COMFORT*• Communication (narrative) • Orientation and opportunity• Mindful presence• Family• Openings• Relating• Team

* Wittenberg-Lyles, E., Goldsmith, J., Ferrell, B., & Ragan, S. (2012). Communication and palliative nursing. New York: Oxford.

Objectives• Describe the main principles of

interdisciplinary team collaboration• Recognize team meetings as a place to

collaborate and resolve conflict• Identify a communication skill to practice

with interdisciplinary team members• Identify a communication skill to practice

to ensure effective team meetings

Interdisciplinary Collaboration

• Sharing resources• Shared power• Respect credibility/expertise• Focus on task and relational

communication

Model of Interdisciplinary Collaboration

Interdependence & flexibility– Characterized by interaction in order to:• Accomplish Goals and Share information• Maintain flexibility for each new case

– Psychospiritual care (Grey, 1996):– meets psychosocial, spiritual, and coping needs of

patients/families laboring with terminal illness

Grey, R. (1996). The psychospiritual care matrix: a new paradigm for hospice care giving. Am J Hosp Palliat Care, 13(4), 19-25.

Model of Interdisciplinary Collaboration

Newly created tasks & responsibilities– Emerge through information

sharing– Collaborate to maximize members’

expertise– Work collaboratively to serve

patient & family– Accessibility allows frequency/ease

of contact

7

Model of Interdisciplinary Collaboration

Collective ownership of goals– Share responsibility to produce

holistic care– Team joined by experience– Patient/family viewed as important

part of team– Shared common purpose

8

Model of Interdisciplinary Collaboration

Reflection on process– Awareness of collaborative

processes – Collectively review team processes– Evaluate own process

*Least ranked aspect of collaboration

9

Communication with Impaired Individuals

• Nearly 100 million impaired patients across care settings

• To achieve true quality improvement, the team must recognize impairments and address them

• Collaborative solutions (Rao, 2011; Mathisen, Yates, & Crofts, 2011)

10

Team Meetings

• Enables communication to produce plan of care for each patient

• Allows elements of interdisciplinary collaboration to emerge

• Collaborative process involves conflict

11

Groupthink

When team members do not engage in brainstorming, problem-solving, critical thinking, or general discussions about decision-making.

Groupthink

• Cohesive group members • Emphasize unanimity • Focus on group cohesion/relations over

decision-making• Leads to poor decision-making and

lack of collaboration• Obstructs effective group discussion

and conflict resolution

13

When Groupthink Occurs

• Embrace least effective decisions• Suppressed disagreements• Perceive conflict as more work• Unable to consider:– All aspects of information– Alternative solutions– Fail to understand risk of failure

14

Aspects that influence groupthink

• Relational Factors• Self-Censorship• Organizational influences• Structural constraints

Ways to combat Groupthink

• Discussions should start by stating the patient’s goal of care

• Designate a team member to play devil’s advocate

• Rotate leadership of team meeting

Adapted from: Wynne Whyman (2005). A question of leadership: What can leaders do to avoid groupthink. Leadership in Action, 25(2), 12.

Assessing team experiences

• Do discussions include family, other healthcare professionals involved?

• Does the team have designated time for sharing frustrations about plans of care (e.g., specific patient/family)?

• Does the team address patient safety issues?