Creating A Culture of Teamwork
Nursing Research on the Green
Tracey Benedict, BSN, RN; Dana Check, MSN, RN, CNL; Kari Hamson-Kalis, MSN, RN, CNL, OCN – Gundersen Health System
- Background: Teamwork is a standard for high performing organizations and is critical for the future of healthcare. Developing a culture that cultivates employees to work together is important for superior quality and safety.
- Significance: Benefits of teamwork have already been proven in a variety of professions. The Agency for Healthcare Research and Quality recognizes, healthcare delivery teams also need to practice with teamwork principles. Various nursing roles contribute to the frontline delivery of patient care therefore it is important for healthcare professionals to acknowledge teamwork.
- Purpose/objective: The inpatient Medical & Oncology unit looked to utilize evidence based teamwork principles; to engage staff, manage a face pace, unpredictable unit and increase safety. The development of high functioning teams is a strategy to sustain outcomes and enhance the Patient and Family Centered Care experience.
- Methods/project: This evidence-based project discovered from the literature that structure and function is necessary in teamwork. Structure includes; a nursing care delivery model with an established team size, staffing patterns, skill mix, roles and responsibilities. Functional aspects of teamwork includes; staff's development of knowledge, skills and attitudes. TeamSTEPPS framework was chosen to support team function and promoted various strategies and tools for designing the team. In addition, team committees, continuous feedback from staff, leadership support and trials supported this project.
- Results: Data results indicated that outcomes are moving in a positive direction. Intangible elements of teamwork are visible daily in workflows and managed chaos. Leadership support was critical and it was important to engage all nursing roles on the team. Overall, it is recognized that a paradigm shift for a teamwork culture takes time.
- Clinical implications: Changing the culture of care takes years and is very complex. Teamwork requires the development of both structure and function. TeamSTEPPS can be customized for unit specific improvements with teamwork, and can be utilized for interdisciplinary teams too, yet further research is needed to strengthen its use in healthcare. The development of staff "coaches" would also be a valuable resource for support.
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