3 Health Care Teams and Communication

Watch or Listen to the Following Media Clip

Media 3.1 ASL Scene [Video]. CC-BY-NC-SA 2021. Conestoga College.

Introduction

A health care team is a group of professionals contributing to the care and treatment of a patient. The team typically consists of professionals from interdisciplinary areas such as physicians, nurses, and technologists.  Communication among members of a health care team is essential for quality patient care and effective team performance. Building cooperative and respectful team relationships assist in a patient’s perception of the care they are receiving. Critical patient information needs to be shared with members of health care teams to ensure a collaborative approach. Conversely, lack of communication creates opportunities for errors to occur, quality of care diminished, and can place patient safety at risk.

Assessing What You Already Know

As you complete this activity reflect on what you already know about teams and team dynamics.

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Interpersonal Dimensions of Health Care Teams

Many components are involved in working effectively in a health care team. Communication channels bring the team together to enable patient-centred care. Therapeutic communication is an important tool that helps put the patient at ease and builds trust in the health care team. When managing patient care each member of the team will have their own interpretation of the information presented and how the information is actioned can be dependent on each member’s uniqueness, expertise, and level of involvement within the team.

Interpersonal communication is the exchange of information between two or more people involving verbal and nonverbal methods. Developed interpersonal communication skills are vital to ensure collaboration with team members to support the best interest of patients. In most health care settings, teams are formed to support patient care and outcomes. A variety of teams are found in health care settings. They can be described as interprofessional care, collaborative care, shared care, or team care.

Common Types of Health Care Teams

Primary care is the fundamental level of health services and contacts a patient has with the health care system. Primary health care teams are composed of health care providers who provide comprehensive health care within the community. As an example, a primary team could consist of a group of family physicians, nurse practitioners, practise managers, pharmacists, and health care administrators (HCAs) working to support the team. Primary care teams work to meet public and patient expectations, optimize health outcomes, and work to support and sustain the health care delivery systems.

Secondary care is concentrated health services. Secondary health care teams are composed of specialized health care providers who provide expert and specific care to patients who are often referred to them by a primary health care provider or team. Secondary health care teams are often found in a hospital setting. As an example, a patient is referred to a hospital outpatient clinic for care or inpatient emergency care. The team composition can include specialized physicians such as a cardiologist, technicians, nurses, dieticians, and HCAs.

Tertiary care is advanced and highly specialized health services. Tertiary health care teams are found in health care settings focusing on advanced treatments and extended procedures such as cancer treatment or neurosurgery. Patients are referred to tertiary health care teams by either the primary or secondary health team. Tertiary team composition typically, includes medical specialists, nurses, technicians, and HCAs.

Collaboration and Open Communication

Collaboration described in the context of the health care team involves professionals undertaking interdependent roles working together, investing in shared strategies, problem-solving, and decision making to design care plans supporting patient outcomes. Inherently, effective teams who coordinate care successfully establish methods of communication, inclusive of data management systems, team meetings, and responses to rapidly evolving public health needs.

Collaboration is a collective action focused on achieving a common goal “in a spirit of harmony and trust” (Franklin, Bernhardt, Lopez, Long-Middleton, & Davis, 2015).

Interventions to support collaborative team dynamics include:

• remove the reliance on continuing the way things have always been done, try new approaches
• encourage change, look for opportunities to find solutions, and improve processes
• support transparency in all interactions
• recognize and celebrate collaboration within the team

Judgement and Decision Making

Many thinking strategies are needed in a health care setting to ensure quality patient outcomes and accountability. Health care team members typically utilize and apply knowledge based on their scope of practice and role. Clinical reasoning is a process undertaken by health care professionals to understand a patient’s problem, analyze information, and implement interventions. Health care decision making is also a process inclusive of definable steps in a sequential order.

Self-Awareness and Identity

Most humans form self-identities through their communication with others, and much of that interaction occurs in a group context. A group may be defined as three or more individuals who affiliate, interact, or cooperate in a familial, social, or work context (Grimes M. et al., 2018).

One should aim to acquire an understanding and develop a sense of when it is important to be the leader, the collaborator, and indeed, at times, the follower. Ultimately one moves back and forth between these roles over the course of a relationship, including the relationship with the client and relationships within interprofessional collaborative teams (Wagner. J. 2018).

Technology and the Impact on Health Care Team Communication

Technology has enhanced the accessibility of team communication in health care settings with the ability to communicate through the variety of devices and channels available.  Connected health care spaces enables more agile treatment plans to develop within the team. Health care innovation allows the sharing and analyzing of patient data with team members to support decision-making capabilities. Technology can strengthen therapeutic communication team relationships when used in a consistent manner to update team members and share information practices.

Navigating Challenging Conversations and Workplace Conflict

An integral part of being a member of the health care team involves navigating challenging or difficult conversations. These conversations may arise based on a number of contributing factors such as stress, fatigue, time of day, a patient who is in pain, angry, or appears aggressive. We should attempt to approach these situations in a non-judgemental manner and avoid labelling someone as hostile or unpleasant. Practicing therapeutic communication techniques can help to de-escalate encounters.

Conflict may typically be thought of as being negative, and it understandably can produce feelings of anxiety for many people. However, conflict is not always negative. In fact, conflict can be positive and productive, leading to creative approaches, reinforced working relationships, and more efficient outcomes. Positive conflict is a conflict where there are positive outcomes—that is, the focus remains on the issues and all parties respectfully and professionally search for outcomes that are agreeable to everyone involved (Ashman M. 2018).

