplish – at all or as well – individually.”*

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y24© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration How Will Your Team Support Collaborative Leadership? 〉Discuss the use of collaborative leadership in your team 〉Compare this concept to how leadership is currently handled 〉Consider if the team wishes changes to the current state 〉Be prepared to share your discussion with the total group

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y25© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Collaborative Leadership 〉 Using collaborative leadership, a team can “invent new ways to attack a problem and collectively make sense together from what once was …”* not known *Raelin, J., Does Action Learning Promote Collaborative Leadership? Academy of Management Learning & Education,, 2006,, 5(2), p,

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y26© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration “Modeling The Way” * In IPE this means: 〉 Knowing your personal values and how these may enhance or interfere in working with others 〉 Helping the team to stay focused on patient care *Kouzes, J.M., & Posner, B.Z., The Janusian Leader, Management 21C, Englewood Cliffs, Prentice Hall, 2000.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y27© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration “Inspire A Shared Vision” * In IPE this means… 〉 Focusing on patient-specified goals and helping the team to consider how to get there 〉 Helping team members to bring their ideas together in an agreed upon plan with the patient *Kouzes & Posner, 2000.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y28© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration “Challenge The Process” * In IPE this means encouraging… 〉 On-going reflection on how the team is working together with the patient and, based on feedback, making needed changes 〉 Members thinking about their professional roles within an interprofessional patient-centred context * Kouzes & Posner, 2000.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y29© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration “Enable Others To Act” * In IPE this means the collaborative leader… 〉 Helps to guide the team in promoting respect for all members and in arriving at shared goals with patients and team members 〉 Encourages other team members to take on the leadership role and supports patients in their decision making with the team *Kouzes & Posner, 2000.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y30© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration “Encourage The Heart”* In IPE this means… 〉 The collaborative leader recognizes the positive work of all team members, including the patient, towards meeting patient-set goals for care 〉 The team, with the patient, celebrate achievement of steps towards patient-set goals of care *Kouzes & Posner, 2000.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y31© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Small Group Work: Collaborative Leadership Using worksheet #7 consider what strengths are already present in the team to support each of the leadership elements; enter these into column 1. Consider what enhancements to teamwork are still needed; enter these into column 2 Be prepare to share your work with all the other participants

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y32© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Collaborative Leadership Competency Statement: Practitioners work together with all participants, including patients/clients/families, to formulate, implement and evaluate care/services to enhance health outcomes.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y33© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Collaborative Leadership Competency Means … Practitioners collaboratively : 〉 Work with others to enable effective patient/client outcomes 〉 Advance interdependent working relationships among all participants 〉 Facilitate effective team processes and decision-making 〉 Establish a climate for collaborative practice among all participants 〉 Co-create a climate for shared leadership and collaborative practice 〉 Apply collaborative decision-making principles 〉 Integrate principles of continuous quality improvement to work processes and outcomes

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y34© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Dealing with Conflicts Conflicts arise from many sources: 〉Role conflicts 〉Goal conflicts 〉Treatment conflicts 〉Interpersonal conflicts 〉Professional conflicts

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y35© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Characteristics of Disagreements* 〉Expressed struggle 〉Perceived incompatible goal 〉Perceived scarce rewards 〉Interdependence 〉Interference from the other party *Adler, Rolls, Proctor III & Towne, Looking Out/ Looking In, 2009, p. 340

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y36© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration We all act in certain ways when our needs are not being met: 〉 Nonassertive “people who avoid conflicts usually believe it’s easier to put up with the status quo than face the problem head-on” * – Avoidance (distracting from) – Accommodation (giving in) *Adler, et al, 2009, p Personal Conflict Styles

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y37© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Personal Conflict Styles cont. 〉 Direct Aggression – Character attacks – Competence attacks – Physical appearance attacks – Wishing the other ill fortune (teasing, ridicule, threats, swearing, etc.) 〉 Passive Aggression “suppressed feelings of resentment, anger or rage they’re unable or unwilling to express directly”* *Adler, et al, 2009, p. 344.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y38© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration 〉Indirect Communication “conveying a message in a roundabout manner in order to save face for the recipient” * 〉Assertion “message expresses the speaker’s needs, thoughts, and feelings clearly and directly without judging or dictating to others”** *Adler, et al, 2009, p **Adler, et al, 2009, p Personal Conflict Styles cont.

