INTRA-DISCIPLINARY AND MULTI-DISCIPLINARY

TEAM WORK AND COLLABORATION

• LEARNING OBJECTIVES:
• ENSURE INTRA-AGENCY, INTERAGENCY, MULTI-
DISCIPLINARY AND SECTORAL COLLABORATION IN THE
DELIVERY OF HEALTH CARE
• IMPLEMENT STRATEGIES/ APPROACHES TO ENHANCE/
SUPPORT THE CAPABILITY OF THE CLIENT AND CARE
PROVIDERS TO PARTICIPATE IN DECISION MAKING BY
THE INTER- PROFESSIONAL TEAM
MAINTAIN HARMONIOUS AND COLLEGIAL RELATIONSHIP
AMONG MEMBERS OF THE HEALTH TEAM FOR EFFECTIVE,
EFFICIENT AND SAFE CLIENT CARE
COORDINATES THE TASKS/ FUNCTIONS OF THE NURSING
PERSONNEL (MIDWIFE, BHW, AND UTILITY WORKER)
COLLABORATE WITH OTHER MEMBERS OF THE HEALTH TEAM
IN THE IMPLEMENTATION OF PROGRAMS AND SERVICES.
COLLABORATE WITH GOS, NGOS AND OTHER SOCIO-CIVIC
AGENCIES TO IMPROVE HEALTH CARE SERVICES, SUPPORT
ENVIRONMENT PROTECTION POLICIES AND STRATEGIES, AND
SAFETY AND SECURITY MECHANISMS IN THE COMMUNITY
INTRA- DISCIPLINARY
-PROVIDE A LINK BETWEEN HEALTHCARE WORKERS IN THE SAME FIELD OF PRACTICE
OR EXPERTISE AND WORK TOWARDS THE ACHIEVEMENT OF A COMMON GOAL.
-USUALLY CONSIST OF A SINGLE DISCIPLINE OR ARE CONCERNED WITH A SINGLE
PATIENT CARE NEED. OPERATE WITHIN INDIVIDUAL HOSPITAL PATIENT CLINICS.
-ENCOURAGES INNOVATION IN A CERTAIN FIELD SINCE IT BRINGS TOGETHER
PROFESSIONALS IN THE SAME FIELD
-AN INTRADISCIPLINARY TEAM COMPRISES OF PEOPLE IN A SINGLE PROFESSION
WHICH HELPS TO PROVIDE ADEQUATE CARE TO THE PATIENT.
E.G. WARD SECRETARIES, RNS, NURSE EDUCATORS, PERCEPTORS, PT CARE
SPECIALISTS; NURSE ANESTHETISTS, MIDWIVES, PHYSICAL THERAPIES, SOCIAL
WORKERS
 MULTIDISCIPLINARY TEAM

ASSIST POPULATIONS TO MAINTAIN AND RESTORE FUNCTION AND

PREVENT DYSFUNCTION, NURSES COORDINATE SERVICES, OPERATE
WITHIN COMMUNITIES AND NATIONS.
E.G. LOCAL AND INTERNATIONAL HEALTH AGENCIES, EDUCATIONAL
AGENCIES.
 TEAMWORK AND COLLABORATION
• COLLABORATION- REFERS TO THE PROCESS WHERE THERE IS
PARTNERSHIP AMONG THE HEALTH CARE PROFESSIONALS WHICH IS
RECIPROCAL AND FOUNDED ON RESPECT AND TRUST, CONSIDERING
EACH OTHER’S EXPERTISE IN ACHIEVING MUTUAL GOALS

