INTERPROFESSIONAL TEAMS IMPROVING PATIENT CARE THROUGH COLLABORATION AND
INTERPROFESSIONAL TEAMS: IMPROVING PATIENT CARE THROUGH COLLABORATION AND Holly Taylor, BSN, RN, CNOR, RN-BC Lauren Taylor, BSN, RN, CPAN, PCCN
SPEAKERS Holly Taylor Perioperative Educator Lauren Taylor Peri. Anesthesia Nurse Manager • Registered Nurse for 14 years • Registered Nurse for 8 years • Double Board Certified • DNP student • LPN prior to becoming a RN • 2016 Arkansas Center for Nursing 40 Under 40 honoree • 2018 Arkansas Great 100 Nurses honoree • 2019 Arkansas Great 100 Nurses honoree • Item Writer for the NCLEX exam • Medical Missions to Honduras
CHI ST. VINCENT INFIRMARY • Faith-based, not-for-profit, acute care hospital in Little Rock, AR • Established in 1888 • Licensed for more than 600 beds • Consistently named by U. S. News and World Report as one of the state’s best hospitals, with high performance in Heart Care, Colorectal Surgery, and Joint Replacement • Current and two-time recipient of the highest recognition in nursing, ANCC Magnet designation.
GET TO KNOW YOUR INTERPROFESSIONAL TEAM
WHO IS THIS GUY? Aristotle, Greek Philosopher • The founder of formal logic. • A scientist, who was a pioneer in biology, botany, chemistry, and zoology. • He extensively studied psychology, philosophy, and ethics.
HOW DOES ARISTOTLE AFFECT MODERN TEAMWORK? 1. “Knowing yourself is the beginning of all wisdom. ” 2. “Pleasure in the job, puts perfection in the work. ” 3. “We are what we repeatedly do. Excellence, then, is not an act, but a habit. ”
PERSONALITY TESTING & SELF-REFLECTION • Myers-Briggs Test o Based upon the work of Carl Jung, psychiatrist and psychoanalyst. o Abbreviated exam here: http: //www. humanmetrics. com/cgi-win/jtypes 2. asp o Extravert vs. Intravert, Intuitive vs. Sensing, Feeling vs. Thinking, Judging vs. Perceiving • Di. SC assessment o Published by Wiley, is a non-judgemental tool used for discussion of people’s behavioral differences. o Abbreviated exam here: https: //discpersonalitytesting. com/free-disc-test/ o Dominant, Influential, Compliant, Steady • The Big Five o Based on the Five Factor Model of Personality by Lewis Goldberg. Validity confirmed by Costa and Mc. Rae, and termed “The Big Five. ” o Abbreviated exam here: http: //www. personal. psu. edu/~j 5 j/IPIP/ o Full Breakdown of the Big Five Factors: https: //backend. fetzer. org/sites/default/files/images/stories/pdf/selfmeasures/Personality-Big. Five. Inventory. pdf o Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness to Experience • Lion-Beaver-Otter-Golden Retriever o Based upon the work of Gary Smalley, a family counselor. o The Smalley Animal Personality Test helps to understand strengths, weakness, and natural inclinations o Take the assessment here: http: //thaoski. com/2013/04/02/5 -minute-personality-test-lion-beaver-otter-golden-retriever/
MYERS-BRIGGS (MBTI): EXTRAVERT VS. INTRAVERT, INTUITIVE VS. SENSING, FEELING VS. THINKING, JUDGING VS. PERCEIVING Holly: ENTJ (The Commander) § § § § § Extrovert, Intuitive, Thinking, Judging Analyst at heart Motto: “find a way or make one” Natural tendency to marshall and direct q Must collaborate and be democratic Likes to plan Salesman Decisive Struggles: Will “Die on the Cross” q Must choose battles that I can actually win One of the rarest MBTI types, at about 1. 8% of the US population. Lauren: ISFJ (The Defender/Protector) § § § Introvert, Sensing, Feeling, Judging Sentinel at heart Motto: “protect and serve” Natural tendency towards loyalty Like to “be needed” by others and produces high-quality work § Family-centered § Struggles: Takes things personally and reluctant to change q Must avoid internalizing criticism and consider change for the better of the team § About 14% of Americans fall into this MBTI type.
