Communication & Collaboration Flashcards
Multiple health workers from different backgrounds working together with patients, families, caregivers, and communities to deliver highest quality of care.
Interprofessional Collaborative Practice
Communication between patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to promoting and maintaining health and prevention/treatment of disease.
Interprofessional Communication
What is the leading cause of patient harm?
Communication failures between healthcare settings, departments, and team members
Communication characterized by a confident declaration of affirmation of what you want/need to say. Form of communication that affirms our POV without being aggressively threatening or submissive.
Assertive Communication
Characteristics of Assertive Communication:
- Feeling free to express ourselves
- Being able to initiate/maintain relationships
- Knowing your rights
- Controlling anger & talking in reasonable manner
- Willingness to compromise
- Having good self-esteem
- Respecting boundaries of others
- Fulfill needs of ourselves and others
- Using “I” statements
How can you overcome barriers to assertive communication?
- Keep in mind that the PATIENT IS THE GOAL OF THE DISCUSSION
- Use two-way communication
- Unite common vocabulary
- Elicit verbal and nonverbal feedback
- Engage in meta-communication
Communicating about your communication to resolve a problem. *i.e- “what can I do to improve our communication?”
Meta-communication
The reason for the organization’s existence that influences the design of the structure.
- Final structure developed
- Formal expression for purpose or reason
- Vision is present within
Mission / Mission Statement
The articulated goal to which the organization aspires to be.
- 2nd structure developed
- Contains 4 elements: written down, in present tense, uses action words, and balances needs or providers/patients/environment
Vision / Vision Statement
Expresses the values and beliefs that members of the organization hold about the nature of their work, about whom they provide service to, and about their behavior as an organization.
- 1st structure developed
- “Value Statement”; “Core Beliefs”
- Include terms like: “patient-centered”, “partnering”, “healing environment”
- Beliefs incorporated into everything
Philosophy
What is the goal of organizational structure?
To facilitate the execution of their mission and goals to establish reporting lines and communication within the structure.
The reflection of the norms or traditions of the organization, exemplified by behaviors that illustrate values and beliefs.
Organizational Culture
How is organizational culture expressed?
In formal manners, such as:
- Written visions, missions, philosophies
- Job descriptions
- Policies and procedures
And day-to-day experience of staff & patients.
What characteristic of organizational structure is this?
“The division of labor, specialization of labor, number of hierarchal levels, and geographic dispersion of units.”
Complexity
What characteristic of organizational structure is this?
“Separation of processes into tasks performed by designated people.”
Specialization
What characteristic of organizational structure is this?
“Degree to which an organization has rules stated in terms of policies that define a member’s function.”
Formalization
*often inversly related to specialization
What are FUNCTIONAL organizational structures?
These structure arrange departments and serices according to specialty and are common to healcare organizations.
* Tends to support expertise & encourage advancement
* May result in discontinuity of patient care services and decision making
* Not too many people between nurse at bedside and CEO
What are SERVICE LINE organizational structures?
The functions necessary to **produce a specific service or product **are brought together in an integrated organizational unit **under control of a single manager or executive. **
* Coordination of services, expedited decision-making process, and clarity of purpose
* More expensive due to duplication of services, loss of professional/technical affiliation, lack of standardization
* More people within the structure in general
What are **MATRIX ** organizational structures?
Complex structures designed to reflect **both function and services **in integrated organizational structure where a manager of unit *reports to both a functional manager and service line manager. *
* Timely response to forces in external environment and faciliates internal efficency through promoting cooperation among disciplines
* Personnel from various departments assigned to specific programs and become responsible to TWO supervisors to create an interdisciplinary team
* Nursing care delivered in teamwork setting or collaborativ emodel
* Puts teams together to minimize number of members needed to care for clients and allows for sharing of specialized resources.
* Difficult to coordinate various tasks between team to save time/money.
i.e- director of peds nursing > VP of peds services & VP of nursing
What are FLAT organizational structures?
Structures with few layers in reporting structure; decision-making delegated to professionals doing the work.
* Decentralizaed decision making replaces centralized
* Providing staff with authority to make decision at place of interaction with patients
* Allows individualized decisions for specific situations and needs
* Focus is to improve patient safety outcomes
DISADVANTAGES:
1. Potential for inconsistent decision making
2. Need to educate managers to communicate effectively
3. Size-oriented; better in smaller settings
Degree to which an organization has spread it’s lines of authority, power, and communication.
Centralized v. Decentralized Structure
What are Centralized Structures?
The chain of command must be followed to communicate with others in the structure.
Bureaucratic & Service-Line
What are Decentralized Structures?
One department can communicate with another without going through a hierarchy of departments.
Flat & Matrix
!! Works better in HC and nursing !!
Communication originates at top or upper levels of organization and works it’s way down.
Downward Communication
Communication originates somewhere below top of organization and moves it’s way up.
Upward Communication
Communication occurs among those at similar levels within the organizational structure.
Lateral Communication
Different levels within the organizational structure communicate with each other.
Diagonal Communication
Informal and unstructured communication. The major benefit is speed, but the major drawback is unreliability.
Grapevine Communication
A number of individuals collaborate in specific work or activity that focuses on a specific goal or outcome.
* Members have complimentary skills
* Committed to a common purpose to which they are mutually accountable for
Team
A number of individuals assembled together have some unifying relationship; performance and outcomes are a result of the work of individual members.
Group
What are the Stages of Team Forming?
