Teamwork & Conflict Resolution Flashcards
Barriers to effective teams
- Inter-professional differences - schedules/routines, qualifications/status, payment/reward and/or accountability.
- Interpersonal differences - personalities, values, expectations, views/opinions.
- Behaviours - disruption, vying for the spotlight, failing to contribute, lacking confidence in others’ decisions.
- Culture - inter-professional rivalries, emphasis on rapid decision-making.
3 Attributes of effective teams
- Team structure & organisational support:
- Clear leadership/direction
- Suitable members with distinct roles/tasks
- Adequate resources
- Shared purpose supported by organisation
- Culture of collaboration
- Clear accountability - Team processes & interactions
- Agreed system of governance
- Balanced distribution of workload
- Measurable processes/outcomes
- Effective communication & regular information sharing - Contribution by individual team members
- Active participation
- Supportive of other team members
- Appreciation for other specialties
- Adaptable to changes
Strategies for managing interpersonal conflict
- Cognitive rehearsal
- Reframing
- Graded assertiveness
Cognitive rehearsal (define)
Using pre-formed ‘shielding’ statements to confront inappropriate behaviour or communication in a non-aggressive manner at the time it occurs, to avoid responding emotionally.
E.g. Criticising a colleague while they are not present - “I wasn’t there/don’t know the situation and don’t feel comfortable discussing it. Have you talked to them about it?”
Reframing (define)
Redirecting the line of communication to create an opportunity for re-evaluation of a potentially inappropriate treatment plan, in terms of patient safety.
E.g. CUS - ‘I’m concerned’, ‘I’m uncomfortable’ and ‘I don’t think this is safe’
Graded assertiveness (define)
Gradual escalation of concerns by providing gentle cues to another clinician regarding management plan or patient condition.
Level 1 - initial concern noted with an ‘I’ statement - e.g. ‘I am concerned’
Level 2 - an inquiry or offer a solution - e.g. ‘would you like me to…?’
Level 3 - asking for an explanation - e.g. ‘It would help me to understand why…’
Level 4 - definitive challenge demanding a response - e.g. ‘for the patient’s safety, you must listen to me…’
Strategies to prevent/eliminate bullying
- Workplace policies - Zero-tolerance, health and safety policies
- Legislation - harassment, discrimination.
- Staff education on identifying, responding to and reporting episodes of bullying
- Workplace culture - respectful communication and empathy
- Organisational systems - counselling, mediation, disciplinary action, education.
Workplace bullying (define)
(aka) Horizontal/lateral violence
A person (or group of people) repeatedly acts unreasonably toward another worker (or group of workers) and those acts create a risk to health and safety.
E.g. excluding someone from work-related events, unreasonable work demands, practical jokes, peer-pressure to behave inappropriately, aggression/violence.
Does NOT include reasonable management action that is carried out in a reasonable manner. E.g. taking disciplinary action, directing the way work is performed.
Open disclosure (define)
The process employed by clinicians to communicate with the patient and family affected by an adverse event.
Key elements:
1. An apology including the words ‘I am sorry’
2. Clear explanation of what happened
3. Opportunity for patient/family to convey their experience
4. Discussion of possible consequences
5. Explanation of steps taken to manage the event and prevent recurrence
Risk factors for aggression/violence
- Patient condition - physical illness, confusion, delirium, anxiety, altered perception, boredom, pain.
- Environment - heat, noise, crowding/lack of privacy.
- Healthcare services - lack of information, no right of appeal, lack of choice, inadequate staff training, staff shortages, perceived negative attitudes.
Antecedants for aggression/violence
- Confusion
- Irritability, angry demeanour, tense posture, pacing/fidgeting
- Loud speech, provocative behaviour or boisterousness
- Verbal or physical threats
De-escalation techniques
- Send for help - notify shift coordinator/DR
- Secure environment - remove dangerous items, ensure visibility/presence of other clinicians, remove other patients/visitors, maintain safe distance from patient, locate exits
- Introduce self and approach with caution
- LASSIE:
LISTEN - what’s wrong/has something happened? What are you feeling? Why do you want to do X?
ACKNOWLEDGE - reflect/paraphrase patient’s words, validate/challenge emotions/thoughts.
SEPARATE (from others) - private location, low-stimulant, maintain safety.
SIT DOWN - match patient eye-level, model calm communication and behaviour, offer comforts.
INDICATE OPTIONS - current concerns/risks, consequences of behaviour, practical options.
ENCOURAGE SOLUTION
HaDSCO (process)
- Individual enquiry - advise to raise concerns with service provider, submit online complaints form or contact other agency (e.g. AHPRA).
- Complaint received and assessed - accepted, rejected or referred.
- Accepted - negotiated settlement, conciliation or investigation.
- Outcomes - explanations by service providers, apologies, refunds/waiver of fees, access to services, staff training, policy/procedure changes.
* if complaint refers to RHP HaDSCO must notify AHPRA.
HaDSCO (function)
Independent statutory authority providing impartial resolution service for complaints relating to health or disability services provided in WA. Escalates serious matters to AHPRA.
Complaint management (individual response)
- Be helpful and aim to resolve issue at the time
- Provide assistance to make a formal complaint