• TEAMWORK IS TO FUNCTION EFFECTIVELY WITHIN NURSING AND

INTERPROFESSIONAL TEAMS, FOSTERING OPEN COMMUNICATION,
MUTUAL RESPECT AND SHARED DECISION-MAKING TO ACHIEVE
QUALITY PATIENT CARE (ASCN 2013)
• TEAM COLLABORATION REFERS TO THE PROCESS BY
WHICH INDIVIDUALS WORK TOGETHER TO ACHIEVE A
COMMON GOAL OR COMPLETE A SHARED TASK.
• IT INVOLVES THE COORDINATION, COMMUNICATION, AND
COOPERATION OF TEAM MEMBERS WHO BRING THEIR
UNIQUE SKILLS, KNOWLEDGE, AND EXPERTISE TO
CONTRIBUTE TO THE OVERALL SUCCESS OF THE TEAM.
• EFFECTIVE TEAM COLLABORATION IS CRUCIAL IN VARIOUS
SETTINGS, INCLUDING WORKPLACES, EDUCATIONAL
INSTITUTIONS, AND COMMUNITY ORGANIZATIONS.
 KEY COMPONENTS OF THE CONCEPT OF TEAM
COLLABORATION:
SHARED GOALS- TEAM COLLABORATION STARTS WITH A CLEAR
1.

UNDERSTANDING OF SHARED GOALS. TEAM MEMBERS MUST BE ALIGNED

WITH THE OVERALL OBJECTIVES AND OUTCOMES THEY ARE WORKING
TOWARDS. THIS SHARED PURPOSE PROVIDES DIRECTION AND MOTIVATION
FOR THE TEAM.

2. COMMUNICATION- OPEN AND EFFECTIVE COMMUNICATION IS A

CORNERSTONE OF SUCCESSFUL COLLABORATION. TEAM MEMBERS NEED TO
EXPRESS THEIR IDEAS, SHARE INFORMATION, AND PROVIDE FEEDBACK TO
ENSURE EVERYONE IS ON THE SAME PAGE. COMMUNICATION CAN OCCUR
THROUGH VARIOUS CHANNELS, INCLUDING MEETINGS, EMAILS, INSTANT
MESSAGING, AND COLLABORATIVE PLATFORMS.
• COOPERATION AND COORDINATION- COLLABORATION INVOLVES A HIGH
DEGREE OF COOPERATION AND COORDINATION AMONG TEAM MEMBERS.
THIS INCLUDES DIVIDING TASKS, ASSIGNING RESPONSIBILITIES, AND
ENSURING THAT EVERYONE IS CONTRIBUTING TO THE BEST OF THEIR
ABILITIES. COORDINATION HELPS AVOID DUPLICATION OF EFFORTS AND
ENSURES THAT THE TEAM PROGRESSES EFFICIENTLY.

• RESPECT FOR DIVERSITY- EFFECTIVE COLLABORATION ACKNOWLEDGES

AND VALUES THE DIVERSITY OF TEAM MEMBERS. THIS DIVERSITY CAN
INCLUDE DIFFERENCES IN SKILLS, EXPERIENCES, PERSPECTIVES, AND
CULTURAL BACKGROUNDS. EMBRACING DIVERSITY ENHANCES CREATIVITY
AND PROBLEM-SOLVING BY BRINGING TOGETHER A RANGE OF IDEAS AND
APPROACHES.
• CONFLICT RESOLUTION- CONFLICTS ARE INEVITABLE IN ANY
COLLABORATIVE EFFORT. THE ABILITY TO ADDRESS AND RESOLVE
CONFLICTS CONSTRUCTIVELY IS A VITAL ASPECT OF SUCCESSFUL
TEAM COLLABORATION. TEAMS THAT CAN NAVIGATE CONFLICTS IN A
POSITIVE MANNER OFTEN EMERGE STRONGER AND MORE COHESIVE.

• USE OF COLLABORATIVE TOOLS AND TECHNOLOGIES- IN THE

MODERN WORKPLACE, COLLABORATION IS OFTEN FACILITATED BY
TECHNOLOGY. COLLABORATIVE TOOLS, SUCH AS PROJECT
MANAGEMENT SOFTWARE, COMMUNICATION PLATFORMS, AND
DOCUMENT SHARING TOOLS, HELP TEAM MEMBERS WORK
TOGETHER SEAMLESSLY, ESPECIALLY WHEN THEY ARE
GEOGRAPHICALLY DISPERSED.
MUTUAL ACCOUNTABILITY- EACH TEAM MEMBER IS ACCOUNTABLE
TO THE TEAM FOR THEIR CONTRIBUTIONS. THIS ACCOUNTABILITY
FOSTERS A SENSE OF RESPONSIBILITY AND ENSURES THAT
EVERYONE IS ACTIVELY PARTICIPATING AND DELIVERING ON THEIR
COMMITMENTS. TEAM MEMBERS RELY ON EACH OTHER TO ACHIEVE
COLLECTIVE SUCCESS.

