NURS 8302 Strategies for Building Effective Teams

Sample Answer for NURS 8302 Strategies for Building Effective Teams Included After Question

By Day 3 of Week 7

Post a brief explanation of a strategy you might recommend for building effective teams to support a quality improvement initiative in your healthcare organization or nursing practice. Be specific. Briefly describe the stakeholders you would recommend to make up this quality improvement team, and explain why. Be sure to define the roles of the members making up the quality improvement team. Then, explain any potential challenges or considerations you should keep in mind that may affect who might “earn a seat at the table” to comprise this team. Be specific and provide examples.

By Day 6 of Week 7

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or offering an alternative strategy recommendation and/or alternative stakeholders to take part in the quality improvement team described by your colleague.

A Sample Answer For the Assignment: NURS 8302 Strategies for Building Effective Teams

Title: NURS 8302 Strategies for Building Effective Teams

Strategies for Building effective Quality Improvement Teams

Primary care clinics manage several chronic diseases, and diabetes is one such chronic disease requiring intense management. However, evidence suggests clinical practice gaps in diabetes care (Mukerji et al.,2019). As a family nurse practitioner and certified diabetes care specialist affiliated at a community clinic, applying a quality improvement (QI) strategy are apparent in improving such gaps in care delivery. One way of such an application is developing a QI team. Quality improvement teams are mechanism healthcare industry utilize to initiate and implement improvements within its organization (Rowland et al., 2018).

This team comprises individuals from various disciplines and departments working together to identify problems, design solutions through testing, and implement a sustainable plan to accomplish the QI goals set in place (Rowland et al., 2018). Therefore, it becomes essential for a successful improvement effort to include the right people within the organization as team members suitable to meet the needs of the organization or department (Institute for Healthcare Improvement, 2021).

The effectiveness of the QI process often depends on the ability of the improvement team members to work well together with the healthcare system. Some of the qualities of a team member include but are not limited to the following: one respected by a broad range of staff, a team player, a good communicator and listener, a problem solver, creative, and one who is ready for change due to frustration with the current situation. (U.S. Department of Health and Human Services Health and Services Administration. (n.d.)). Additionally, it is also important to include members possessing three different kinds of expertise within the organization, namely system leadership, technical expertise, and day-to-day leadership, to drive improvement successfully (Institute for Healthcare Improvement, 2021).

The role of a strong leader is crucial because such a leader should understand the implications of the changes and the consequences of the proposed change to the organizational system; therefore, the leader should be one with clinical expertise with authority in the healthcare organization. For example, the medical director of the community primary care center’s primary is the QI leader of our organization. Secondly is selecting a technical expert knowledge about the care process, providing technical support, assisting with design, measuring tools, interpreting, and displaying data such as models for improvement, the plan do-study act cycles, workflow mapping (AHRQ, 2013).

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Thirdly, is selecting day-to-day leadership. According to IHI (2021), this individual team member has a vital role because they oversee data collection, ensure implementation, and understand the system’s details and the effects of making changes in the system. Additionally, this individual should have a good working relationship with the leader and front-line clinician, or nurse manager fit such description. Lastly is the project sponsor, who can be the chief operating officer in an organization who may not necessarily participate with the QI team but stay apprised with teams’ progress because of the crucial position by serving as a link to the QI team and senior management in obtaining resources and help overcome barriers on behalf of the team (AHRQ, 2013).

NURS 8302 Strategies for Building Effective Teams
NURS 8302 Strategies for Building Effective Teams

 Finally, stakeholders in a QI team are those staff members, physicians, such as nurses, Dietitians, medical assistants who have an interest and can influence the outcome of QI implementation. Organizations such as primary care clinics or any healthcare setting embarking on QI should seek and identify stakeholders who will buy in to change projects early to develop a positive relationship, thus preventing conflict and delays of project implementation from creating sustainable change in the organization (AHRQ, 2013).

References

Agency for Healthcare Research and Quality. (2013). Model 14. Creating quality improvement teams and QI plans. https://www.ahrq.gov/ncepcr/tools/pf-handbook/mod14.html

Institute for Healthcare Improvement. (n.d.). Science of improvement: Forming the team. http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementFormingtheTeam.aspx

Mukerji, G., Halperin, I., Segal, P., Sutton, L., Wong, R., Caplan, L., Whitham, D., and Gilmour, J. A. (2019). Beginning a diabetes quality improvement project. Canadian Journal of Diabetes. 43(4): 234-240

Rowland, P., Lising, D., Sinclair, L., Baker, R. G. (2018). Team dynamics within quality improvement teams: a scoping review. International Journal for Quality in Health Care. 30(6), 416–422

U.S. Department of Health and Human Services Health and Services Administration. (n.d.). Improvement teams. http:// www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/improvementteams.pdf.

