Demand for the Interprofessional Team
Achieving technology-enabled healthcare transformation means involving nurses in interprofessional teams. These teams increasingly tackle challenges ranging from data storage, genomic information, cyber-attacks and interoperability to meaningful use, security, reimbursement shifts, and unique patient identifiers.
Nursing schools and healthcare organizations (HCOs) that hire and retain nurses should consider creating team-building modules, tutorials, coaching programs, and online courses that feature team-building content, tools, and exercises. Among the concepts schools and HCOs should include are the following:
Start out right—the I-Team kick-off
Goal-setting: Nurses who join and participate in informatics (I)-teams should ensure that team goals align with broader HCO goals and strategies—from value-based care and patient engagement to cybersecurity and clinical integration. They should also verify that the I-Team is in sync with the HCO's mission, vision, and values.
Sponsor: Be sure to identify the I-Team's sponsor—CIO, CNO, CNIO, CMIO, or faculty member—with a focus on the individual's roles, responsibilities, expectations, and support in the form of time, funding, or human and material resources.
Membership: Create an I-Team that's small enough—less than 10 people—to generate connection and interdependence. Choose content and process experts and end users with diverse knowledge, skill, and experience as team members. And be sure to aim for a mix of skills—HIT, group dynamics, and leadership, for example—along with unit, department, division, or specialty representation.
Launch pad: Use a kick-off event to help I-Team members grasp team goals, mission, and structure and generate team momentum and productivity. Whether such an event takes the form of a one-day off-site retreat or a mid-week lunch-and-learn session, it should help create consensus around I-Team deliverables, roles, responsibilities, and success factors.
1. Delineate the I-Team's mission. Consider addressing the following questions: Why did executive or nursing management bring us together as a team and what must we accomplish? How will processes, systems, and/or outcomes change as a result of this team's work? How will the team know that it has achieved its mission and goals? Or, how can this team best measure its success over time? Whatever your answers, make sure the I-Team's mission statement is simple, brief, and easily understood by team members and management.
2. Develop I-Team goals. While the I-Team's mission statement offers broad guiding principles, its goals direct team members' activities. As most nurses know, the best goals meet the criteria of specific, measurable, achievable, relevant, and time-bound—SMART. In other words, it's not enough to say "improve patient engagement." Team members must zero in on the function or behavior they want to reduce or enhance in a measurable way over a specific timeframe.
3. Identify I-Team roles and responsibilities. Only when I-Team members fully understand expectations do they develop mutual accountability and trust in the team. Enter the I-Team leader, the person whom the sponsor holds accountable for the team's results. The team leader typically speaks for the team and coordinates its work, although a facilitator sometimes guides the team's process, sets agendas, and runs meetings.
4. Set team ground rules. Make sure the I-Team knows how its members will work together by creating behavior guidelines or ground rules. Among the issues for discussion are the following:
- Communication during meetings: How will I-Team members communicate during meetings? Examples: Is it OK to interrupt someone who wants to weigh in on predictive analytics when the discussion is focused on patient engagement? Should the leader or facilitator call on team members before they speak? Are side conversations allowed or encouraged?
- Communication between meetings: How should I-Team members communicate between meetings? Examples: Must team members respond to phone calls or e-mails within 12 hours? Should e-mails conform to specific length, content, structure, or style requirements? Should a team member copy every other team member on decisions or progress made?
- Respectful communication: How should I-Team members demonstrate dignity and respect? Should they honor time limits, avoid interruptions, focus discussions, or offer evidence in support of assertions?
5. Create decision-making guidelines. I-Team members need a model or framework that addresses two questions: Who will make decisions for the team and how will other team members be involved in decision making? More specifically, will the team make decisions via consensus, where everyone agrees to support the final decision? Or will the team leader make the final decision after securing input from every team member? Or will team members vote on decisions? Only when I-Team members know what is expected of them and what to expect from the decision-making process will they be able to support and implement a final decision.
Also, make sure that all I-Team decisions meet the criteria of quality and commitment. Quality informatics-related decisions deserve support in the form of accurate, timely, evidence-based data and information, which team members can verify by asking the following questions: Has the I-Team gathered and shared all relevant information on the informatics challenge under discussion? Has the leader consulted with all I-Team members before making a decision? Has the I-Team sought input from end-users or stakeholders who might be affected by the team's decision?
Every team member should support or demonstrate commitment to the decision. Among the issues include: Does each I-Team member agree with the decision? Is each team member committed to implementation of the decision? Do team members understand and accept their roles and responsibilities in decision execution?
By adhering to the success factors noted above, nurses at all levels of experience will have the satisfaction of being part of teams that resolve informatics challenges and drive healthcare transformation.
The Kinds of Teams Healthcare Needs: https://hbr.org/2015/12/the-kinds-of-teams-health-care-needs
The best way to improve healthcare is with a small, dedicated team: https://hbr.org/2016/03/the-best-way-to-improve-health-care-delivery-is-with-a-small-dedicated-team
Leadership development team-building tips for nurse managers: http://www.strategiesfornursemanagers.com/ce_detail/216818.cfm
Collaborative healthcare, how nurses work in team-based settings: http://nursingworld.org/MainMenuCategories/Career-Center/Resources/Collaborative-Health-Care-How-Nurses-Work-in-Team-Based-Settings.html
Team-building essentials: http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Team-Building-Essentials.aspx
Building blocks of teamwork: http://nursing.advanceweb.com/Article/Building-Blocks-of-Teamwork.aspx