Professional Documents
Culture Documents
INVESTIGATORS
1
2
EXPLORING THE CHALLENGES AFFECTING MULTIDISCIPLINARY
TEAM COLLABORATION AT ST. AMANUEL MENTAL SPECIALIZED
HOSPITAL 2023 G.C
INVESTIGATORS
OCTOBER 2023
I
DECLARATION
We the researchers declare,
II
APPROVAL SHEET
This research study entitled "Challenges Affecting Multidisciplinary Team
Collaboration at St. Amanuel Mental Specialized Hospital" has been proposed by
Seifeslassie Wendwosen, Kedire seid and Kalkidan Dawit in currentlyworking at St.
Amanuel Mental Specialized Hospital. This study aims to investigate and address the
challenges that impact multidisciplinary team collaboration within our healthcare
setting.
The research proposal and methodology have been reviewed and evaluated by the
undersigned, who hereby grants approval for the commencement of the research
study.
III
ACKNOWLEDGMENT
We would like to express our sincere appreciation to the individuals and organizations
that have supported us during the preparation of this research proposal. Although this
proposal has not been approved yet, we would like to acknowledge the potential
contributions and support we anticipate receiving. We extend our gratitude to the St.
Amanuel Mental Specialized Hospital, whose potential financial support would
greatly facilitate the execution of this study. We would also like to thank the
administration and staff of the specialized mental health hospital for their anticipated
cooperation and willingness to participate in this research. Furthermore, we anticipate
the involvement of participants in this study and express our gratitude for their
potential contribution in providing insights and perspectives crucial to the success of
this research. Finally, we would like to acknowledge our advisors, mentors, and
colleagues for their anticipated guidance, feedback, and valuable input throughout the
research proposal development process.
IV
ACRONYM/ABBREVIATION
CPAT……………………………… Collaborative Practical Assessment Tool
IPE…………………………………Interprofessional Education
V
Table of Contents
DECLARATION...........................................................................................................II
APPROVAL SHEET...................................................................................................III
ACKNOWLEDGMENT..............................................................................................IV
ACRONYM/ABBREVIATION...................................................................................V
LIST OF FIGURES....................................................................................................VII
SUMMARY.................................................................................................................IX
1. INTRODUCTION..................................................................................................1
LITERATURE REVIEW...........................................................................................3
1.2.1 Introduction...................................................................................................3
3.3 Population..........................................................................................................17
VI
3.4 Eligibility Criteria..............................................................................................18
REFERENCE...............................................................................................................25
ANNEX 1.....................................................................................................................28
LIST OF FIGURES
VII
Figure 1: Conceptual Framework for Challenges of Multidisciplinary Team
Collaboration.................................................................................................................................29
VIII
SUMMARY
Background:Multidisciplinary teamwork is crucial for providing comprehensive
patient care in healthcare systems, including mental health care settings in Ethiopia.
However, challenges such as disciplinary barriers, organizational hurdles, and limited
integration of mental health services hinder effective collaboration among healthcare
professionals. Addressing these challenges is essential to optimize collaboration and
improve healthcare outcomes in Ethiopian healthcare settings.
Budget Breakdown: The research study is allocated a budget of 78,500 ETB, which
will cover expenses related to research materials, data collection tools, data analysis
software, participant incentives, and administrative support.