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y39© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Choice of Conflict Style Depends on… 〉 Relationship within the team (power dynamics) 〉 Situation which team is addressing 〉 Other people on team (how receivers respond) 〉 Individual goals vs team goals

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y40© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Getting to Win-Win Consider… 〉 Deferring to the other person 〉 Compromising 〉 Competing 〉 Cooperating

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y41© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Competency Statement: Learners/practitioners actively engage self and others, including the patient/ client/family, in dealing effectively with interprofessional conflict. Interprofessional Conflict Resolution

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y42© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Interprofessional Conflict Resolution cont. Practitioners actively engage in positively and constructively addressing disagreements as they arise including: 〉 Valuing the potential positive nature of conflict 〉 Recognizing the potential for conflict to occur and taking constructive steps to address it 〉 Identifying common situations that are likely to lead to disagreements or conflicts 〉 Knowing and understanding strategies to deal with conflict 〉 Setting guidelines for addressing disagreements 〉 Effectively working to address and resolve disagreements, including causes, and working to acceptable solutions 〉 Establishing a safe environment in which to express diverse opinions 〉 Developing a level of consensus among those with differing views

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y43© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Resolution of Conflicts 〉 Win-win conflict resolution is the goal 〉 Getting to a solution that all can live with 〉 NOT A COMPROMISE but a collaborative decision

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y44© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration How Can Teams Agree to Handle Conflicts? 〉 Create openness to hear each other’s views 〉 Consider all views within your own perspective 〉 Consider biases that might exist in your viewpoint 〉 Consider justification for your biases and how you can come to terms with other views 〉 Weigh the alteration in your view, based on other views in the context of your patient’s safety 〉 Share your thinking with the others 〉 Hear each other’s viewpoints 〉 Come to a shared agreement

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y45© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration 〉You are a member of the Stroke Team in the regional hospital. 〉You receive an from the local hospital 20km away, they are sending a patient who had a stroke two days ago and you reply asking what care has been provided thus far. 〉You find out that only stabilization of their blood pressure and basic assessment of swallowing, walking and speaking has occurred. Case Scenario:

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y46© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration 〉 Using the Conflict Resolution Process, work in your group to determine how to handle this situation. Have one of the members of the group play the role of the referring health provider and the remaining participants as the Stroke Team. 〉 Be prepared to share with the total group, how you work through this conflicting situation to come to a resolution. Small Group Work

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y47© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Reflection 〉 What works well in our team? 〉 What do you feel still needs attention to make your team more collaborative? 〉 How well do we manage our team meetings? 〉 Is the leadership of our team supportive of collaborative work? 〉 How well do we move to win-win resolutions when disagreements occur in the team?

Workshop 02 – Our Teamwork Effectiveness ver 16D12M14Y48© TEAM C – Toolkit to Enhance and Assist Maximizing Team Collaboration Next Workshop: Ideal Collaborative Team Functioning Workshop #3 will 〉 Reflect on Workshop #2 and the strengths the team already enjoys 〉 Help set how your ‘dream team’ might function and exploring explore what changes are needed to move to this dream 〉 Discuss how to be guided by a patient and/or family member in shaping how the team’s dream can reflect true patient and family member inclusion as full team members 〉 Create the final dream for the best practices in interprofessional patient-centred collaborative team functioning by all members Ahead of the next workshop: 〉 Review work completed in Workshops #1 & #2 Workshop #3: Ideal Collaborative Team FunctioningNext workshop is (date)