Introduction
Teamwork and communication are very important in the process of providing quality healthcare in any dispensary. When these critical aspects are missing, the lives of patients are easily put in jeopardy. This state of affairs goes against the health facility’s aim of providing quality, responsive, and effective healthcare to all customers. The Quality Hospital is facing various challenges, especially in its Intensive Care Unit (ICU) where issues such as a breakdown in communication and lack of teamwork are greatly affecting service delivery. The 16-bed ICU, of the 300-bed hospital, is a critical part of the hospital’s desire to serve different customers, especially those who need critical care. Hence, poor communication and lack of teamwork are vices that must be addressed as soon as possible so that the hospital can live up to its expectations of providing quality healthcare. In the quest for addressing the challenges of communication and teamwork at Quality Hospital’s ICU, this paper provides a breakdown of the formation of a task force that will help the ICU to address the challenges it is facing. Further, the paper will address the specific challenges in the facility before providing possible solutions that the task force will highly recommend for Quality Hospital.
Challenges
Currently, the hospital is facing the following various challenges that are linked to teamwork and communication.
- Lack of effective communication during hand-offs among caregivers
- Lack of teamwork among Registered Nurses (RNs) and Nursing Assistants (NAs) on the unit
- Unsafe working environment operational failures such as unavailable equipment or machines that are not in working order, and missing patient medications have resulted in ‘workarounds’ and often delayed treatment
- Sporadic reporting of critical lab values from lab personnel to patients’ nurses
The above challenges require immediate intervention to ensure that the hospital can provide quality healthcare. However, to ensure that these challenges are addressed effectively, the process must be inclusive to ensure that the suggested solutions are agreeable to stakeholders, and most importantly, effective for the Quality Hospital’s environment.
Construction of a Taskforce
To investigate and find solutions to the problems that the ICU of Quality Hospital is facing, a task force that draws membership from various staff members will be formed as identified below. The task force will be inclusive. It will get its members from different parts of the organization. The eligible members will be determined by their expertise and skills. Such an approach will guarantee maximum representation of all interests in the hospital so that the provided solutions are effective and applicable to many areas of operation in the hospital, but most importantly, the ICU. The task force will be referred to as the Teamwork and Communication Improvement Taskforce-ICU, Quality Hospital.
Taskforce Members
The task force will constitute the following members as identified in the table below.
Schedule for Meetings
The task force will meet weekly on Wednesdays, starting from 2 pm to 4 pm, duration of 2 hours. The task force will take a duration of three (3) months, from its inception to the presentation of a report of its findings and recommendations for addressing the challenges at the ICU of Quality Hospital.
Stages of Team Development for the Taskforce
According to Meredith (2011), teams develop through five stages, which include forming, storming, norming, performing, and adjourning. The Teamwork and Communication Improvement Taskforce will not be an exception to these stages of team development. It will follow all the stages to actualize its mandate.
The first stage of team development is referred to as the forming stage. In this stage, the focus is on the formation and familiarizing of members (DeMarco & Lister, 2013). The leader plays a dominant role in this stage where he or she lays down the expected outcomes for the team. He or she also lays down the framework of how members will interact to meet the team’s key objectives (Meredith, 2011). As the leader for the Teamwork and Communication Improvement Taskforce, my focus will be on ensuring that all members of the task force understand their respective roles in the team, as well as the objectives of the task force. To accomplish this stage successfully, I will allow members to air their opinions on how to proceed with the activities of the task force, which will ensure that members feel included and that their input is valued from the start of the task force.
The second stage of teamwork development is referred to as storming phase (DeMarco & Lister, 2013). During this stage, members often push beyond the boundaries that are set during the forming stage, as their different working styles easily come into conflict. The probability of failure for a team during this stage is very high and hence the need for the team leader to create a platform where conflicts are minimized and handled properly. During this stage, success or failure of the group is easily determined (Valentine, Nembhard & Edmondson, 2012). As the leader of the task force, I will be prepared to address conflicts as they arise during this stage. My role in this stage will be ensuring that all members are heard and respected without intimidation based on their skills and roles in the task force. While members will be allowed to air their discomforts and opposing opinions, I will guarantee respect for all members. No intimidation or abusive language will be allowed. In this case, I will ensure that the raised issues are handled effectively and the dignity of all members and the team upheld.
The third stage is referred to as the norming stage where people slowly become comfortable with each other’s characteristics and expertise (Valentine et al., 2012). In this stage, team members appreciate each other’s strengths, amicably resolve their differences, and respect the authority of the leader. Further, members socialize better while at the same time providing constructive feedback as an important milestone for achieving the team’s objectives.
The fourth stage of team development is referred to as the performing stage where members are now more proactive and dedicated to meeting the objectives that the team is focused on (Meredith, 2011). Here, members express less friction and conflicts. Dedication leads to the achievement of the team’s goals.
The last stage is the adjourning stage where all members eventually reach. This stage marks the end of the team after it has achieved its objectives for the project at hand (Ulrich, 2013). Some teams may be adjourned for a short period while others may be adjourned permanently.