IX
1.INTRODUCTION
Collaborative work among different professionals is crucial for delivering the desired
outcomes such as accurate diagnosis, effective treatment planning, seamless care
transitions, and improved patient satisfaction.The Norwegian health system conducted
a research to explore the challenges from the perspectives of both healthcare providers
and patients and arrived in a conclusion that the lack of collaboration had negative
consequences, including fragmented services for mental health service users,
inadequate rehabilitation services, and prolonged institutional stays for older
patients(2)
1
professionals in mental health settings, such as strong unprofessional cultures and
conflict over leadership, further contribute to the limited adoption of IPE.in (4)
Power dynamics and trust among health professionals are observed, with
professionals using their power to protect their autonomy, power imbalances between
private and public sector providers, and attempts to reduce dependency on others to
maintain power. These power dynamics influence the strategic choices made by
health professionals regarding collaboration, impacting patient experiences. Trust is
identified as a crucial element in collaboration, developed through factors such as role
perceptions, demonstrated competence, and effective communication. However,
despite government policies promoting shared decision-making, its implementation
remains limited. The complexity of interprofessional relationships, particularly in the
delivery of primary and community-based health services across organizational
boundaries, adds challenges. The changing roles and boundaries generate uncertainty
and vulnerability, affecting trust levels and leading to mistrust. Ultimately, these
power dynamics and levels of trust directly influence patient experiences, highlighting
the importance of addressing power imbalances and fostering trust to improve
collaboration and enhance patient care.(5)
Study that was conducted by also showed that Communication barrier can arise by
using complex medical terminologies and jargon. Healthcare professionals, including
nurses, often use specialized terminology that may not be easily understood by all
team members. This can create confusion and misinterpretation of information,
leading to errors or conflicts arising from misunderstandings. Effective
communication requires clear and concise language that is easily understood by all
members of the team. And also time constraints and high workload in the acute care
setting can also contribute to communication barriers. Nurses and other healthcare
professionals often face time pressures, requiring them to convey information quickly
and efficiently. This can result in incomplete or unclear communication, leading to
gaps in understanding and potential conflicts. Additionally, the fast-paced nature of
the acute care setting may limit opportunities for team members to engage in thorough
discussions or seek clarification, further exacerbating communication barriers.(6)
2
research aims to uncover the organizational culture factors that hinder successful
collaboration, such as resistance to change or the absence of a learning culture. It will
also investigate communication barriers, including the use of complex medical
terminologies and time constraints, which can impede effective teamwork.
Additionally, the study will explore power dynamics among healthcare professionals
and their influence on collaboration, trust, and shared decision-making. Furthermore,
the role of interprofessional education in improving collaboration and patient
outcomes will be examined. Overall, this research will provide a comprehensive
understanding of the challenges faced by the hospital and offer valuable
recommendations for enhancing multidisciplinary collaboration, communication, and
patient care.
1.2.1 Introduction
In contemporary healthcare systems, the provision of high-quality patient care
requires the collaboration and coordination of diverse healthcare professionals within
multidisciplinary teams(8) (MDTs). MDTs consisting of professionals from different
disciplines, such as physicians, nurses, pharmacists, social workers, and allied health
professionals, have become the norm in complex healthcare settings due to their
potential to improve patient outcomes, enhance care coordination, and optimize
resource utilization (9)
This literature review aims to explore the challenges faced by MDTs in healthcare
settings, focusing on the factors that impact collaboration and hinder the achievement
of desired outcomes. this review will examine the literature on the challenges related
to communication barriers, role ambiguity, power dynamics, divergent goals, and
interprofessional conflicts within MDTs. By examining the evidence from various
healthcare contexts, this review seeks to provide a comprehensive understanding of
3
the challenges faced by MDTs in different settings and identify common themes and
patterns.
Communication Barriers
A study conducted in USA California the authors emphasize the need for greater
collaboration between professions, taking into account the unique knowledge and
expertise of professionals in each field and the impact on client outcomes. The
importance of shared values and ethics among professionals, as well as a respect for
the unique expertise each discipline brings to the table. It calls for a better
understanding of other professions and their contributions to treatment, and suggests
that students and trainees in these fields should recognize the value of
multidisciplinary teams and the expertise available within them. According to the
study absence of the capacity to actively listen, to engage in dialogue, and to reflect
another person’s point of view may derail an interdisciplinary collaborative
effort.While the article briefly mentions the need for greater collaboration and the
impact of differing scopes of practice and training, it does not extensively explore the
barriers or challenges that professionals face in working collaboratively and but it
does not delve into the empirical evidence demonstrating the impact of such
collaboration on client outcomes.(10)
4
A prospective observational study that was conducted in children’s hospital in
Philadelphia nd the University of Pittsburgh Medical Centerallowed for the systematic
examination of communication patterns, teamwork, and collaboration within the
interprofessional team setting.The study finds that physicians dominate the speaking
time during team meetings, while non-physicians have limited opportunities to
contribute. This communication imbalance can hinder effective teamwork and
collaboration within the team. The study found that physicians spoke for an average
of 83.9% of each meeting's duration (with a standard deviation of 7.5%), while non-
physicians (presumably other members of the interprofessional team) averaged 9.9%
of the meeting's duration (with a standard deviation of 5.2%). These findings indicate
a significant difference in speaking time between physicians and non-physicians,
suggesting an imbalance in participation and communication patterns within the team.
(12)
Organizational Factors
5
multidisciplinary team collaboration The review emphasizes the importance of
understanding the organizational context in which IPE initiatives are implemented.