A Sample Answer 2 For the Assignment: NURS 8302 Strategies for Building Effective Teams

Title: NURS 8302 Strategies for Building Effective Teams

Strategy for Building Effective Teams to Support a Quality Improvement Initiative

Quality improvement (QI) in medical practices is a method for continuously finding better ways to provide better patient care and service. At its core, QI is a team process. Before assembling a QI team, it is recommended to create an infrastructure within the practice that will support the team’s work. Without such infrastructure, teams risk being set adrift with no clear course, no resources, and no destination.

Some strategies are to be a QI champion and actively support the teams (Schwarz et al., 2019). Without strong endorsement, support, and resources from practice leaders, teams will struggle. In larger practices, it is recommended to pull together an interdisciplinary oversight group, such as a quality council, that keeps the QI momentum going and provides guidance and resources to the teams.

For smaller practices, a physician and office manager can provide this function. One can cultivate a spirit of QI within the practice that continuously encourages everyone to improve services and programs. One can even develop a set of improvement principles to help guide the practice. One can identify internal experts or external consultants who have experience and training in QI to help get the teams started. Staff members’ skills can be developed in data collection, analysis, information retrieval, such as conducting literature searches and accessing databases (Van Zelm et al., 2019). 

Before a team can be assembled and begin its work, one must establish what the team is to accomplish and why. One should establish clear parameters and goals for the QI project and define the team’s mission (Van Zelm et al., 2019). 

Stakeholders to Make Up this quality improvement team

Stakeholders are individuals or groups who have an interest in a project and can influence its outcome. They may support or resist changes that are part of improvement. Identifying stakeholders who can affect your project early is essential so that these relationships can be developed. Stakeholder mapping and analysis are valuable tools, and these are reviewed to help identify individuals who might have a vested interest in the project. After stakeholders are identified, the stakeholder map requires analysis to determine which stakeholders to approach. Analysis requires prioritization of different stakeholders because it is not feasible or necessary to engage all stakeholders with the same level of intensity. 

Stakeholder analysis also involves consideration of stakeholder motivations that may act as facilitators or barriers. These motivations may include patient care, finances, process efficiency, staff satisfaction, or staff recognition. Different stakeholders have different perspectives on a given quality improvement initiative. Therefore, stakeholder engagement strategies may have to be individualized to build a change team and overcome resistance to change. It is important to note that stakeholder mapping and analysis are dynamic processes, with new stakeholders emerging and stakeholder influence and interests changing as a quality improvement project evolves (Schwarz et al., 2019).

Members Making up the Quality Improvement Team

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. The members making up the quality improvement team including team lead, the individual responsible for the day-to-day management of the quality improvement project, who is also part of the system that will change; the technical experts, the individuals who understand different components of the quality of care problem and constitute a significant part of the system that needs to be improved; the clinical/system leader, the manager who understands the implications of changes on other parts of the system, with sufficient authority to test changes that are recommended by the team lead and technical experts; the improvement advisor, the individual with expertise in quality improvement methods to act as a resource and advisor for the team lead and technical experts; and the executive sponsor, the individual with power and leadership skill within the organization who can be approached when needed to secure resources and remove barriers.

Filling these roles will help ensure that an improvement team possesses the right balance of leadership, management, expertise, and power to succeed. Although these team members can come from any area of health care, the role of physicians and patients/families in quality improvement has garnered the most attention (Silver et al., 2016).

References

Silver, S. A., Harel, Z., McQuillan, R., Weizman, A. V., Thomas, A., Chertow, G. M., Nesrallah, G., Bell, C. M., & Chan, C. T. (2016). How to Begin a Quality Improvement Project. Clinical journal of the American Society of Nephrology: CJASN, 11(5), 893–900. https://doi.org/10.2215/CJN.11491015

Schwarz, M., Landis, S. E., & Rowe, J. (2019). A Team Approach to Quality Improvement. Family Practice Management Journal 6(4), 25-30.

Van Zelm, R., Sermeus, W., Coeckelberghs, E., Seys, D., Panella, M., & Vanhaecht, K. (2019). Setting improvement priorities: Importance-Performance-Analysis in care pathways for integrated care. International Journal of Integrated Care (IJIC), 19(S1), 1–2. https://doi-org.ezp.waldenulibrary.org/10.5334/ijic.s3297

A Sample Answer 3 For the Assignment: NURS 8302 Strategies for Building Effective Teams

Title: NURS 8302 Strategies for Building Effective Teams

Quality improvement (QI) is any systematic process that seeks to improve patient safety or clinical effectiveness in healthcare.  The QI team meets regularly to review performance data, identify areas needing improvement, and carry out and monitor improvement efforts using a variety of QI approaches and tools, consisting of the Model for Improvement (MFI), Plan-Do-Study-Act (PDSA) cycles, workflow mapping, assessments, audit and feedback, benchmarking, and best practices research.