FLEXIBILITY AND ADAPTABILITY- COLLABORATIVE TEAMS NEED TO

BE FLEXIBLE AND ADAPTABLE TO CHANGING CIRCUMSTANCES.
THIS INCLUDES BEING OPEN TO NEW IDEAS, ADJUSTING PLANS
WHEN NECESSARY, AND RESPONDING EFFECTIVELY TO
UNEXPECTED CHALLENGES.
CELEBRATING ACHIEVEMENTS- RECOGNIZING AND CELEBRATING
TEAM ACHIEVEMENTS, WHETHER BIG OR SMALL, REINFORCES A
POSITIVE COLLABORATIVE CULTURE. ACKNOWLEDGING
INDIVIDUAL CONTRIBUTIONS AND MILESTONES CONTRIBUTES
TO TEAM MORALE AND COHESION.

CONTINUOUS IMPROVEMENT- TEAMS THAT VALUE

COLLABORATION ARE OFTEN FOCUSED ON CONTINUOUS
IMPROVEMENT. THEY REFLECT ON THEIR PROCESSES, LEARN
FROM BOTH SUCCESSES AND FAILURES, AND SEEK WAYS TO
ENHANCE THEIR COLLABORATIVE EFFORTS OVER TIME.
1.HOSPITAL SETTING
• -PATIENT SAFETY EXPERTS AGREE THAT COMMUNICATION AND TEAMWORK
SKILLS ARE ESSENTIAL FOR PROVIDING QUALITY HEALTH CARE. WHEN ALL
CLINICAL AND NONCLINICAL STAFF COLLABORATE EFFECTIVELY, HEALTH
CARE TEAMS CAN IMPROVE PATIENT OUTCOMES, PREVENT MEDICAL
ERRORS, IMPROVE EFFICIENCY AND INCREASE PATIENT SATISFACTION.
2. COMMUNITY SETTING
• - COMMUNITY PARTNERSHIP, WHICH HAS BEEN STUDIED DURING
THE LAST 20 YEARS, HAS BEEN IDENTIFIED AS A KEY PROCESS TO
PROMOTE INTERVENTION AND RESEARCH WITHIN COMMUNITIES.
• COLLABORATION IS A COMPLEX PROCESS THAT REQUIRES INDIVIDUALS TO BE
WILLING TO SHARE INFORMATION ABOUT THE PATIENT FROM THEIR OWN AREA
OF EXPERTISE. EACH DISCIPLINE THAT CARES FOR THE PATIENT HAS ITS OWN
KNOWLEDGE, SKILLS, AND CLINICAL EXPERIENCES. MUTUAL RESPECT IS THE
BACKBONE OF A POSITIVE COLLABORATIVE ARRANGEMENT. IT IS ALSO
IMPORTANT TO FIND COMMON GROUND BETWEEN DISCIPLINES BECAUSE THERE
MAY BE DIFFERENT PATTERNS OF COMMUNICATION. INDIVIDUALS CARING FOR
THE PATIENT BRING UNIQUE CONTRIBUTIONS FROM THE VARIOUS DISCIPLINES
(KEARNEY-NUNNERY, 2016).
TEAM COLLABORATION BEYOND THE USUAL TEAM-BUILDING GAMES AND
GROUP CHATS MATTERS FOR A VARIETY OF REASONS.
THE MOST IMPORTANT (AND MOST MEASURABLE) IS THAT IT REDUCES
THE AMOUNT OF TIME AND MONEY SPENT ON COMPANY TASKS.
PRODUCTIVE TEAMS MOVE FASTER AND ACHIEVE BETTER RESULTS WHEN
THEY WORK COLLABORATIVELY THAN WHEN THEY WORK
INCONGRUENTLY.
A.BENEFITS OF TEAM COLLABORATION
 LESS TIME SPENT ON GROUP TASKS AND PROJECTS
 LESS MONEY SPENT ON RESOURCES AND EMPLOYEE HOURS TO ACCOMPLISH A
TASK
 BETTER USE OF TOOLS LIKE EMAIL, VIDEO CHAT, PROJECT MANAGEMENT TOOLS,
AND MORE
 MORE OPPORTUNITIES FOR TEAM MEMBERS TO CONTRIBUTE CREATIVE IDEAS
 IMPROVED KNOWLEDGE SHARING WITHIN THE COMPANY
 INCREASE IN TEAM-FOCUSED DECISION-MAKING VS INDIVIDUAL-FOCUSED
DECISION MAKING
 QUALITY CONTROL ACROSS PROJECTS AND CLIENT-FACING TASKS
 A MORE OPEN, ACCEPTING, AND RESPECTFUL WORK ENVIRONMENT FOR ALL
B.DEVELOPMENT OF TEAM AND COLLABORATION
INTRODUCTION
HEALTH PROFESSIONALS OFTEN ASSUME THEY ARE SKILLED AT
COMMUNICATING WITH COLLEAGUES, PATIENTS AND FAMILIES. HOWEVER, MANY
PATIENT SAFETY INCIDENTS, COMPLAINTS AND NEGLIGENCE CLAIMS INVOLVE
POOR COMMUNICATION BETWEEN HEALTHCARE STAFF OR BETWEEN STAFF AND
PATIENTS OR THEIR RELATIVES, WHICH SUGGESTS STAFF MAY OVERESTIMATE
HOW EFFECTIVELY THEY COMMUNICATE.