Factors such as the culture, structure, and resources of the organization can
significantly impact the success of IPE. Therefore, it is necessary to align IPE efforts
with the goals and priorities of the organization. Furthermore the study suggests
exploring the effectiveness of interprofessional team-based learning by bringing
together learners from different professions to work on shared tasks or case scenarios,
fostering collaboration, communication, and problem-solving skills. Team-based
learning can simulate real-world healthcare settings and enhance the readiness of
learners for interprofessional practice.(15)
A concurrent mixed research method design that was conducted in the northwest
region of Ethiopia. Specifically, teaching and referral hospitals on 2022, among 279
nurses and 87 physicians revealed that unsatisfactory organizational support, poor
professional support, and poor interpersonal support were independently associated
with ineffective collaboration among nurses and physicians. a significant number of
the respondents (43.4%) reported ineffective collaboration during their professional
activities.Participants reported that ineffective communication between nurses and
physicians hindered collaboration.Furthermore the qualitative data indicated instances
where both nurses and physicians did not fulfill their professional responsibilities,
which impeded collaboration. This could include neglecting to consult with each
6
other, not sharing important patient information, or not involving the appropriate
healthcare professional in decision-making.The qualitative findings identified
unsatisfactory organizational support as a significant barrier to collaboration. This
could involve inadequate resources, lack of clear policies and guidelines, or
insufficient support from management or administration. However the study fails to
Includes broader range of healthcare professional’s policy makers and incorporating
patient perspectives which could have provided valuable insights into the
collaborative dynamics and outcomes of healthcare delivery.(17)
Team Factors
A collaborative study was conducted in the USA by using a mixed method approach
by combining both quantitative and qualitative approach. The study managed to find
out common challenges faced by healthcare teams and strategies for overcoming
them. Among the challenges were accountability, conflict management, decision-
making, reflecting on Progress, coaching. The study proposed a comprehensive
framework for team effectiveness that can be applied to different types of healthcare
teams. The framework consists of multiple levels that build upon each other to
contribute to the development of ideal team states. Strategies and guidance for
managing each of the identified challenges were provided based on the researcher’s
collective experience with Team Development Interventions (TDIs). However the
study does not explicitly discuss the influence of cultural, organizational and
contextual factors on teamwork in healthcare. (18)
A qualitative study using the Theoretical Domain Framework (TDF) was conducted
in Canada in 2021, with a total of 66 OR healthcare professionals participated,
including registered nurses, practical nurses, anesthesiologists, surgeons, and
perfusionists. The study managed to figure out enablers of effective teamwork like
people management, shared definition of teamwork, communication strategies,
positive emotions, familiarity with team members, and alignment of teamwork with
professional roles. On the other hand, barriers to teamwork included others'
personalities, gender dynamics, hierarchies, resource issues, lack of knowledge of best
teamwork practices, negative emotions, conflicting norms and perceptions across
professions, unfamiliarity with team members, and challenges related to on-call and
night shifts. The study demonstrates the application of the Theoretical Domains
7
Framework in understanding the determinants of interprofessional behavior and
informs the development of evidence-based interventions to improve teamwork.
However while qualitative research provides rich insights and in-depth understanding
of the experiences and perspectives of healthcare professionals, quantitative research
can offer additional information on the prevalence and impact of the identified
barriers and enablers. The study lacks a quantitative research approach that could
complement the qualitative data. (19)
A qualitative study with grounded theory analysis that was conducted in Sabah
Malaysia identified several barriers that hindered collaboration in the mental health
system. These barriers included Lack of autonomy: Limited decision-making
authority or independence for individuals or systems involved in the mental health
system. Lack of relatedness, a lack of trust, understanding, or caring about each other
among stakeholders.. Lack of motivation: A lack of willingness or motivation to
engage in collaborative efforts. Lack of resources: Inadequate availability of
competence, time, physical resources, and opportunities necessary for
collaboration.The study insists the need for a conceptual framework that specifically
addresses collaboration in psychiatry, particularly in non-Western and lower- and
middle-income countries. Furthermore the study acknowledges patient-centered
approach which can lead to increased patient and care satisfaction, improved
treatment adherence, and better overall mental health outcomes.(20)
8
A discursive paper study that was conducted in Anglophone Caribbean, Jamaica on
challenges of implementing a multidisciplinary team (MDT) in a tertiary hospital in
Jamaica. A retrospective audit was conducted during the study and they managed to
establish MDT having encountered challenges along the way. Among those
challenges Established clinicians had reservations and reluctance to participate in the
MDT process. Their opinions were not readily valued, and there was a divide between
them and the younger, more recently trained clinicians who supported the MDT
concept. The MDT approach was not routinely practiced in the Anglophone
Caribbean region. Established clinicians were skeptical about the need for change and
were resistant to participating in the MDT process. While the article discusses the
challenges faced in implementing the MDT approach, it does not delve into a detailed
assessment of the specific barriers and their impact. Further research could explore
the barriers encountered in different healthcare settings and regions, as well as the
strategies to overcome them effectively.(22)
Data from the selected studies were extracted using a standardized approach. The
study collected information on study characteristics, participant demographics,
intervention details, outcome measures, and results. A narrative synthesis approach
9
was used to summarize and analyze the findings of the included studies. The main
findings of the systematic review described in the document were
Attitudes and Perceptions: Out of the 19 studies included in the review, 17 (89%)
reported statistically significant improvements in attitudes toward other disciplines
and the value placed on a team-based approach for improving patient care. This
suggests that IPE had a positive impact on changing attitudes and perceptions among
healthcare students and professionals.