DISC ASSESSMENT: Holly: Compliant/Influencer Lauren: Steadiness/Dominant § C’s are accurate, analytical, systematic fact-finders with high standards. Likes organization and rules. Dislikes criticism. q Described as the “anchor of reality. ” q Weaknesses: needs clear boundaries. § S’s are good listeners, team players, predictable, and friendly. Likes loyalty and safety. Dislikes loss of security and sudden changes. q Described as the “reliable team worker. ” q Weaknesses: resists change. § I’s are enthusiastic, optimistic, persuasive, talkative, and emotional. Likes praise, friendly environments, and motivating others. Dislikes rejection. q Described as the “creative problem solver. ” q Weaknesses: overuses gestures § D’s are direct, decisive, have ego strength, and take risks. Likes challenges. Dislikes being taken advantage of. q Described as the “innovative, bottom-line organizer. ” q Weaknesses: perceived as argumentative and attempts too much at once.
THE BIG FIVE: Holly: § Extraversion vs. Introversion – 89 (high) § Highest – Assertiveness § Lowest – Cheerfulness § Agreeableness vs. Antagonism – 11 (Low) § Highest – Sympathy § Lowest – Trust § Conscientiousness vs. Lack of Direction – 48 (average) § Highest – Self-Efficacy & Achievement. Striving § Lowest – Orderliness (I got a 1 ) § Neuroticism vs. Emotional Stability – 34 (average) § Highest – Anger/Frustration § Lowest – Depression § Openness to Experience vs. Closedness – 55 (average) § Highest – Intellect § Lowest – Liberalism Lauren: § Extraversion vs. Introversion – 76 (high) § Highest – Friendliness § Lowest – Excitement-Seeking § Agreeableness vs. Antagonism – 53 (average) § Highest – Altruism § Lowest – Modesty § Conscientiousness vs. Lack of Direction – 53 (average) § Highest – Dutifulness § Lowest – Orderliness § Neuroticism vs. Emotional Stability – 51 (average) § Highest – Immoderation § Lowest – Depression § Openness to Experience vs. Closedness – 29 (low) § Highest – Emotionality § Lowest – Liberalism
LION – BEAVER – OTTER – GOLDEN RETRIEVER : Holly: § Lion – 34 § Leader, goal-oriented, competitive § May be dictatorial or directness may hurt the feelings of others. § Otter – 29 § Social creature, influences and motivates others. § Talks too much § Golden Retriever – 10 § Beaver – 26 § Has high standards, and likes order and respect. § Has unrealistic expectations of self and others, often misses the optimistic side of things. Lauren: § Lion – 20 § Otter – 21 § Golden Retriever – 30 § Deep relationships but usually with only a few close friends. Loyal, accommodating, affirming. § Dislikes big changes § Struggles to hold others accountable and may be indecisive or indifferent. § Beaver – 29 § Has high standards, and likes order and respect. § Has unrealistic expectations of self and others, often misses the optimistic side of things.
FACTS ABOUT COMMUNICATION • Poor communication and communication overload are shown to have a direct correlation with 1. 2. 3. 4. 5. Poor patient outcomes Adverse events Decreased RN job satisfaction Transfer delays Increased length of stay • According to healthcare providers, 1 out of 6 patients are described as “difficult. ” • People who are Caucasian or College-educated report higher levels of satisfaction with physician and nurse communication than other populations.
HOW DOES THE ART OF COMMUNICATION AFFECT THE SCIENCE OF • HEALTHCARE? At any given time, 1 in every 20 patients has an infection related to their hospital care. (CAUTI, CLABSI, SSI) • A CAUTI costs over $1000 per patient • A CLABSI costs over $35, 000 per patient • A SSI costs over $7000 (superficial) and over $25, 000 (deep organ space) • 1 in 7 Medicare beneficiaries is harmed during the course of their care. (infections, falls, wounds, etc. )
INTERPROFESSIONAL TEAMWORK 1. Chemotherapy Administration in the Perioperative/Peri. Anesthesia Setting 2. Malignant Hyperthermia Response and Supply Cart Standardization 3. Colorectal Surgical Site Infection Quality Improvement Team 4. Surgical Consent Documentation 5. Bereavement Program Coordination and Documentation
WHO IS THIS GUY? Mike Krzyzewski, Duke University Men’s Head Basketball Coach • 80% winning percentage over 39 years • Most wins as a college coach in history (over 1000 and counting) • Coached 5 national championship teams • Coached 3 Olympic gold medal winning teams • Duke’s Fuqua School of Business has a Coach K Center on Leadership and Ethics
COACH K ON TEAMWORK: THE “FIST” ANALOGY • The “fist” describes effective teamwork. Each finger represents a member of the team. To make the greatest impact, each member of the team must come together like a fist, to unify the mind and body towards a single goal. If the goals are not aligned, teamwork fails and so does the ability to achieve your objective.