TEAMS THAT WORK WELL TOGETHER AND COMMUNICATE EFFECTIVELY

PERFORM BETTER AND PROVIDE SAFER CARE. THERE IS ALSO GROWING
EVIDENCE THAT TEAM TRAINING FOR HEALTHCARE STAFF MAY SAVE LIVES
(HUGHES ET AL, 2016).
TEAMWORK AND PATIENT SAFETY
 CARING FOR PATIENTS IS A TEAM ACTIVITY. EFFECTIVE PATIENT CARE RELIES ON
INDIVIDUAL STAFF, IN A WARD OR DEPARTMENT, WORKING TOGETHER
EFFECTIVELY. THE TEAM MAY COMPRISE EXCELLENT INDIVIDUAL NURSES OR
DOCTORS WHO ARE KNOWLEDGEABLE AND SKILLFUL IN A CLINICAL SENSE, BUT
FOR THIS TO BENEFIT PATIENTS, THERE ALSO NEEDS TO BE GOOD
COLLABORATION WITH EACH OTHER.
 WHEN ERRORS HAPPEN, IT IS NOT USUALLY DUE TO LACK OF TECHNICAL
KNOWLEDGE ABOUT A DISEASE OR DRUG, BUT TO POOR COMMUNICATION OR
TEAMWORK (YULE ET AL, 2006; GAWANDE ET AL, 2003).
FOR EXAMPLE, A TECHNICALLY SKILLED NURSE MAY DIAGNOSE A PATIENT’S
SEPSIS, BUT ENSURING THE CASE IS ESCALATED IN GOOD TIME ALSO
REQUIRES THE NON-TECHNICAL SKILLS OF COMMUNICATION AND
TEAMWORK.
MANY STAFF WORKING IN THE NHS WERE TRAINED UNDER THE ASSUMPTION
THAT BEING INDIVIDUALLY EXCELLENT IS ENOUGH TO KEEP PATIENTS SAFE.
THIS IS STARTING TO CHANGE, AS MANY UNDERGRADUATE NURSING
CURRICULA NOW INCLUDE SOME INTERPROFESSIONAL AND HUMAN
FACTORS TRAINING.
THE KEY ELEMENTS OF TEAMWORK ARE:
1. COMMUNICATION;
2. SITUATIONAL AWARENESS;
3. LEADERSHIP;
4. MUTUAL SUPPORT.
TOOLS FOR FACILITATING HEALTH CARE TEAM WORK
TEAM STRATEGIES & TOOLS TO ENHANCE PERFORMANCE AND PATIENT
SAFETY (TEAMSTEPPS )
 AN EVIDENCE-BASED FRAMEWORK TO OPTIMIZE TEAM PERFORMANCE
ACROSS THE HEALTH CARE DELIVERY SYSTEM.

