Magazine article American Nurse Today

Creating a Nursing Dream Team: Working Together Effectively Can Improve Quality of Care and Patient Outcomes

Magazine article American Nurse Today

Creating a Nursing Dream Team: Working Together Effectively Can Improve Quality of Care and Patient Outcomes

Article excerpt

Teamwork is fundamental to successful nursing care. But many nursing teams struggle with poor communication, lack of confidence in fellow team members, lack of unity around shared goals, and disruptive behavior. The quality of professional relationships between nurses can affect the quality of patient care and healthcare outcomes, which makes teamwork an urgent topic for nurses in many practice settings. So how can you create a team that enhances the quality of care?

A framework for building a cohesive nursing unit

The concept of a transformational team provides a framework for improving cohesiveness among nursing colleagues and strengthening workplace effectiveness. Understanding and adopting the qualities of a transformational team can help a nursing unit improve quality of care and patient outcomes.

Both leaders and individual members have a role to play in creating a transformational team. A transformational leader influences individual members and the team as a whole to perform optimally, resulting in higher quality outcomes. Each team member within a transformational team has a positive influence on the team and other team members.

In this article, I discuss key factors in creating a transformational nursing team: resolving interpersonal conflict, involving all team members, and promoting and practicing informal leadership. (See Six paths to better teamwork.)

Resolving interpersonal conflict

Teamwork can be greatly enhanced by dealing effectively with conflicts between coworkers that inevitably occur, but it isn't easy. As one nurse said to me, "I don't want the drama. I don't claim it's the right thing to do, or the responsible thing to do, but naturally I just try to avoid conflict."

Interpersonal conflict can be beneficial to humans in small doses. But avoiding conflict permits it to fester, just as a local disturbance slowly expands into systemic infection. Unresolved conflict can negatively affect the entire team and harm quality of care.

Seek to become more skilled at addressing conflict. Relying on management to handle conflict is usually not as effective as dealing with coworkers directly. Learn the rules of effective communication skills and practice them. Many resources are available both online and in print to help people communicate more effectively. For example, I recommend the book Crucial Conversations: Tools for Talking When Stakes Are High. Learning to handle conflict through professional dialog is a powerful way to become more effective within an organization.

Involving all team members

Your nursing team may include registered nurses, advanced practice nurses, and licensed practical or vocational nurses. It may also encompass unlicensed assistive personnel such as nursing assistants and even unit secretaries and medical assistants. Make sure to include all team members in initiatives to build teamwork, improve patient care, and achieve quality outcomes. This inclusion also enhances motivation to engage more fully in quality improvement initiatives.

One cultural model that provides a framework for creating a more inclusive environment is Relationship-Based Care. This model emphasizes the importance of self-knowledge, self-care, cultivating relationships with the healthcare team, and forming positive relationships with patients and their families. The overarching goal is to improve relationships throughout the entire organization as a path toward improving patient outcomes and quality of care. One recent study showed evidence that Relationship-Based Care can help improve patient satisfaction and decrease length of stay and readmission rates. (See Relationship-Based Care and nursing practice.)

Principles discussed in the book The Six Secrets of Change: What the Best Leaders Do to Help Their Organizations Survive and Thrive offer another framework for building teamwork. In this book on organizational leadership, author Michael Fullan advocates purposeful peer interaction toward a common goal instead of leadership from the top down. …

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