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Team Work and

Team Work
The way in which the team members function
and coordinate to produce synchronized
output ( patients outcomes ).
Team Process
Poor team work is causal factor underlying
critical care incidents.

Team effectiveness Communication

Performance Leadership

Errors Coordination

Patient outcomes Decision Making
Team Communication

Definition :
The way in which the team members function
and coordinate to produce a synchronized
Poor team work is a causal factor underlying
critical care incidents in ICU’s
Team Communication
 information transferred accurately during written
and verbal handover.
 Information disseminated on newly admitted patients.
 Information distributed on patient treatment plan.
 Appropriate information requests during
 Team member acknowledge communications.
 Clear and direct requests made for team assistance.
 Junior team members show speaking –up behavior
Team Communication/ Literature Review
 Communication is linked to safety and
 Errors are concentrated after communication
events such as shift changes and hand over.
 37% of these errors are associated with
communication between nurses and physicians.
 Researches demonstrate that the ICU’s with
high level of group development (e.g. mutual
trust and absence of interdisciplinary conflict)
have a lower risk adjusted morbidity rate.
Team Leadership

Definition :

The guidance of a team and involves defining
goals, expectations, organizing team
resources and coordinating team activities.
Efficient Leader
 Encourage team input.
Stating and evaluating plans.
Asserting opinions when appropriate.
Listen to staff feedback.
Delegate tasks effectively.
Prioritizing aspects of care.
Ensure team members comfort with assigned
Team Leadership/ literature Review

 Real time observation had shown association
between rating of performance and leadership
Researches have indicated that the leadership
style of the team leader influence team work.
e.g leader inclusiveness ( Listening and
encouraging Junior nurses ideas) has been shown
to increase team members involvement in PI.
Team Coordination

Concerted and synchronous performance of work
activities by team members with each team
member maintaining an awareness of one
another work.
Examples of team coordination

Nurses cross check physician
generated patient care plan.

Physicians and nurses providing
“heads-up” alerts to each others.
Team Decision Making

Definition :
Relates to decision making by the leader by
integrating information and perceptions from the
members of the team.
Team Decision Making/ Literature Review

 collaborative decision making has been linked to
improved patient outcomes.

 units with higher level of collaboration between
nurses and physicians during transfer decisions
have a lower rates of risk adjusted mortalities and
higher level of nurse and physician job
Team Process
• Output
T•Team Communication
•Patient Outcomes:
•Adverse events
•Patient mortality
• Length of stay
•Team Leadership • Unit Efficiency
• Compliance with protocols

•Team Coordination •Team Outcomes:
• Team satisfaction
• Job satisfaction
• Staff Morale
• Stress
•Team Decision Making •Burnout
• Staff turnover
Nurse Physician
Is it Important
Nurse – Physician Relationship

Collaborative Nurse- Physician
Relationships are associated with
improved patients , Nurse and
physician outcomes.
Patient Outcomes
 Improved patient satisfaction.
Improved patient transferred and
satisfaction decisions.
Improved patient care.
 Decrease length of stay
Reduce medication errors.
Nursing & Physician Outcomes
 Improved job satisfaction.
 Decrease job associated stress.
 Lower nurse turnover rate.
Improved communication amongst care
Improve understanding of the nursing role.
Improved Efficiency.
Barriers to Nurse-Physician

Role misunderstanding: real and precieved
differentials in power.

Position and respect.

Varying perceptions of decision making
input and autonomy.