As per a study (17)that was conducted among nurses and physicians in specialized
public hospitals, the northwest, Ethiopia: mixed method multi-centered cross-
sectional study" presents a research study conducted in Ethiopia to investigate inter-
professional collaboration between nurses and physicians in specialized hospitals. The
study utilized both quantitative and qualitative methods to gather data and analyze the
factors affecting collaboration.
10
unsatisfactory organizational support, poor professional support, and poor
interpersonal support as independent factors associated with ineffective collaboration.
In addition to the quantitative data, qualitative data were collected through focused
and semi-structured interviews with nine key informants. The thematic analysis of the
qualitative data revealed that poor communication, lack of professionalism, and
failure to adhere to professional duties were barriers to nurse-physician collaboration.
The study concludes that nurse-physician collaboration in the studied hospitals was
below the expected level, with a large proportion of participants experiencing
ineffective collaborations. The findings highlight the importance of improving
collaboration by enhancing organizational, professional, and interpersonal factors.
The qualitative findings support the quantitative results, emphasizing the need for
interventions to empower interprofessional collaboration.
The review identified organizational factors that impact MDT collaboration. Lack of
adequate training and education was highlighted as a major challenge, negatively
affecting the quality of care provided. Interprofessional education (IPE) interventions
were found to be beneficial in improving professional practice, enhancing
11
communication, collaboration, and patient-centered care. The organizational context,
including culture, structure, and resources, significantly influenced the success of IPE
initiatives.
1. Empirical Evidence: Some studies mentioned the need for greater collaboration and
the impact of certain factors on collaboration, but they did not delve into the empirical
evidence demonstrating the actual impact on patient outcomes. Future research should
focus on gathering empirical data to support the identified challenges and their effects
on desired outcomes.
12
strategies and interventions to enhance multidisciplinary team collaboration and
improve patient outcomes in healthcare settings.
13
1.4 Conceptual Framework for Challenges of Multidisciplinary Team
Collaboration
Team
Factors
Roles and
Communicatio
Responsiblilit Multidiscip n Barrier
y linary Active listening
Trust abd Team Information
Respect Collaborati Sharing
Decision Feedback
Making on Mechanism
Conflict
Resolution
Organizat
ional
Factors
Leadership
Resource
Allocation
Policies
IPE
14
1.3Justification of the Study
While the importance of collaboration and the need for multidisciplinary teams are
acknowledged, there is limited exploration of the specific barriers and challenges
faced by professionals in working collaboratively. By conducting this research study,
it can contribute to filling this gap in empirical evidence by providing a deeper
understanding of the challenges specific to multidisciplinary team collaboration in a
mental health hospital setting. Furthermore mental health hospitals often have distinct
characteristics and challenges compared to other healthcare settings. By focusing
specifically on multidisciplinary team collaboration within a mental health hospital,
this research study can shed light on the unique challenges faced by professionals in
this context. This knowledge can inform the development of targeted interventions
and strategies to enhance collaboration and address the specific needs of mental health
patients Specifically in St. Amanuel mental Specialized Hospital. In summary,
conducting this research study on the challenges of multidisciplinary team
collaboration in St. Amanuel Mental Specialized Hospital is significant because it
addresses a gap in empirical evidence, examines the impact on client outcomes,
considers the unique context of mental health hospitals, and has practical implications
for improving collaboration and patient care in mental health settings.