Knox and Brach (2015) state that the QI team members should include clinical leadership or an individual with the authority to test and implement a change and to problem-solve issues that arise in the process.  There should be numerous technical expertise, like experts in the QI process and experts in health information technology.  Day-day leadership should be in the team as the lead for the QI team, ensuring the completion of team tasks.  Project sponsorship has the executive authority and serves as the link to the QI team and organization’s senior management.  The QI team should have a clearly identified “practice champion” who is committed to the cause and ensures that the team functions effectively and fulfills its goals for the organization (Knox & Brach, 2015).  Other potential members of the QI team: physicians, nursing staff, as they probably will be the ones implementing the change after it has been approved; medical directors, pharmacy, case managers, directors of clinical services, and patients, as they will be the greatest critics for what is about to be implemented, etc.

A project manager might still find herself dealing with conflict even as ground rules are stated clearly.  Not all conflicts are bad, but it is essential to learn to deal with disputes professionally (Sipes, 2020).  Not all team members can get along, but everyone should act professionally and cordially with each other.  As a charge nurse, I do not always like everyone I work with, but since I still have to work with him/her, I act cordially unless he/she is acting completely rude.  I just ignore it and move along.  I still do not understand why people feel the need to be rude, but I try not to think about it too much.  I was told once by a wise old person that sometimes, people are just rude.  We should only worry about things we can change, and we cannot change how other people behave.

A Sample Answer 4 For the Assignment: NURS 8302 Strategies for Building Effective Teams

Title: NURS 8302 Strategies for Building Effective Teams

Building Effective Teams to Support Quality Improvement

Developing a high-reliability organization that focuses on “zero” harm to our patients requires a leadership team willing to be courageous and to take risks in redesigning how we provide healthcare. In a paper published by the Institute of Healthcare Improvement, Swensen et al. (2013) identified five characteristics of a high-performing leadership team. The behaviors were identified as person-centeredness, authentic engagement with all levels of the organization, relentless concentration, transparency, and “no silos.” The identified strategy for building effective teams is to put these values front and center when making organizational decisions. I have worked in an organization that starts every decision-making process by stating who we are and what we stand for. We repeated those values at the beginning of every session. All levels of the organization could recite those five values. It was a powerful tool to align everyone to our purpose and to understand how decisions were made and implemented (Nash et al. 2019).

The stakeholders within a quality improvement team must be diverse and multidisciplinary. One of the most successful projects I was involved in was improving efficiency in the operating room. The group had OR staff, anesthesiologists, surgeons, and leadership; however, the most influential members were a pediatrician and an emergency department physician. These two people, who did not utilize the services in the OR, had  different perspectives on how the team could improve overall performance. I have always used the learnings from this exercise to include people not intimately involved with the issue or problem. Sometimes, we get overinvolved in our issues and have difficulty being objective and open to dialogue. Members of the team with different perspectives and backgrounds may interpret the problem differently, which creates more robust decision-making (Schmutz, et al. 2019).

When defining a quality improvement project charter stakeholders to be included are the content experts, the associated partners, and representatives from quality, safety, and leadership. For example, if we are implementing an evidence-based practice, I would include nursing staff and nursing management from the identified units, key physicians in leadership and physicians who  admit patients to the identified units, and representatives from the departments of quality and patient safety. Senior leadership must be involved at all levels of the project. In addition, I would select two clinical leaders in the organization who have had success in leading teams, but do not have a direct impact on the work.

A challenge in defining teams is how big is necessary to demonstrate inclusion and support. Large teams have more significant opportunities for different perspectives, but coordinating can be challenging (Schmutz et al. 2019). In the example of the OR group that I mentioned, it was an ongoing issue of ensuring participation by the members because of the multiple meetings. We identified up front what the time commitment would be and used this to select members. The meetings were held from 6-8 pm every other Tuesday, a multi-course dinner was served, and we stateded there would be no more than four meetings. All as a way of keeping interest and engagement in the process.  

References

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (2019). The Healthcare Quality Book: Vision, Strategy, and Tools. Chicago, IL: Health Administration Press.

Schmutz, J. B., Meier, L. L., & Manser, T. (2019). How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: A systematic review and meta-analysis. BMJ Open, 9 (9), e028280. https://doiorg/10.1136/bmjopen-2018-028280 Swensen, S., Pugh, M., McMullan, C., Kabcenell, A. (2013).  High-Impact Leadership: Improve Care,Improve the Health of Populations, and Reduce Costs. IHI White Paper. Cambridge, MA: Institute for Healthcare Improvement.