Developing Effective Team Work

Delivering Safe and High-Quality Healthcare
For effective discharging of duties by health professionals which will, in turn, give a quality service to patients under their care, there is a need for effective inter-professional communication among personnel in a hospital environment. While territoriality concept within the sector is being adhered to, that, however, should not be a barrier to a fluid collaboration among health workers of different backgrounds. There is a need to formulate a working communication strategy to solve the lingering inter-professional problems in hospital environments generally, and particularly, in the emergency department. As important as it is, a look at inter-professional communication in emergency department shows a seemingly unfavorable situation among practitioners involved in this one of the most significant subsectors of health profession (Varjoshani1, Hosseini, Khankeh, & Ahmadi, 2014). Among other numerous issues in the department, this paper looks at the problem of boisterous atmosphere in the emergency department, explores the contributing barriers to the lingering issue, and formulates a working leadership strategy needed to bring a lasting solution to the problem.
Effective healthcare delivery in the emergency department will need a team of carefully-selected qualified personnel, which includes nurses, physicians, technicians, and nursing assistants. Just as it applies in every working environment, these inter-professional team members will need a highly committed team spirit to work successfully. Unfortunately, the rowdy atmosphere in the department has been a significant hindrance to effective inter-professional teamwork among these medical personnel. Varjoshani et al., (2014), highlighted the causes of the tumultuous environment to include overcrowded emergency; stressful emergency environment; ineffective management; and inefficient communication channels. For instance, an overcrowded emergency is a major information barrier which prevents effectual scientific data exchange between physicians and nurses, and in some cases, it causes frictions among the practitioners in the course of their duty. Apart from that, it usually leads to both physical and emotional stress for the personnel, which might in turn result in errors, overreactions, and other unprofessional conducts in the department. Record has it that among other departments in hospitals, the emergency department is where most medical errors occur (Varjoshani et al., 2014). Overcrowding, in this case, may be due to the critical condition of the patient, which will require many professionals to be present, or due to a high number of agitated family members present with the patient. Either way, the situation is a significant hindrance to efficient healthcare delivery. Regarding communication failure, this in most cases is responsible for role conflict, ambiguity, interpersonal power and conflict, and other inter-professional scuffles commonly witnessed in the health sector (Busari, et al., 2017). Studies have, however, traced the root of this to some factors which according to Morley & Cashell (2017), include “compensation schemes, professional practice regulation, institutional policies, and the physical environment factors which may be beyond the control of the team.”
To bring an end to these barriers responsible for an inadequate inter-professional working relationship in the sector, many studies have proffered solutions to help alleviate the effects of these barriers caused by the tumultuous atmosphere in the emergency department, and other issues the profession generally. One of the many recommendations, as suggested by Kessler, Cheng & Mullan (2014), was a debriefing after clinical events. Debriefing, which is a reflection process in the cycle of experiential learning, helps in ascertaining areas of optimal and suboptimal performance to determine and formulate schemes for improvement in subsequent performances. If well harnessed, it would improve the delivery in the emergency department and bring a permanent solution to the lingering scuffles in the department as every stakeholder will reflect on their past actions, and agree on how to be better in their next performance. To improve communication between the healthcare professionals, Busari, et al (2017), suggested, among other things, that a competency-based approach to teamwork learning be adopted. Also, a call was made for a focus on group sessions as a platform for continuous appraisal. This, they believe will be suitable for the educational intervention for communication and continuous professional development. Different studies have proffered solutions like these and many others. Unfortunately, despite all this, there seem to be no ending in sight to the problem.
Interestingly, the availability of the methods is not enough to drive the change process needed for efficient inter-professional teamwork in the sector. As useful as the suggestions are, they require a custom leadership approach to achieve them. This is where situational leadership comes in. To achieve a result while leading a group of people, it is required that the person in the position of authority posses a high degree of leadership qualities. Being a leader involves many things, which includes being visionary, thorough, ready to sacrifice, and being flexible. Situational leadership style is an encompassment of the behavior pattern (both directive and supportive) of a person who wishes to influence others (Northhouse, 2016). To this end, it is expected of a leader to know the right leadership style needed to employ under different circumstances. The key elements to consider while in a leadership position include the personalities of followers, the mission at hand, and experience and skills of an individual follower. All these are attributes of the situational approach in leadership theory. Situational leadership is one of the most recognized approaches in leadership management, and it has been employed by many leaders to achieve results. As the name implies, it understands that followers’ skills and motivation vary over time, and as a result, a leader will be faced with different circumstance while discharging his leadership roles, and as such will need to adopt the strategy that best fits a given situation (Northhouse, 2016).