Diversity and the Health Care Team

Diversity in care teams involves members from multiple races, ages, genders, ethnicities, and orientations who present with various backgrounds and experiences. Health care teams composed of diverse members often have a wide range of decision-making and critical thinking abilities as they relate to health care decisions leading to more positive outcomes. Unconscious bias can impact decisions as a result of this some teams do not embrace diversity. Developing an awareness of unconscious bias allows for strategies to prevent and address it.

Check Your Understanding

After completing the chapter content, complete this activity to assess your understanding of  concepts presented.

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Summary

In this chapter you have:

• Reviewed the complexity of health care delivery systems makes the ability to work effectively as a member of the health care team an essential attribute.
• Explored different types of health care teams.
• Considered strategies for effective and productive communication channels.

Key Terms

Accountability: The act of being responsible for an action.

Affiliate: Association such as a member/ To contribute to group working conditions (Merriam Webster, n.d).

Agile: Ability to move quickly and easily (Merriam Webster, n.d).

Bias: An inclination towards a certain point of view without consideration for other points of view.

Collaborative: To work together to achieve a common goal.

Components: To contribute to a larger whole in your scope of practice.

Composition: The make-up of the team who is involved.

Comprehensive: Having vast knowledge on a topic or to cover completely.

Conversely: Opposite way of looking at something.

Implementation: To enact or start something such as a rule.

Innovation: New idea, method, or product (Merriam Webster, n.d).

Interdependent: Dependent on each other.

Interdisciplinary: More than one branch of knowledge.

Interprofessional: More than one branch of knowledge.

Neurosurgery: Surgery of the nervous system.

Primary: Main care provider.

Reasoning: To apply reasoning techniques to situations of distress.

Reliance: A thing or person someone might rely on for assistance.

Secondary: Coming after main care.

Sequential: Following a logical order.

Tertiary: Third order or level.

Transparency: Open and direct approach (Merriam Webster, n.d).

Utilized: A device that can be used for practical assistance or someone a client can ask questions of.

References

Ashman, M. (2018). Introduction to professional communications. https://pressbooks.bccampus.ca/professionalcomms/

Franklin, C. M., Bernhardt, J. M., Lopez, R. P., Long-Middleton, E. R., & Davis, S. (2015). Interprofessional teamwork and collaboration between community health workers and healthcare teams: An integrative review. Health Services Research and Managerial Epidemiology. doi:10.1177/2333392815573312

Grimes, M., Roch, S., & Simon, D. (2018). Communication for business professionals.  https://openlibrary.ecampusontario.ca/catalogue/item/?id=b100f2d8-e81d-f482-99c3-08bdfdac826c

Wagner. J. (2018). Leadership and influencing change in nursing. https://openlibrary.ecampusontario.ca/catalogue/item/?id=00e26b2d-3c99-4955-9173-fe6dee00a840

Image Descriptions

Figure 3.1: Individuals and teams often have several choices for decision-making as represented by these three doors. [Return To Figure]

Assessing What You Already Know (Text-based Activity)

Question 1

Recall the video shown at the start of the chapter showing a discussion between two health care team members, HCAs. From the options below, select the statement which describes your initial impression of the situation:

1.  One team member is not communicating effectively to assist a patient with their needs.
2.  This is simply a miscommunication and does not affect patient needs.
3.  Both team members are not communicating effectively to assist a patient with their need

Solution. The correct response is option three. Communication breakdown usually involves a series of missed opportunities and a failure to collaborate together. Read the chapter to explore health care teams and communication.

Question 2

As you complete this activity reflect on what you already know about teams and team dynamics.

Poor team work practices can lead to the following consequences. Select all that apply:

1. Solve problems
2. Incomplete communication
3. Higher risk of errors
4. Failing to utilize expertise

Solution. The correct response is Options two, three and four.

Option two. Incomplete communication. In many situations incomplete communication could affect patient care and incomplete hand-over or transfer of information can and will occur. Read the chapter to explore health care teams and communication

Option three. higher risk of errors. This could be a serious consequence when communication breaks down, it places patient safety at risk. Explore this chapter to discover communication strategies of productive health care teams

Option four. failing to utilize expertise. The failure of productive team practices can result in some teams members not contributing fully to positive patient outcomes. Read the chapter to explore health care teams and communication. Return to Activity

Check your Understanding (Text-based Activity)

Question 1

Select the term which applies to this statement: When working with others on a health care team you accept responsibility for your actions.

1. Accountability
2. Credit
3. Praise

Solution. The correct response is Option one. Accountability. All team members are accountable for their actions in a health care setting to support patient care and assist with positive care outcomes.

Question 2

When working with others it is effective to avoid decisions that favour one point of view over another based on a close minded approach. Select the term which describes this action.

1. Tolerance
2. Preference
3. Bias

The  correct response is Option three. Bias based decisions create challenges for teams to be productive and often discounts therapeutic communication based approaches.

Question 3

Interprofessional care includes, select all that apply,

1. Clear verbal communications
2. Two-way communications between professionals
3. Respectful communication

Solution: The correct response is Options one, two and three. Interprofessional care is integral to a client’s overall care. It includes respectful, clear two way communication between all professionals. Return to Activity