- Forming - group is created, purpose is determined, relationships are formed.
- Storming - interpersonal interaction/reaction, dealing with tension, conflict and confrontation
- Norming - cooperation/collaboration, increased cohesion, formation of solidified goals
- Performing - solidarity evident, maturity, emphasis on maintaining and improving the group, synergy & teamwork, group gets work done
- Adjourning - team goals met, closure evaluation, outcomes review, debrief, may reform if needed
What are the basic rules of synergy?
- Establishing a clear purpose
- Active listening
- Telling the truth
- Compassion
- Flexibility
- Commit to resolution
- Capitalize on what members bring to team; acknowledge strengths (specific, eye-to-eye, & sincere)
How does synergy present in nursing?
- Understanding that the whole is greater than the sum of the parts
- Needs and characteristics or a patient, clinical unity, or system are matched with nursing competencies
- Stable staff works harmoniously
A reflection or conscious consideration of the meaning and implication of an action, which includes the assimilation of knowledge, skills, and attitudes.
Can lead to new understandings and ensure best possible learning outcomes.
Debriefing
Why is “group think” harmful?
The desires for harmony and consensus override members’ rational efforts to appraise the situation.
- Reduction in willingness to disagree or challenge
- Results in failure to communicate, failure to review decisions in light of changing events, failure to consult with experts, and conflict/hurt feelings
END RESULT = POOR PATIENT OUTCOMES
Disagreement in values/beliefs within oneself or others that cause harm or could potentially cause harm.
Conflict
Stages of Conflict: FRUSTRATION
- Believe goals are blocked
- May escalate into anger and resentment
- Stop & clarify the nature/cause of differences to resolve
Stages of Conflict: CONCEPTUALIZATION
Interpretation of situations differently and what should occur next.
- Often interpretations are dissimilar and involve own perspective.
- Form basis for reaction to frustration
- Clarify conflict as “I” see it and how it makes “me” respond before defining conflict, develop shared concept, and resolve
Stages of Conflict: ACTION
Behavioral response that follows conceptualization.
- The longer ineffective actions occur, the more frustration and hostility develops
- Seeking clarity about other views, collecting additional information, or engaging in dialogue to resolve
Stages of Conflict: OUTCOMES
Tangible and intangible consequence result
- Conflict being resolves, stagnation, or no future movement
- Assess degree of conflict
Unassertive and uncooperative approach to conflict resolution that ignores own needs/goals/concerns and other’s needs/goals/concerns.
Avoiding
- Only ensures conflict is being postponed
- Conflict may esclate
- Only positive is that it may postpone to a better time
When is AVOIDING appropriate?
- Trivial or temporary issues
- Other issues are more pressing
- No chance to obtain one’s needs
- Others could resolve more effectively
- Potential negative results of initiating are greater than benefit of resolution
- Need to cool down and gather more information
Neglecting own needs while trying to satisfy others.
Accommodating
- Can be self-sacrificing and simply obeying others
- May feel disappointment or resentment
When is ACCOMODATING appropriate?
- Other’s ideas are better
- Issue is more important to the other person
- Continued competition would hurt the group
- Preserving harmonious relationships is more important
- Letting others learn from mistakes is not harmful
Pursuing own needs or goals at the expense of others by using power/strategies to win or standing up for your rights.
Competing
- Often react by feeling threatened, act defensive, or result to cruelty
- Can generate ill-will
When is COMPETING appropriate?
- Quick, decisive action is necessary
- Important, unpopular action needed
- Trade-offs may result in continued conflict
- Right about issues and it’s vital to group welfare
- Others have taken advantage of non-competitive behavior
Assertiveness & cooperation on everyone that requires maturity and confidence to give and take, creating a middle ground.
Compromising
- Nobody gets all needs met but some sense of equality
- Balance of power between self and others
When is COMPROMISING appropriate?
- Two powerful sides committed to mutually exclusive goals
- Temporary solutions to complex situations needed
- Conflicting goals aren’t worth major confrontation
- Time pressures to expedite workable situation
- Collaborating and competing fail
People work creatively and openly to find the solution that most fully satisfies all important goals and concerns.
Collaboration Conflict Resolution
- Analyzing situations and conflict at higher levels where shared goals are identified and members committed to working together
- Decision-making is a collaborative process
- Merges unique strengths of all professions to improve patient outcomes
The process of working together in a joint intellectual effort to develop the optimal outcome and creative endeavor to find the best solution to the conflict.
Creating higher goals that encompass the goals of BOTH sides.
Collaboration
The process of altering or replacing existing knowledge, skills, attitudes, systems, policies, or procedures. The outcomes must align with the organization’s vision.
Change
Model that requires prior learning to be rejected and replaced using driving forces to change, restraining forces that hinder changes, and equilibrium where no change occurs.
Lewin’s Change Model
Altering behavior to agitate the equilibrium of the current state that is necessary is resistance needs to be overcome. This can be done by increasing driving forces while decreasing the restraining forces.
Step 1: Unfreezing
i.e- encouraging active participation in recognition of problem and brainstorming
The process of moving to a new equilibrium.
Step 2: Moving (Changing)
i.e- connecting views of the group to powerful leaders who will support change, redefine goals and reeducation, encouraging to view problem from a new perspective
Attaining equilibrium and maintaining newly desired behaviors that must take place after change has been implemented.
Step3 3: Refreezing
If this step is not attained, it is likely the change will be short-lived.
i.e- reinforcing new behaviors by adopting new policies