COACH K ON TEAMWORK: FIVE WORD EMPHASIS • Communication – Trust – Care – Collective Responsibility – Pride 1. Effective leaders are effective communicators. 2. Without trust, teams can fall into the trap of one person micromanaging the entire operation, thus disrupting group synergy. 3. Care is the equivalent of giving your best effort and minimizing errors. 4. Every member of a team is accountable for the desired outcome. 5. Develop an environment of encouragement and support, where big and small accomplishments are celebrated.
QUESTI ONS?
RESOURCES Academy of Communication in Healthcare. (2019). Welcome to the academy of communication in healthcare (ACH). Retrieved from https: //www. achonline. org/ Agency for Healthcare Research and Quality [AHRQ]. (2013). Eliminating CLABSI, a national patient safety imperative: Final report companion guide. Retrieved from https: //www. ahrq. gov/professionals/quality-patient-safety/cusp/clabsi-finalcompanion/clabsicomp 4 c. html Agency for Healthcare Research and Quality [AHRQ]. (2015). Toolkit for reducing catheter-associated urinary tract infections in hospital units: Implementation guide. Retrieved from https: //www. ahrq. gov/sites/default/files/publications/files/implementation-guide_0. pdf Curtis, K. , Tzannes, A. , & rudge, T. (2011). How to talk to doctors – a guide for effective communication. International Nursing Review, 58, 13 -20. 1111/j. 1466 -7657. 2010. 00847. x Duke University Masters of Business Blog. (2014). From the court to the classroom: The “fist” team analogy. Retrieved from https: //blogs. fuqua. duke. edu/duke-mms/2014/02/14/patron/from-the-court-to-the-classroom-the-fist-teamanalogy? category=about-mms#. XGWW 6 d. GWy. Uk Edgoose, J. , Regner, C. , & Zakletskaia, L. (2015). Breathe out: A randomized controlled trial of a structured intervention to improve clinician satisfaction with “difficult” visits. Journal of the American Board of Family Medicine, 28(1), 13 -20. 10. 3122/jabfm. 2015. 01. 130323 Ellison, R. (2014). The cost of surgical site infections. NEJM Journal Watch. Infectious Diseases. 1056/mejmjw. NA 34755 Encyclopaedia Brittanica. (2019). Aristotle: Greek philosopher. Retrieved from https: //www. britannica. com/biography/Aristotle Istockphoto. com. (n. d. ). Image. Retrieved from http: //media. istockphoto. com/vectors/medical-team-vector-illustrationvector-d 533858370? k=6&m=533858370&s=612 x 612&w=0&h=Jd. Hqki. Xnr_u. On. Qow. V 8 n. XMzr. Rl. O-9832 noze. Qp. Oqi. OME=
RESOURCES John, O. P. & Srivastava, S. (1999). The Big-Five trait taxonomy: History, measurement, and theoretical perspectives. In L. A. Pervin & O. P John (Eds. ), Handbook of personality: Theory and research (Volume 2, pp. 102 -138). New York: Guilford Press. Kowalsi, K. (2018). Creating interprofessional teams. Journal of Continuing Nursing Education, 49(7), 297 -298. 10. 3928/00220124 -20180613 -04 Mc. Farland, D. , Shen, M. , & Holcombe, R. (2017). Predictors of satisfaction with doctor and nurse communication: A national study. Health communication, 32(10< 1217 -1224. 1080/10410236. 2016. 1215001 O’Malley, A. S. , Gourevitch, R. , Draper, K. , Bond, A. , & Manasi, T. (2014). Overcoming challenges to teamwork in patient-centered medical homes: A qualitative study. Journal of General Internal Medicine, 30(2), 183 -182. 1007/s 11606 -014 -3065 -9 People. Keys, Inc. (2019). DISC insights. Retrieved from https: //discinsights. com/disc-theory Poll Everywhere. (n. d. ). Live interactive audience participation. Retrieved from https: //www. polleverywhere. com/ Robert Wood Johnson foundation. (2011). What can be done to encourage more interprofessional collaboration in health care? Retrieved from https: //www. rwjf. org/en/library/research/2011/09/what-can-be-done-to-encouragemore-interprofessional-collaborati. html Smalley Institute. (2019). Welcome: let us help you build a better relationship. Retrieved from https: //www. smalleyinstitute. com/ The Myers & Briggs Foundation. (2019). How frequent is my type. Retrieved from https: //www. myersbriggs. org/my-mbti-personality-type/my-mbti-results/how-frequent-is-my-type. htm? bhcp=1
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