Lara Newman CM6

Discuss the typology of teams in health care. Provide an analysis of each element

Typology is another term for grouping items by dimensions.

1. Function/purpose- Is it more desirable to have a team or individual complete a task? Utilizing teams will open up possible advantages for the task. It can create synergy amongst the project team, inspire innovation, and help fill in gaps that might have been missed by an individual participant. One must determine the multiple purposes of a team to determine if the team approach is the most appropriate approach for the task. We use project teams at work when hospitals are implementing Cerner.
2. Decision authority- The various roles teams could potentially play during the decision making process. Managers need to ensure that team players understand the role they are playing in decision making. It is crucial that managers respect the decisions that are made by the various team players to avoid frustration.
3. Temporal nature- The temporal nature is how permanent the team is for the task. Some tasks call for temporary “time-limited” teams, while others require a long-term team. Hospitals will hire third-party individuals to help run software updates or help with the implementation of a new EHR system.
4. Time and space- Teams typically exist with time and space. A team meeting requires there to be a set time of when the meeting will take place, as well as space or meeting room for the team to use for the meeting. Teams can use communication technology to meet with individuals that are remote. This type of communication can happen over a span of time if necessary. Virtual teams are extremely popular today. There are some limitations that virtual associates bring to the table. I have seen teams utilize web cams to help avoid miscommunication opportunities that stem from remotely held meetings.
5. Diversity- People on teams have different social statuses between professions, hold different views of the world, and can sometimes speak different languages both in their personal world and within their professional world. It also includes gender, age and generation, demographic and cultural diversity, hierarchical levels, and consumer and professional diversity.
6. Accountabilities- Teams all vary in the types of accountability they require of each member. Team members can be externally accountable, internally accountable, or even sometimes both. Each member is held accountable for the other individual contributors.
7. Membership fluidity and boundary permeability- Teams can be stable over time or even fluid. There are different liabilities within membership fluidity. This includes the lack cohesiveness amongst the different team members. Some memberships are more permanent than others. The board of trustees are more likely to have a stable set of members versus the residents that come and go within a hospital.

 

Using the model of team effectiveness, describe each element.

The model of team effectiveness helps teams be more effective. There are certain actions that can be taken, and processes to put into place to ensure teams perform at higher levels. The team effective model consists of different elements listed below.

1. Team characteristics- This includes team size/composition/diversity, status differences, psychological safety, team norms, and team cohesiveness.
2. Nature of the work- Consists of team goals and task interdependence.
3. Environmental Context- Includes intergroup relationships and conflict, organizational culture, and external environment.
4. Team Process- The team process includes leadership, structure and interaction patterns, decision making, learning, and stages of team development.
5. Team effectiveness includes performance, member satisfaction, quality of work, and capacity for sustainability.

What is context? What is environmental context and describe it in health care?

Context is an environment or the type of setting where something exists. The environmental context are different events and pressures that exist outside of the team and are directly related to the infrastructure and restrictions. It consists of intergroup relationships and conflicts, organizational culture, and the external environment. These different pressures and events can potentially affect the team’s performance, relationships/conflict, and other external environments.  One example that comes to mind is when two hospitals merge together. Sometimes smaller critical access hospitals will merge with larger hospitals to potentially save money on their EHR system and overhead costs. This can cause some conflict between the different teams that are involved within the merge if they are unsuccessful at creating a positive intergroup relationship.

 

What is a context analysis? Using the context analysis model, provide an example in health care.

Context analysis is a method that is used to analyze a business environment in which it operates. It focuses on the internal and external environment. It can help the team understand contextual factors that could potentially affect their sustainability and implementation. There are four dominate features within context analysis.

1. Enabling environment- infrastructure/market. What is the research and nutrition within the ministry of health?
2. Actors/Inputs- Inputs include the technologies at play, while actors include the customers, administrators, union health workers, and farmers. Who is the authority within the ministry of health?
3. Interactions- Private sector, academia, government (how, what, when, where, & why). How does the ministry of health relate to hospitals, delivery agents, etc.?
4. Outputs/Outcomes- central outcomes (health, wealth, wellbeing). How does the ministry of health quantify health outcomes in children with health issues?

An example of context analysis within healthcare would be a patient care team collaborating and using their unique knowledge of various systems to review the patient’s symptoms and diagnostics, and medical history to determine or rule out a diagnosis.

 

What is the Nominal Group Technique? What is the Delphi Technique? Provide examples of both.

A nominal group technique can be used as a method for brainstorming that would ideally encourage contributions from the entire team. It can help facilitate quick agreements to problems, solutions, and issues. The group will pick a problem, question, or issue. Each individual will then state aloud one of their ideas, while the facilitator rights it down. Individuals will then discuss their idea. The facilitator will then prioritize the recorded ideas. The nominal technique can be used to help determine the information patients would be able to see on their patient portal. Can they see their vitals, lab results, and radiology results? How long should the health system wait to post those results in case a provider needs to speak with the patient first? All of this can be discussed amongst a group of individuals where a facilitator can jot down the ideas.

The delphi technique is used to promote team members opinions and help them generate ideas. The delphi technique includes the nominal group technique. It does not require face to face meetings. The focus groups within this technique utilize group dynamics to generate debate topics. The anonymity of the participant is maintained within this method. This method reminds me of the associate satisfaction surveys that are sent out within my organization on a quarterly basis.

