1. Teamwork, Collaboration and Networking Education and Practice Workshop Suzanne Gordon Co-Editor The Culture and Politics of Health Care Work Series Cornell University Press Author, Beyond the Checklist Rebecca Shunk, MD Co-Director

2. Is this a Team/IPE? What Is a Team?

3. A Team is NOT – An assortment of people assigned to a particular unit, task, or patient(s) at the same time or during the same shift (e.g., “the Care Team,” “the Transport Team”)

4. A Team IS – A trained aggregate of persons with specific individual and interactive roles, a distributed set of skills, and with shared and explicit Purpose(s) Goals Information Plans / protocols Feedback / correction mechanisms

5. Structure Primary care training in a team-based, PCMH model Practice partnership model Each trainee has his/her own panel and cross-covers partners’ patients Interprofessional trainees support multiple trainee teamlets Teamlet Dietetics Social Work Psychiatry Pharmacy NP student Medicine R2 Psychology Health Professions Trainees

6. Curricular Content: Interprofessional Collaboration Interactive small group seminars: Handoff communication Debriefing Huddling Feedback Conflict Resolution Daylong retreat: Team building Practice key communication skills Workplace reinforcement: 1) Preceptors reinforce skills and provide feedback during teamlet huddles 2) Teams engage in formative assessment processes Interactive small group seminars: Handoff communication Debriefing Huddling Feedback Conflict Resolution Daylong retreat: Team building Practice key communication skills Workplace reinforcement: 1) Preceptors reinforce skills and provide feedback during teamlet huddles 2) Teams engage in formative assessment processes Didactics Interactive small group seminars: Huddling Team Members Roles Handoff communication Feedback Conflict Resolution Debriefing Workplace reinforcement: Huddling Huddle Coaches Preceptors reinforce skills and provide feedback during huddles Teams engage in formative assessment processes Reflection Half-day retreat: Team building Opportunities to reflect Identifying similarities and differences

7. PACT Team-based patient-centered model of care 1200 patients per team Teamlet- Primary Care Provider, Registered Nurse, Licensed Vocational Nurse and Clerical Associate Practice Changes Population Management Panel Management Pre-visit planning Huddles Shared Medical Appointments/Group Clinics Walk-in appointments Telephone appointments Secure Messaging Health Coaching

8. Huddle

9. Rate Your Team

10. Hackman on Teams “The team must be a real team, rather than a team in name only; it has a compelling direction for its work; it has an enabling structure that facilitates teamwork; it operates within a supportive organizational context; and it has expert teamwork coaching.” Simply accomplishing a particular task or set of tasks – performing an activity or activities – is not enough, Hackman cautions, to qualify as a successful team. To be effective, a team or workgroup must satisfy three other requirements:

11. Hackman on Teams (cont) It must produce an output that “meets the standards of quantity, quality, and timeliness of the people who receive, review, and/or use that output.” The process through which that output is produced must enhance “the capability of members to work together interdependently in the future.” The process through which the team or group works must contribute “to the growth and personal well-being of team members.

12. Rate Your Team Again

13. Team Intelligence “Team Intelligence is the active capacity of individual members of a Team to learn, teach, communicate, reason, and think together, irrespective of position in any hierarchy, in the service of realizing shared goals and a shared mission.”

16. Reframing Teamwork “We do not typically think of an effective team as being a group of people who really know how to help each other, yet that is precisely what good teamwork is – successful reciprocal help.” Edgar Schein, Helping

17. Arm Exercise

18. Clarifying Assumptions

19. What Is Psychological Safety In a psychologically safe environment people believe that if they make a mistake others will not penalize them or think less of them for it. They also believe that others will not resent or penalize them for asking for help, information, or feedback. Edmondson, Amy. “Managing the Risk of Learning: Psychological Safety in Work Teams.

20. Envision a Highly Functioning Team Cohesion Role Clarity Goals and Means Clarity Communication

21. Goffman’s Dramaturgy Frontstage Space Backstage Space Private Space

22. The Challenge Move from sometimes false assent in frontstage spaces to Behavioral change in backstage and private spaces by drilling down, analyzing, creating awareness and…

23. Changing the Dynamics of Cool

24. Discuss “Co” Stories

25. Infiltrating private spaces Three private space stories

26. Worksheet on Your Dilemmas Discuss successes or dilemmas in teamwork in the current environment in which you are working.

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