Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Are You Mindful of Your ED's Team Performance? Maybe You Should Be: (Part 2 of 2)

5/29/2014 7:05:48 PM | 2 comments

Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.

Welcome to my second post on using mindful attention to mold strong, dynamic emergency department (ED) teams. Building on what we discussed in part 1, today, we'll focus on the value of mindful attention in leading teams, plus what you can do as a leader to infuse a sense of purpose and mission into your team.

Please note that while this article focuses on ED teams, these tools and strategies can be adapted to any acute care team — and may be especially useful for cross-departmental teams.

Emphasizing the Case for Strong, Smart Teamwork

Building effective and successful ED teams can be challenging and complex at times, but it can also be pretty straightforward when we identify what it is we want to achieve.

More than anything else, positive team results come down to common sense, emotional intelligence, courage and being "present," or "mindful," day-to-day, hour-by-hour, minute-by-minute.

Staying present in today's high-tech acute care environment can be challenging.  EDs in particular operate at breakneck speed, and circumstances can change in a nanosecond. Team members grapple constantly with life-or-death decision-making and ubiquity.

That being said, teamwork in healthcare (or in any industry or organization for that matter) remains the one sustainable competitive advantage that is often largely untapped. Is this the case in your ED?

Building Great Teams Takes Focus

It's easy to lose our "mindfulness" about teams and relationships and just focus on things like the bottom line, revenue generation, technology, billing issues and marketing strategies. After all, these things produce measurable results while the value added by teams is tough to quantify.

Teamwork can be tough to measure because it impacts the outcomes of an organization in such personal ways. Human factors can be difficult to isolate as single variables. Another reason teamwork is tough to measure is that we often fail to set specific goals or aims upfront.

Despite these challenges, improving team performance can pay dividends for your department and hospital. And with focus and persistence, it's certainly possible to assess both the immediate and ongoing impact of teamwork. (For specific suggestions, see part 1.)

Creating the Conditions for Success

When people come together and set aside their individual needs for the good of the whole, they can accomplish what might appear to be the impossible! As a leader, you can create the right conditions for success by eliminating (to the best of your ability) the confusion, unnecessary clutter and politics that plague the healthcare system.

The result? People get more done in less time, with less cost and more accuracy. In a recent survey of Perspectives readers, administrators and providers identified throughput as the number one pressure facing their hospitals. So it's important to remember that taking time for your team can actually increase your efficiency — and will likely have an impact that goes far beyond your ED's walls.

Teams Need to Be Clear On Desired Outcomes

For any ED or acute care team to succeed, it should adopt a results-driven team philosophy and step-by-step action plan.

What exactly does that mean? While teams take a variety of approaches, these team-building steps can provide a foundation:

Step 1: Have team members contribute ideas for outcomes and goals. Ask everyone to be as specific as possible. What are the specific aims of your team that will lead to success? Are the aims strategic or cost-saving? Are they relationship-based? Obviously the goals must be aligned with what your team needs most.

Note that these aims and objectives should come primarily from team members themselves. The people doing the job are the ones best-equipped to help set attainable goals and come up with ways to improve processes. It's not a top-down directive that builds great teams but involvement of the team members.

Step 2: Provide a structure that commits everyone to success. Some call this a team charter. It outlines the purposes of the team and any administrative support (or other kinds of support) that will be expected and provided to the team. It's called setting people up for success!

After your list of team members is finalized (see part 1), create a document of commitment that each member can sign — all for one and one for all! By signing the charter, each member demonstrates in writing her or his commitment to the big picture.

Step 3: For meetings, use a standard team meeting agenda that focuses on actions and results. This template should include assigned action steps from previous meetings, deadlines, and new issues and process strategies for discussion. Using this type of agenda will keep the team focused on the issues at hand.

Meetings should also provide an opportunity for teams to review project progress as evidenced by the data captured. This allows for informed planning and discussion of next steps.

To aid in agenda setting, keep a "master issues" list. Allow the team to prioritize what is on the list and reprioritize when called for.

Step 4: Give praise in progress. Don't wait two or three months to recognize success. Keep the ball rolling by rewarding people for incremental improvements.

Reward the staff of ancillary departments as well. They are the end users of your improvement strategies, and their buy-in and compliance will help ensure that new processes and changes are captured and hardwired in the department.

It's okay to boast! Share your team's accomplishments with the entire hospital or health system. This establishes a foundation for facility-wide performance improvement and steers culture in the right direction. In fact, you might find others reaching out to you and your team for advice on how to foster strong commitment and teamwork in their own department.

Your overall goal is to mesh different levels of teams and different departments' representation within your organization into a well-oiled team of workers. Ideally, these highly functional teams collaborate to develop facility-wide strategies that will have lasting improvements for the patients you serve and the internal customers you work alongside of.

Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at Anne@AnneBruce.com.



Comments
Anne Bruce
Dave, thank you for taking time to reply to my article. I agree with you. The concept of a "team charter" seems to give the entire process a wee bit more credibility and accountability. Your thoughts and comments on my monthly column on "Mindfulness in Medicine," are always appreciated!
6/14/2014 5:40:09 AM

Dave Birdsall
Anne, great article. I couldn't agree more. I love the idea of a team charter.
6/11/2014 2:47:59 PM