What are the stages of team development?

1. Forming- Members get to know one another and begin to understand the team purpose. They must establish a clear connection, establish trust and familiarity, and discover what behaviors are acceptable.
2. Storming- The team begins to face disagreement and conflict within this stage. The team will need to focus on process improvements, collaborative relationships, and team achievements.
3. Norming- Team becomes more cohesive and aligns more closely to the purpose and actions. Forward progress will require emphasizing the team’s goals and direction.
4. Performing- Team needs to focus on continuous improvement, speed, and innovation. Their leaders need to generate new ideas and foster high performances from the different members.
5. Adjourning- Task accomplishment, regret, and increase emotionality.

 

Answer the questions on pg. 154 (Questions 1-3)

1. Turnover can negatively impact the team by forcing other individuals to take on more work. This can lead to potential misses since that individual will have more tasks on their plate. It can also lead to individuals being overworked and potentially lead to poor performance and more turnover. Turnover can also mean the team’s knowledge decreases. Sometimes extremely knowledgeable individuals will leave without transferring any of their knowledge to other team members. Leaders can be proactive and hire new team members to fill those empty spots. They can ensure knowledge transfers happen across the team members, so the knowledge doesn’t leave the team next time turnover occurs. The one advantage to turnover would be the open opportunities for individuals to move up, or to even move into roles on the team that they are more interested in learning. Turnover also opens the opportunity to potentially clean house if those individuals leaving were poor performers.
2. I believe minimal involvement from the consumer could be beneficial in this scenario. Involving the consumer opens the opportunity for feedback. Otherwise, I would leave the consumer out of other conversations and decisions being made at the quality improvement team meetings. Involving a consumer in everything could be difficult and costly. In my mind, a consumer would want some type of payment if they are asked to be involved in more than just a questionnaire for feedback. It could also be difficult for the consumer to attend team meetings since they are outside of the organization. Leaders and members can utilize the knowledge consumers receive from the patient side and the feedback they have to offer from their patient experience. Consumers can fill some of the knowledge gaps that other team members may not be able to fill due to their patient experiences.
3. Some of the obstacles to sustaining improvements include; the potential lack of training of the team members, lack of capability to acquire specific knowledge and skills that are necessary for team improvement, lack of motivation and commitment, poor communication, and conflicting goals. Some factors that might lead to the dissolution of improvement include; the lack of trust between members, conflicts with other team members, resistance to change, and poor decision making. Diversity could also lead to dissolution over time. A leader could ensure there is adequate training available to members, promote communication within the team, set clear goals, promote system improvement, and motivate their team members to contribute to the decision-making process.

What is the gist and database? How can you apply it?

The gist would be like a hook. It is the essence, the key idea, and the one line that is used to summarize the verbatim. Professor Bunch explains that you have to have a good subject line (gist) to get the boards attention. Leaders can use a gist by simplifying an idea or concept to a group of individuals. An example would be A database is the memory of the leader or the repository of knowledge they have on a subject. A leader can utilize the gist and verbatim to trigger the index of the database. Leaders need to be able to scan the horizon for irregularities and adapt to chaotic situations.

What did you learn from watching The Strategic Leader in a VUCA World?

The pace of change has made VUCA more powerful. VUCA stands for volatility, uncertainty, complexity, and ambiguity. I like how Professor Bunch took a military concept and applied it to the business world. He associates the fog from the battlefield to the chaotic fog we face in society. Leaders and competitors cause chaos, or fog, and people are supposed to make decisions in the fog. We must make decisions among the volatility, uncertainty, complexity, and ambiguity that we face on a day to day basis. Professor Bunch explains that you have to know the gist to get the verbatim. The gist helps us get into the VUCA details. Leaders must be able to get their point across with minimal words. Professor Bunch used a subject line as an example. He explains that a great strategic leader is able to communicate meaningfully and memorably. The biggest thing I learned from watching this video was in regard to being able to simplify something, yet understand the ambiguous, complex, uncertain, and volatile side.

What is the difference between a Soldier and Scout Mindset?

The soldier mindset is primarily based on one’s emotional responses such as defensiveness, while the scout mindset is more geared towards curiosity, the enjoyment of learning new things, and are more grounded. The soldier is more likely to approach situations by defending their beliefs. A scout, no matter the starting point, is driven more by their desire to find what is real.

What did you learn from watching and reading Why you think you’re right, even when you’re wrong?

I had never heard of the soldier vs scout mindset. This video and reading taught me that perspective is everything. Perspective really comes into play when examining your mindset or beliefs. Although I almost do not want to admit it, I feel like this video has taught me that most the time I favor a soldier mindset over a scout mindset. Most of the time, I favor my viewpoints no matter the cost. Our mindsets shape how we think, our relationships, and what we as individuals would consider as fair or ethical. The soldier mindset is an unconscious mindset. If one is not careful with a soldier mindset, they can ruin the life of someone that is innocent. I need to have more of a scout mindset in some situations versus defending my own beliefs. I believe that you must pick your battles. Not all situations need to be soldier or scout minded. Leaders must pick and choose which their mindset based on the situation.

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