15
2. OBJECTIVE OF THE STUDY
16
3. METHODS AND MATERALS
3.3 Population
17
3.4 Eligibility Criteria
18
Demographic data (Age, sex, Marital status, Religion, Job, Educational status)
19
Qualitative Study: In-depth Interviews: Individual, semi-structured interviews will
be conducted with selected participants. These interviews will allow for a
comprehensive exploration of participants' perspectives, experiences, and challenges
related to MDT collaboration. The interviews will be audio-recorded with
participants' consent and transcribed verbatim for further analysis.
To ensure data quality in the upcoming study several measures will be implemented
Special attention will be given to ensuring that healthcare professionals clearly
understand the instructions for answering the questionnaire. They will be explicitly
instructed not to provide their names or identification on the questionnaire to
encourage open and honest responses.The filled questionnaires will be collected in the
same session to minimize the possibility of missing or incomplete data. This approach
will ensure that the data collection process is efficient and comprehensive. A pre-test
will be conducted to determine the time needed to complete one questionnaire and to
assess the understandability of the questionnaire among the study participants. The
data collected during the pre-test will not be included in the final analysis, but it will
help identify any issues or areas of improvement in the questionnaire. Prior to and
during data processing, the information collected will be checked for completeness.
This step aims to ensure that all necessary data fields are properly collected and
recorded, minimizing the chances of missing or incomplete data.
20
3.8 Data Analysis Method
Quantitative Section-To analyze the data and examine the relationship between
the identified challenges and multidisciplinary team collaboration, regression
analysis will be performed. Multiple linear regressions will be used to assess the
impact of independent variables (challenges) on the dependent variable (team
collaboration). The independent variables will include communication
breakdowns, role ambiguity, conflicts, and organizational factors. The dependent
variable, team collaboration, will be measured using a validated scale assessing
collaboration effectiveness.
The regression analysis will allow for the identification of significant predictors of
team collaboration challenges and provide insights into the relative influence of each
challenge. Additionally, it will allow for the quantification of the strength and
direction of the relationships between the independent and dependent variables. The
regression analysis will be conducted using statistical software such as SPSS version
26.
The qualitative findings will be integrated with the quantitative results obtained from
the census survey to provide a comprehensive understanding of the challenges
affecting MDT collaboration. The convergence of data from both methods will allow
for a triangulation of findings, enhancing the overall validity and reliability of the
research outcomes.
Prior to initiating the study, ethical approval will be obtained from the relevant
institutional review board or ethics committee at St. Amanuel Mental Specialized
Hospital. The research protocol, including the study design, data collection methods,
and participant confidentiality measures, will be reviewed to ensure adherence to
ethical guidelines and the protection of participants' rights.
21
Informed consent will be obtained from all participants involved in the study.
Participants were provided with detailed information about the research objectives,
procedures, potential risks, and benefits. They will be assured of their right to refuse
participation or withdraw from the study at any time without consequences. Written
consent will be obtained from participants, and their anonymity and confidentiality
were strictly maintained throughout the research process.
22
CHAPTER FOUR- WORK PLAN
Table 1: Work plan of the study
Total 65
23
CHAPTER FIVE- BUDGET BREAKDOWN
Surveys/questionnaire 4,000
4 Data Collection
Interviews/ Focus Group 8,000
Miscellaneous
5 Unforeseen Costs 10,000
Expenses
Contingency
6 Reserve Budget 15,000
Fund
Total 78,500
24
REFERENCE
1. Kaini BK. (1) (PDF) Interprofessional Team Collaboration in Health Care | Dr
Bachchu Kailash Kaini - Academia.edu. 2017;17(2). Available from:
https://www.academia.edu/33146990/Interprofessional_Team_Collaboration_i
n_Health_Care?email_work_card=title
8. Spaulding EM, Marvel FA, Jacob E, Rahman A, Hansen BR, Hanyok LA, et al.
Interprofessional education and collaboration among healthcare students and
professionals: a systematic review and call for action. J Interprof Care
[Internet]. 2021;35(4):612–21. Available from:
https://doi.org/10.1080/13561820.2019.1697214
25
9. Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional
collaboration to improve professional practice and healthcare outcomes.
Cochrane Database Syst Rev. 2017;2017(6).
12. Walter JK, Schall TE, DeWitt AG, Faerber J, Griffis H, Galligan M, et al.
Interprofessional Team Member Communication Patterns, Teamwork, and
Collaboration in Pre–family Meeting Huddles in a Pediatric Cardiac Intensive
Care Unit. J Pain Symptom Manage [Internet]. 2019;58(1):11–8. Available
from: https://doi.org/10.1016/j.jpainsymman.2019.04.009
16. Mickan SM, Rodger SA. Effective health care teams: A model of six
characteristics developed from shared perceptions. J Interprof Care.
