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COMFORT* Communication (narrative) Orientation and opportunity Mindful presence Family Openings Relating Team * Wittenberg-Lyles, E., Goldsmith, J., Ferrell, B., & Ragan, S. (2012). Communication and palliative nursing. New York: Oxford.
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Objectives Describe the main principles of interdisciplinary team collaboration Recognize team meetings as a place to collaborate and resolve conflict Identify a communication skill to practice with interdisciplinary team members Identify a communication skill to practice to ensure effective team meetings
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Interdisciplinary Collaboration Sharing resources Shared power Respect credibility/expertise Focus on task and relational communication
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Model of Interdisciplinary Collaboration Interdependence & flexibility – Characterized by interaction in order to: Accomplish Goals and Share information Maintain flexibility for each new case –Psychospiritual care (Grey, 1996) : – meets psychosocial, spiritual, and coping needs of patients/families laboring with terminal illness Grey, R. (1996). The psychospiritual care matrix: a new paradigm for hospice care giving. Am J Hosp Palliat Care, 13(4), 19-25.
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Model of Interdisciplinary Collaboration Newly created tasks & responsibilities – Emerge through information sharing – Collaborate to maximize members’ expertise – Work collaboratively to serve patient & family – Accessibility allows frequency/ease of contact
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7 Model of Interdisciplinary Collaboration Collective ownership of goals – Share responsibility to produce holistic care – Team joined by experience – Patient/family viewed as important part of team – Shared common purpose
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8 Model of Interdisciplinary Collaboration Reflection on process – Awareness of collaborative processes – Collectively review team processes – Evaluate own process *Least ranked aspect of collaboration
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9 Team Meetings Enables communication to produce plan of care for each patient Allows elements of interdisciplinary collaboration to emerge Collaborative process involves conflict
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Groupthink Cohesive group members Emphasize unanimity Focus on group cohesion/relations over decision-making Leads to poor decision-making and lack of collaboration Obstructs effective group discussion and conflict resolution
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11 When Groupthink Occurs Embrace least effective decisions Suppressed disagreements Perceive conflict as more work Unable to consider: – All aspects of information – Alternative solutions – Fail to understand risk of failure
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12 Aspects that influence groupthink Relational Factors Self-Censorship Organizational influences Structural constraints
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Ways to combat Groupthink Discussions should start by stating the patient’s goal of care Designate a team member to play devil’s advocate Rotate leadership of team meeting Adapted from: Wynne Whyman (2005). A question of leadership: What can leaders do to avoid groupthink. Leadership in Action, 25(2), 12.
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Assessing team experiences Do discussions include family, other healthcare professionals involved? Does the team have designated time for sharing frustrations about plans of care (e.g., specific patient/family)? Does the team address patient safety issues?
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