Management of Health Care Organization: Assignment Week 5

Chapter 12: Collaborating Inside the Organization

Chapter Objectives

• Be able to define collaboration within organizations.

• Explain the characteristics of four types of teams.

• Describe methods of collaboration used in each type of team.

• Be able to apply techniques characteristic of highly collaborative teams.

• Understand the role of leadership in collaboration.

Outline

• Types of Teams – Ongoing Teams

– Microsystem Teams

– Rapidly Formed Teams

– Quality Improvement Teams

• Techniques for Effective Collaboration within Teams

• Team Leadership

• Team Conflict

Collaboration within Organizations

• Defined as “combining the knowledge, experience, and skills of many individuals to deliver services, programs, or products”

• Occurs at all levels: individual, team, department, etc.

• Results in “buy-in” among team members • Management and staff must take a collaborative

approach • Individuals recognize that their views alone are

not sufficient to convert an idea into a reality

Teams within an Organization

• The most effective method for achieving collaboration within an organization is the use of teams

• The organization must promote and reinforce effective teamwork

• Four commonly encountered types of teams: – Ongoing Teams

– Microsystem Teams

– Rapidly Formed Teams

– Quality Improvement Teams

Ongoing Teams

• Consist of a formally established and defined set of individuals who work together over time

• Four characteristics:

1. Team members have similar training and are assigned to the same department or working group

2. A formal reporting relationship exists

3. Have an identified leader

4. Team members work together frequently

Four Phases of Ongoing Teams

1. Forming: members are unsure of rules and expectations; individuals try to avoid conflict and gain acceptance

2. Storming: members begin to disagree and conflicts arise; often the most difficult phase

3. Norming: teams resolve issues and find constructive approaches to work

4. Performing: cohesive team that can reach consensus and be highly productive

Microsystem Teams

• A single or small component of a larger system (embedded in a “macro” organization)

• Work must result in value to the larger system

• Attributes of teams include: value, cooperation, and communication

• Example: a unit that provides medical services, embedded within the larger hospital and public health systems.

Rapidly Formed Teams

• A group of employees that come together for a specific, unplanned purpose

• Most emerge spontaneously

• Can face significant complexity and time pressures

• When the immediate goal is achieved, the team usually disbands

Quality Improvement Teams

• A group of individuals who work together to improve a process

• Cross-functional and interdisciplinary

• Focused on addressing a single problem or process

• Informal

• Use quality improvement tools and techniques

Techniques and Tools for QI Teams

• Write a project charter

– Outlines goals and activities to be taken to reach goals

– Short, but with all relevant details of the project

• Identify a project champion

– A champion is an executive-level manager who manages and guides the QI project and aligns it with system priorities

• Select team members

– Team members should have the expertise necessary to address the targeted problem

– A team of 5-9 individuals is preferred

Techniques for Effective Collaboration within Teams

• Communication • Training • Conducting effective meetings

– Preparing an agenda – Assigning important roles – Following the agenda

• Brainstorming – Structured – Unstructured

• Prioritization Matrices • Six Hats Method

Communication

• Open, concise, and effective communications are important to all types of teams

• Require channels through which information is transmitted:

– Formal: created by management and defined; easily understood but often slow

– Informal: created by individuals and based on relationships; hard to define but often rapid

Training

• Team training involves different behaviors and skills than training individuals

• Two interdisciplinary team training methods include:

1. TeamSTEPPS: teaches skills that support team performance: training, behavior, human factors, and cultural changes

2. In situ simulation: an experiential team training method

Conducting Effective Meetings

• Successful meetings require three components:

– Preparing an Agenda: provides guidance and helps participants focus

– Assigning Important Roles: Facilitator, Timekeeper, and Recorder

– Following the Agenda: start and end on time and prevent distractions

Brainstorming

• A quality improvement method used by a team to generate many ideas around a single issue of interest

• Three primary benefits:

– The whole is greater than the sum of its parts

– An effective way to generate ideas rapidly

– Inclusive and non-judgmental

Two Approaches to Brainstorming

• Structured

– Facilitator controls the discussion and ensures critique is withheld

– Each person participates in turn until all ideas are exhausted

• Unstructured

– No facilitator

– Ideas may be offered by participants at any time

Prioritization Matrices

• A QI tool used to evaluate alternatives generated by brainstorming in a systematic manner using predetermined decision criteria

• Has two components: a list of alternatives and criteria to evaluate each alternative

• Each component is decided on by the team

• Generates scores that yield a ranking of alternatives

Six Hats Method

• Used when members of a team have to evaluate a proposed solution in a systematic way

• The “six hats” represent six different roles for team members to assume

• Five team members take on roles of objective, subjective, positive, negative, and imaginative

• The sixth hat is for the leader/facilitator

Example: Six Hats Method

Team Leadership

• Good leaders listen to team members and facilitate collaboration

• Accomplished by applying two important elements:

– Accomplishing Tasks: ensure all assigned tasks are performed by team members

– Supporting Individuals: address the needs of all team members and promote positive interpersonal dynamics

Successful Team Leaders

• Team leaders can successfully achieve a goal by:

1. Establishing a vision that supports the goal: provides context and boundaries; includes an outline and timeline

2. Communicating the vision to others: essential for motivation and encouragement

3. Exhibiting confidence that the goal can be accomplished: share enthusiasm and have a positive attitude

Team Conflict

• Defined as tension between team members due to real or perceived differences.

• Two common sources of team conflict: relationships and tasks

• Can have positive and negative consequences

• The inability to resolve conflicts may cause a team to lose focus and even disintegrate.

• The type of team often determines optimum ways to manage conflict.

Four Methods to Handle Team Conflicts

1. Set Goals

– Established and agreed upon goals make it easier to resolve problems

2. Assign Accountability

– Delegate authority to give team members responsibility, then evaluate their performance

3. Understand How Decisions Are Made

4. Ensure that Meetings Are Effective