2005;19(4):358–70.
26
18. Zajac S, Woods A, Tannenbaum S, Salas E, Holladay CL. Overcoming
Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and
Evidence-Based Guidance. Front Commun. 2021;6(March):1–20.
19. Etherington N, Burns JK, Kitto S, Brehaut JC, Britton M, Singh S, et al.
Barriers and enablers to effective interprofessional teamwork in the operating
room: A qualitative study using the Theoretical Domains Framework. PLoS
One [Internet]. 2021;16(4 April):1–19. Available from:
http://dx.doi.org/10.1371/journal.pone.0249576
22. Cawich SO, Johnson PB, Shah S, Roberts P, Arthurs M, Murphy T, et al.
Overcoming obstacles to establish a multidisciplinary team approach to
hepatobiliary diseases: A working model in a Caribbean setting. J Multidiscip
Healthc. 2014;7:227–30.
26. Quek GSM, Kwan YH, Chan CQH, Phang JK, Low LL. Validation of the
Collaborative Practice Assessment Tool (CPAT) to assess the degree of inter-
professional collaboration (IPC) in a Community Hospital in Singapore. J
27
Interprofessional Educ Pract. 2022;
ANNEX 1
Informed Consent
Participating in this research study does not involve any physical risks. However,
discussing potential challenges in multidisciplinary team collaboration may evoke
personal or professional discomfort. Should you experience any distress during the
interview, you have the right to decline answering any specific questions or withdraw
from the study at any time without penalty.
There are no direct benefits to you as a participant, but your involvement will
contribute to the advancement of knowledge in the field of multidisciplinary team
collaboration in a mental health setting. The findings from this study may help
28
identify areas for improvement and inform future interventions to enhance teamwork
and patient care outcomes.
Your confidentiality and privacy are of utmost importance in this study. All
information collected during this research will be kept strictly confidential and stored
securely. Your personal identifying information will be separated from the data
collected during the interview, ensuring that your responses remain anonymous. Only
the researcher and authorized personnel will have access to the data, and your
information will be used solely for the purpose of this study.
By signing this document, you confirm that you have read and understood the
information provided above, and that you voluntarily agree to participate in this
research study. You understand that you have the right to withdraw from the study at
any time without penalty and that your decision to participate or decline participation
will be respected.
Date: _______________________
29
Q4 Religion? 1.Orthodox
2.protestant
3.muslim
4.Catholic
5.others(specify)---------------
Q5 Ethnicity? 1.amhara
2.oromo
3.tigre
4.gurage
5.others(specify)-----------------
Q6 Job? 1.Psychiatrist
2. General Practitioner
3. MSc in ICCMH
4. Nurses
5.Pharmacist
6. Psychologist
7. Social Worker
8.others
Q7 Educational level? 1. Diploma
2. .BSc
3. MSc
4. PhD
5. Doctorate (MD)
TheOrganizationalCultureAssessmentInstrument (OCAI)
The OCAI consists of six questions. Each question has four alternatives. Divide 100
points among these four alternatives depending on the extent to which each alternative
is similar to your own organization. Give a higher number of points to the alternative
that is most similar to your organization. For example, in question one, if you think
alternative A is very similar to your organization, alternative B and C are somewhat
similar, and alternative D is hardly similar at all, you might give 55 points to A, 20
30
points to B and C, and five points to D. Just be sure your total equals 100 points for
each question.
Note, that the first pass through the six questions is labeled “Now”. This refers to the
culture, as it exists today. After you complete the “Now”, you will find the questions
repeated under a heading of “Preferred”. Your answers to these questions should be
based on how you would like the organization to look five years from now
A Theorganizationisaverypersonalplace.Itislikeanextendedfamily.Peoplese
emto share a lot ofthemselves.
D Theorganizationisaverycontrolledandstructuredplace.Formalproced
uresgenerally govern what people do.
Total
A Theleadershipintheorganizationisgenerallyconsideredtoexemplifymentor
ing,facilitating, or nurturing.
B Theleadershipintheorganizationisgenerallyconsideredtoexemplifyentrepr
eneurship,innovating, or risk taking.
C Theleadershipintheorganizationisgenerallyconsideredtoexemplifyano-
nonsense,aggressive, results-oriented focus.
D Theleadershipintheorganizationisgenerallyconsideredtoexemplifycoordi
nating,organizing,orsmooth-running efficiency.