KEY PRINCIPLES:
TEAM STRUCTURE
IDENTIFICATION OF THE COMPONENTS OF A MULTI-TEAM SYSTEM THAT
MUST WORK TOGETHER EFFECTIVELY TO ENSURE PATIENT SAFETY.
 MULTI-TEAM SYSTEM FOR PATIENT CARE
SAFE AND EFFICIENT CARE INVOLVES THE
COORDINATED ACTIVITIES OF A MULTI-TEAM SYSTEM
COMMUNICATION
 ONE LIKELY CAUSE OF ERRORS IS WHEN A HEALTH
PROFESSIONAL COMMUNICATES WITH A COLLEAGUE BUT
DOES NOT CHECK WHETHER THAT COLLEAGUE HAS
CORRECTLY RECEIVED THE MESSAGE, AND/OR WHEN THE
COLLEAGUE DOES NOT CHECK THAT THEY HAVE
UNDERSTOOD IT.
 STRUCTURED PROCESS BY WHICH INFORMATION IS CLEARLY
AND ACCURATELY EXCHANGED AMONG TEAM MEMBERS.
CALL-OUT
STRATEGY USED TO COMMUNICATE IMPORTANT OR CRITICAL INFORMATION
 INFORMS ALL TEAM MEMBERS SIMULTANEOUSLY DURING EMERGENT SITUATIONS.
 HELPS TEAM MEMBERS ANTICIPATE NEXT STEPS.
 IMPORTANT TO DIRECT RESPONSIBILITY TO A SPECIFIC INDIVIDUAL RESPONSIBLE FOR CARRYING
OUT THE TASK.

CHECK-BACK
USING CLOSED-LOOP COMMUNICATION TO ENSURE THAT INFORMATION CONVEYED BY THE SENDER
IS UNDERSTOOD BY THE RECEIVER AS INTENDED
THE STEPS INCLUDE THE FOLLOWING:
1.SENDER INITIATES THE MESSAGE.
2.RECEIVER ACCEPTS THE MESSAGE AND PROVIDES FEEDBACK.
3.SENDER DOUBLE-CHECKS TO ENSURE THAT THE MESSAGE WAS RECEIVED.
SBAR
A TECHNIQUE FOR COMMUNICATING CRITICAL INFORMATION THAT
REQUIRES IMMEDIATE ATTENTION AND ACTION CONCERNING A
PATIENT'S CONDITION
SITUATION—WHAT IS GOING ON WITH THE PATIENT
BACKGROUND—WHAT IS THE CLINICAL BACKGROUND OR CONTEXT?
ASSESSMENT—WHAT DO I THINK THE PROBLEM IS?
RECOMMENDATION AND REQUEST—WHAT WOULD I DO TO
CORRECT IT?
HANDOFF
 THE TRANSFER OF INFORMATION (ALONG WITH
AUTHORITY AND RESPONSIBILITY) DURING
TRANSITIONS IN CARE ACROSS THE CONTINUUM. IT
INCLUDES AN OPPORTUNITY TO ASK QUESTIONS,
CLARIFY, AND CONFIRM
 STRATEGY DESIGNED TO ENHANCE INFORMATION
EXCHANGE DURING TRANSITIONS IN CARE
IN SUMMARY, THE CONCEPT OF TEAM
COLLABORATION INVOLVES A GROUP OF
INDIVIDUALS WORKING TOGETHER
SYNERGISTICALLY TO ACHIEVE COMMON GOALS.
IT REQUIRES EFFECTIVE COMMUNICATION,
COOPERATION, AND A SHARED COMMITMENT TO
SUCCESS. SUCCESSFUL COLLABORATION CAN
LEAD TO INCREASED CREATIVITY, PRODUCTIVITY,