Situational approach’s credibility cannot be overemphasized, having been effectively used by many past leaders like Patricia Summitt, Dwight Eisenhower and John Wooden. During her time as the head coach of the Tennessee Lady Volunteers for over 38 years, Summitt was faced with the challenges of having to build a new basketball team every few years, a situation that requires much flexibility for a leader. However, she recorded great successes and ended her career with a 1098-208 career record. Also, she was named the head coach for the U.S. women’s basketball team to the 1984 Olympics. Similarly, Eisenhower, who was the U.S president after World War II, has a military background which equipped him with skills to order direct military exercises. However, due to his possession of situational approach of leadership traits, he was able to maintain his statesman status despite his military background, contested for president and won two terms in office (“What is Situational,” 2014).
In the situational approach, a leader is equipped with four major styles which are, styles to tell, to sell, to participate, and to delegate (“What is Situational,” 2014). Its premise is in the belief that followers, due to differences in personalities, and sometimes years of experience, and other personal and organizational factors, in many cases, will have to move from developing stage of low competence-high commitment; low to some competence-low commitment; and moderate to high competence-low commitment, before graduating to the highest developmental level, which is high competence-commitment, the developed stage whereby a follower can be said to be capable of achieving result without the leader’s interference or influence (Northhouse, 2016). So, due to the ample opportunities, options and flexibilities, it presents to a team leader, in this case, in emergency department with personnel from inter-professional backgrounds, Situational leadership approach is my best bet having found myself in the position of authority. As a team leader, my approaches will include telling, selling, participating and delegating as appropriate in different situations or with different individuals.
Having identified lack of efficient management and communication gaps as some of the barriers in my department, I will at the outset reiterate to each of my team members, his/her expected roles in a task before the commencement of duty. I will not stop at that, I will also buttress on how the roles should be carried out. People perform better when they are constantly reminded of their obligations. For instance, I will remind nurses under me of their emergency room duties which include triage; taking vital signs; administering medicines; providing treatments; monitoring patients charting, and after completion of treatment; discharging of the patient (Rapp, 2017). For the technicians under me, I will constantly remind them of their duties regarding phlebotomy procedures, collection and delivering lab samples, caring for wounds, transportation of patients and coordination of visitors, preparing patients for procedures (“ER Tech Job”). This communication will continue until the treatment completion and discharging of a patient.
Furthermore, knowing too well the negative impact of emotional and physical stress being faced by my team members as a result of tumultuous atmosphere usually witnessed in the emergency department, I will, as a selling leader, inculcate motivational approach to inspire my followers’ confidence. While the ultimate goal is patient-based, I, however, will not allow that deter me from continually praising, encouraging and persuading them before, during and after every task.
Moreover, having suggested debriefing as a working method for the improvement of emergency department performance, I will organize a weekly meeting with my team members. This will be where we will all have the chance to reflect on each of our tasks for the week with the view to improve our quality of service to patients, and welfares of my members, as it takes motivated practitioners to have happy and satisfied patients. The debriefing moments will not be a time for blame but it will be absolutely a time of reflection (Kessler, 2014). This will be an opportunity for us to collectively identify our shortcomings, celebrate our achievements in the past week, and project a better approach for the tasks ahead. With this approach, I am actively leading my team by telling and motivating. However, delegation as an integral aspect of the situational leadership approach, will not be left out. As my team members are constantly encouraged, they will be moving up the follower developmental stages. This will allow me to confidently delegate tasks according to individual’s ability, while not relenting in supervising and motivating as appropriate.
In conclusion, there is a serious need to improve inter-professional collaboration in the healthcare sector. With the empirical evidence staring us in the face, it is glaring that theory based approaches will not bring an effective solution to the lingering problems affecting inter-professional efficiency in the health sector. There is a need for practical methodology in health sector generally and in the emergency department in particular. This practical solution is what the situational approach of leadership will adequately provide. It, therefore, becomes inevitable for leaders within the health sector to embrace this tested and trusted leadership style.






References
ER Tech Job Description. JobHero. https://www.jobhero.com/er-tech-job-description/
Kessler, D., Cheng, A., & Mullan, P. (2014). Debriefing in the Emergency Department. Annals of Emergency Medicine
Morley, L. & Cashell, A. (2017). Collaboration in Health Care. Continuing Medical Journal of Medical Imaging and Radiation Sciences. 48, 207-216.
Northouse, P. G. (2007). Situational Approach. Leadership theory and practice, Thousand Oaks, CA, US: Sage Publications, Inc.7, 93-115.
Rapp, A. (2017).7 Key Responsibilities of an Emergency Room Nurse. eMedCert. Electronic Medical Certification. https://emedcert.com/blog/key-responsibilities-of-an-emergency-room-nurse
Varjoshani1, N.J., Hosseini1, M.A., Khankeh, H.R., & Ahmadi, F (2014). Tumultuous Atmosphere (Physical, Mental), The Main Barrier to Emergency Department Inter-Professional Communication. Global Journal of Health Science. Canadian Center of Science and Education; 7, 1916-9744.
“What is Situational” (2014) Leadership? How Flexibility Leads to Success. St. Thomas University. STU Online.