Total
A Themanagementstyleintheorganizationischaracterizedbyteamwork,consens
us,and participation.
B Themanagementstyleintheorganizationischaracterizedbyindividualrisk-
taking,innovation, freedom, and uniqueness.
C Themanagementstyleintheorganizationischaracterizedbyhard-
drivingcompetitiveness,high demands,and achievement.
31
D
Themanagementstyleintheorganizationischaracterizedbysecurityofemploy
ment,conformity,predictability,andstabilityinrelationships.
Total
A The glue that holds the organization together is loyalty and mutual
trust.Commitmentto this organization runs high.
B The glue that holds the organization together is commitment toinnovation and
development.There is an emphasis on being on thecuttingedge.
C The glue that holds the organization together is the emphasis onachievement
and goal accomplishment.Aggressiveness and winningarecommonthemes.
Total
Total
32
C The organization defines success on the basis of winning in
themarketplaceandoutpacingthecompetition.Competitivemarketleaders
hipis key.
Total
Instructions: Please respond to the questions below by placing a check mark (√) in
the box that corresponds to your level of agreement from Strongly Disagreeto
Strongly Agree
StronglyAgree
Agree
Neutral
Disagree
StronglyDisagree
TeamStructure
Itisimportanttoaskpatientsandtheirfamilies forfeedback
1.
regardingpatientcare.
2. Patientsareacriticalcomponentofthecareteam.
Thisfacility’sadministrationinfluencesthesuccessofdirect
3.
careteams.
A team's mission is of greater value than the goals
4.
ofindividualteammembers.
Effective team members can anticipate the needs of
5.
otherteammembers.
High-performing teams in health care share
6. commoncharacteristics with high-performing teams
in otherindustries.
Leadership
33
It is important for leaders to share information with
7.
teammembers.
Leadersshouldcreateinformalopportunitiesforteam
8.
memberstoshareinformation.
Effective leaders view honest mistakes as
9.
meaningfullearningopportunities.
Itisaleader'sresponsibilitytomodelappropriateteam
10.
behavior.
It is important for leaders to take time to discuss with
11.
theirteammembers plans for each patient.
Teamleaders shouldensure thatteam members helpeach
12.
otheroutwhennecessary.
StronglyAgree
Agree
Neutral
Disagree
StronglyDisagree
SituationMonitoring
Individuals can be taught how to scan the environment
13.
forimportantsituational cues.
Monitoring patients provides an important contribution
14.
toeffectiveteam performance.
Even individuals who are not part of the direct care
15. teamshouldbeencouragedtoscan forandreportchangesin
patientstatus.
It is important to monitor the emotional and physical
16.
statusofother team members.
It is appropriate for one team member to offer assistance
17.
toanotherwhomaybetootiredorstressedtoperformatask.
Team members who monitor their emotional and
18.
physicalstatusonthe job are moreeffective.
MutualSupport
To be effective, team members should understand the
19.
workoftheir fellow teammembers.
Asking for assistance from a team member is a sign that
20.
anindividualdoesnotknowhowtodohis/herjobeffectively.
Providingassistance toteammembers isa signthat an
21.
individualdoes nothave enough workto do.
Offering to help a fellow team member with
22. his/herindividual work tasks is an effective tool for
improving teamperformance.
Itisappropriatetocontinuetoassert a patient safety concern
23.
untilyouarecertainthatithasbeenheard.
Personal conflicts between team members do not
24.
affectpatientsafety.
34
StronglyAgree
Agree
Neutral
Disagree
StronglyDisagree
Communication
Teams that do not communicate effectively
25.
significantlyincreasetheir risk ofcommittingerrors.
Poor communication is the most common cause of
26.
reportederrors.
Adverse events may be reduced by maintaining
27.
aninformationexchangewithpatientsandtheirfamilies.
Ipreferto workwithteam memberswho askquestionsabout
28.
informationIprovide.
It is important to have a standardized method for
29.
sharinginformationwhenhanding off patients.
It is nearly impossible to train individuals how to be
30.
bettercommunicators.
SomewhatAgree
MostlyDisagree
StronglyAgree
MostlyAgree
AgreenorDis
Mission,MeaningfulPurpose,Goals
Somewhat
Disagree
Neither
agree
1. Ourteammissionembodiesaninterprofessional
collaborativeapproachtopatient/clientcare.
2. Ourteam’sprimarypurposeistoassistpatients/clientsin
achievingtreatmentgoals.
3. Ourteam’sgoalsareclear,usefulandappropriatetomy
practice.
