True collaboration is a process, not an event. It must be ongoing and build over time, eventually resulting in a work culture where joint communication and decision-making between nurses and other disciplines, and among nurses themselves, becomes the norm (AACN, 2005).
As part of a commitment to fostering a healthy workplace, the American Association of Critical-Care Nurses (AACN) posited that true collaboration is a requirement for good patient outcomes.
While this is true of patient care, care of each other and the teams we work within should also be held to the same standards.
For the nursing student assigned a group project, a staff nurse heading up a committee at a hospital, or an educator getting ready to revise curriculum, team-based work is a given. In theory, teamwork equates to efficiency, creativity and increased resources. Realistically, conflict resolution, missed deadlines and poor buy-in ensue. There are many resources from both the business world and the healthcare sector that nurses can adopt on the next group project they will encounter. A brief discussion of some current trends in collaborative work follows.
Implementing Collaborative Techniques
Within business management theory, UC Berkeley Professor Morten Hansen writes about disciplined collaboration, maintaining that the goal “is not collaboration itself, but great results” (Hansen, 2011). Often times, a group will get caught up in team building activities. Or the team will focus on making acceptable compromises with each other to diffuse conflict and keep the team happy. The time spent on these activities is often at the expense of reaching the goal. Hansen terms this over-collaboration, and notes that over-collaboration can lead to decreased accountability and poor decision-making. Therefore, teams need to determine from the beginning which members will take on leadership roles to ensure the project stays on track.
Fostering Collaborative Efforts
With a focus purely on healthcare needs, TeamSTEPPS® (2012), a U.S. Department of Health & Human Services developed program, is designed to increase patient safety outcomes by offering a framework for healthcare professionals to successfully use collaborative efforts to meet key goals. While formal training and organizational implementation is the typical pathway to institute TeamSTEPPS, smaller groups are utilizing some of the guiding principles for smaller-scale project management. Based on three steps, collaborators are required to assess needs; plan, train and implement; and finally commit to sustainment. Key tools include gaining commitment from leadership, developing a communication plan and celebrating wins. Celebrating wins is considered a critical need, as it both recognizes contributions and provides a tangible example of the power of teamwork. For the naysayers that were involved (either closely or from afar) seeing the win provides an opportunity for them to see that success was possible and potentially help with future buy-in.
Resources to Boost Productivity
For some nurses getting ready to begin group work, the team may be highly functioning or the project scope small in nature. Enhancing the project may simply require optimal organization. As an alternative to group emails and video conferencing, consider investing in project management tools, much of which is web-based. Some examples include the Gantt Chart Principle (multiple online resources, some free) and Basecamp.com. The benefits of project management tools are that they have minimal costs, and often users pay a monthly fee. These applications allow the overall project and accompanying tasks to be mapped and tracked, and provide a centralized location for group work.
Optimizing Collaboration
For any group embarking on a team project, the most important piece will be goal agreement. Donna Belgard, RN, MSN, and nursing faculty at Kaplan Test Prep, is a life-long educator who believes that collaborative work should lead to the development of a shared vision, and once established, smaller scale decisions can be made by individuals and sub-groups within the team. Even so, when multiple stakeholders come to the table to solve complex problems, the diversity within viewpoints can derail the best intentions.
“In order for collaboration to be successful, effective communication – active listening, flexibility, developing trust – must be the cornerstone,” notes Belgard. “Effectively communicating will most likely require a daily effort so putting the collaborative hat on for a monthly meeting will not garner the best results. True collaboration is a continual process.”
References
AACN Standards for Establishing and Sustaining Health Working Environments: A Journey to Excellence. (2005) American Association of Critical-Care Nurses; Aliso Viejo, CA
Hansen, M.A. & Ibarra, H. (2011, May 16). Getting Collaboration Right. Harvard Business Review online.
TeamSTEPPS®. (December 2012). Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/redirects/teamstepps.html