Contributing Factors/Underlying Causes
The problems that have been identified above have serious implications for the quality of care that is provided to patients who require intensive healthcare. However, the problems are caused by several underlying factors. Firstly, the problem of lack of effective communication during hand-offs among caregivers is caused by several issues. It is worth noting that handling patients from one health caregiver to another is an inevitable process due to the changing of shifts on the part of the caregiver, or a change of the type of expertise that the patient requires (Kalisch & Aebersold, 2006). During the hand-off process, it is very important for the outgoing and incoming caregivers to communicate effectively to ensure continuity of healthcare provision to the patient. However, if such an area is not handled correctly as it is witnessed in the case of Quality Hospital, important information may be ignored or left out during the hand-offs (Dougherty & Larson, 2010). This situation may put the patient at a high risk. The main causes of hand-off problems include poor communication, which can be brought about by lack of reporting logs or sign-out sheets. In addition, even where there are proper sign-out sheets, errors are often reported. This case contributes to an even bigger communication breakdown. According to Dougherty and Larson (2010), a study that was carried out to determine the accuracy of the information that was provided in sign-out sheets found more than 67% reporting errors. Lastly, lack of proper interaction between caregivers during handoff is another issue that the incoming and outgoing members can discuss. Aspects of the handoff information are an important factor for communication breakdown at the facility. Poor interpersonal communication and lack of teamwork are also important factors of poor handoff communication at Quality Hospital.
The second problem that the Quality Hospital’s ICU is facing is the lack of teamwork and effective delegation by RNs to NAs. This problem is common in many other healthcare facilities. It is caused by various underlying factors. For instance, a poor partnership between RNs and NAs is a major factor that hinders effective healthcare delivery and delegation (Harris, Vanderboom & Hughes, 2009). Without good partnerships, nurses are not sure of the skills and abilities of their colleagues. This gap makes the delegation very difficult. Providing effective healthcare is a team or group process. Hence, no single nurse can solely provide all the necessary care that is required for patients, especially those who receive intensive care (Dougherty & Larson, 2010). Consequently, without teamwork, it becomes difficult to communicate important information to other caregivers. Having no joint effort hinders duty delegation. The situation jeopardizes the process of providing quality healthcare.
The evident issue of unsafe practices and the working environment forms the third problem that the healthcare facility is facing. Unsafe practices and working environments are caused by many factors, including lack of adequate and elaborate occupational health, safety, and wellness policies that should address workplace hazards, personal security, and discrimination among other issues (Dougherty & Larson, 2010). Further, overloading of workload and the allocation of unmanageable and unfair work are recipes for job stress, which can lead to unsafe practices and environments (Ulrich, 2013). In addition, work schedules and workloads that do not permit a healthy work-life balance are all contributing factors to the problem. Other underlying factors include the lack of equal opportunity and treatment, poor leadership, lack of job security, poor pay and benefits, understaffing, and poor support, supervision, and mentorship among other problems.
The last issue that the ICU department of the Quality Hospital is facing is the lack of interdisciplinary collaboration among the ICU and laboratory departments. The laboratory department plays an important role in ensuring quality healthcare for patients. The laboratory is important for reporting diagnostic information that is highly needed in determining the best healthcare for a patient (Valentine et al., 2012). Poor skills and knowledge of the laboratory staff can lead to misdiagnosis and misreporting of diagnostic information, which sets a chain of reaction processes that ultimately lead to poor health care to the patient. Further, sporadic reporting of critical values of the patient to the in-charge nurses leads to poor healthcare for the patient.
Plan to Resolve the Issues
The role of the task force is not only to identify the problems that the ICU department of Quality Hospital is facing, but also to provide solutions to address the problems to guarantee quality service delivery to all patients. To address the identified challenges, the following plan will be applied used as represented in the table.
Conclusion
From the above discussion, it is evident that to address the challenges that the ICU department at Quality Hospital is facing, the central focus will be on enhancing effective communication and teamwork at all stages. As it stands, communication and teamwork processes are very poor. The situation has effectively affected the unit’s ability to provide adequate and quality care to the patients. The problems, which include the lack of effective communication during hand-offs among caregivers, lack of teamwork among RNs and Nursing Assistants (NAs) on the unit, unsafe working environment, and lack of interdisciplinary collaboration among the ICU and laboratory department can all be attributed to poor communication and lack of teamwork in the facility. Consequently, by applying the above recommendations, Teamwork and Communication Improvement Taskforce is assured that the Intensive Care Unit at Quality Hospital will provide adequate, high quality, and safe care to all critical-care patients at the facility.
Reference List
DeMarco, T., & Lister, T. (2013). Peopleware: productive projects and teams. New York, NY: Addison-Wesley.
Dougherty, B., & Larson, L. (2010). The nurse-nurse collaboration scale. Journal of Nursing Administration, 40(1), 17-25.
Harris, M., Vanderboom, C., & Hughes, R. (2009). Nursing-sensitive safety and quality outcomes: the taming of a wicked problem? Applied Nursing Research, 22(2), 146-151.
Kalisch, J., & Aebersold, M. (2006). Overcoming Barriers to Patient Safety. Nursing Economics , 24 (3), 143-148.
Meredith, R. (2011). Management teams: Why they succeed or fail. Human Resource Management International Digest, 19(3), 34-43.
Ulrich, D. (2013). Human resource champions: The next agenda for adding value and delivering results. Harvard: Harvard Business Press.
Valentine, A., Nembhard, M., & Edmondson, C. (2012). Measuring teamwork in health care settings: A review of survey instruments. Boston, MA: Harvard Business School.