4. Ourteam’smissionandgoalsaresupportedbysufficient
resources(skills,funding,time,space).
5. Allteammembersarecommittedto collaborativepractice.
6. Membersofour teamhaveagoodunderstandingof
patient/clientcareplansandtreatmentgoals.
7. Patient/clientcareplansandtreatmentgoalsincorporate
bestpracticeguidelinesfrommultipleprofessions.
8. Thereisarealdesireamongteammemberstowork
collaboratively.
GeneralRelationships
9. Respectamongteam membersimproveswithourabilityto
worktogether.
35
10.Teammemberscareaboutoneanother’spersonalwell
being.
11.Socializingtogetherenhances teamworkeffectiveness.
12.Itisenjoyabletoworkwithotherteammembers.
13.Teammembersrespect eachother’srolesandexpertise.
14.Workingcollaborativelykeepsmost teammembers
enthusiasticandinterestedintheirjob.
15.Teammemberstrusteachother’sworkandcontributions
relatedtopatient/clientcare.
16.Ourteam’slevelofrespectforeach otherenhancesour
abilitytoworktogether.
StronglyDisagree
SomewhatAgree
MostlyDisagree
TeamLeadership
StronglyAgree
MostlyAgree
AgreenorDis
Somewhat
Disagree
Neither
agree
17.Proceduresarein placetoidentifywhowilltakethelead
roleincoordinatingpatient/clientcare.
18.Teamleadershipensuresallprofessionalsneedingto
participatehavearoleonthe team.
19.Teamleadershipassuresthat rolesandresponsibilitiesfor
patient/clientcareareclearly defined.
20.Teamleadershipdiscourages professionals fromtakingthe
initiativetosupportpatient/clientcaregoals.
21.Teamleadershipsupportsinterprofessionaldevelopment
opportunities.
22.Ourteamleadermodels,demonstratesandadvocatesfor
patient/client-centeredbestpractice.
23.Ourteamleaderisoutoftouchwithteammembers’
concernsandperceptions.
24.Ourteamleader encouragesmemberstopracticewithin
theirfullprofessionalscope.
25.Ourteamhasaprocessforpeerreview.
GeneralRoleResponsibilities,Autonomy
26.Teammembersacknowledgetheaspectsofcarewhere
membersofmyprofession havemoreskillsandexpertise.
27.Physiciansassumetheultimateresponsibilityforteam
decisionsandoutcomes.
28.Teammembersnegotiatetheroletheywanttotakein
developingandimplementingthepatient/clientcareplan.
29.Teammembersareheldaccountablefortheirwork.
30.Itisclearwhoisresponsible foraspectsofthepatient/client
careplan.
31.Physiciansusually askotherteammembersfor opinions
aboutpatient/clientcare.
32.Teammembersfeelcomfortableadvocatingforthe
patient/client.
33.Eachteammembersharesaccountabilityforteamdecisions
andoutcomes.
36
34.Teammembershavetheresponsibilitytocommunicateand
providetheirexpertisein anassertivemanner.
35.Teammembersfeellimitedin thedegreeofautonomyin
patient/clientcarethattheycanassume.
SomewhatAgree
MostlyDisagree
StronglyAgree
MostlyAgree
AgreenorDis
Somewhat
CommunicationandInformationExchange
Disagree
Strongly
Disagre
Neither
agree
e
36.Patients/clientsconcernsareaddressedeffectivelythrough
regularteam meetingsanddiscussion.
37.Ourteamhasdevelopedeffectivecommunicationstrategiestosh
arepatient/clienttreatmentgoalsand
outcomesofcare.
38.Relevant information relating to changes in
patient/clientstatusorcareplan isreportedtotheappropriateteam
memberinatimely manner.
39.Itrusttheaccuracyofinformationreportedamongteam
members.
40.Ourteammeetingsprovideanopen,comfortable,safe
placetodiscussconcerns.
41.Thepatient/clienthealthrecordisusedeffectively byall
teammembersasacommunicate 0ontool.
CommunityLinkagesandCoordinationofCare
42.Ourteamhasestablishedpartnershipswithcommunity
organizationstosupportbetterpatient/clientoutcomes.
43.Membersofourteamshareinformationrelatingto
communityresources.
44.Ourteamhasaprocesstooptimizethecoordinationof
patient/clientcare withcommunityserviceagencies.
45.Patient/clientappointmentsarecoordinatedsotheycan
seemultipleprovidersinasinglevisit.
37
S
38