Teamwork As A Health Management Problem

Introduction

The management issues affecting healthcare ranges from very serious concerns that can affect the immediate worker's physical safety to those that can improve efficiency and productivity that can make the organization a preferred healthcare setting by patients (Hilliard, Powell, & Anderson, 2016). These ranges from social issues, ethical responsibilities, professional codes, legislative and environmental regulations to human resource issues such as training and development, teamwork, selection and recruitment among others as pointed out by /////. However, this paper presents a detailed analysis of teamwork as a management issue affecting effective productivity and performance of healthcare organizations. After a brief overview of teamwork and healthcare, the paper focuses on the analysis of this management problem using four different forms, i.e., human resource, structure, political, and symbolic forms. The paper then concludes with providing suggestions and recommendations that can help the managers of the healthcare organizations to find solutions towards teamwork challenges.

Interdisciplinary teamwork is an essential management model in the delivery of healthcare to various patients. In the healthcare settings, teamwork is defined as the independent interaction between two individuals with a common interest in working towards achieving the strategic goals of the healthcare as pointed out by the Global Resource Center (2015). It is a leadership requirement that involves stability so as to encourage problem solving and honest discussions.  It is hence a vital component that needs to be integrated into the healthcare service provision among the health care providers mainly for the underserved populations and communities that limitedly access the required health care services. Teamwork in the healthcare setting is characterized by collaboration and effective communication that helps in expanding the traditional roles of health workers in making decisions towards a common goal Bolman and Deal (2013).

Analysis of the situation using different frames

As a human resource function, teamwork can be effective and functional when the team members have a clear purpose as well as protocols for implementation procedures depending on their responsibilities in the organization. In his study, Barbara (2015) points out that it is the responsibility of the human resource management to ensure the healthcare organization trains the employees on the importance of embracing teamwork. It is within the teamwork platforms that discussions such as patient results, health information, suggestions of debates and other discussion forums can be done so as to improve the provision of healthcare within their respective facilities. In his study, Barbara (2015) point out these challenges to be a loss of autonomy, role ambiguity for new recruits, heightened relationship and power expectations, as well as professional, cultural differences among other challenges.

The management in the healthcare organizations hence needs to incorporate measures that can promote and reward corporation among health workers so as to sustain good relationships among them. Finding solutions to teamwork challenges requires managers to identify two main categories of team conflicts between health workers. For instance, group and dynamic interpersonal problems tend to occur as a result of poor communication, high level of unresolved conflicts, lack of effective corporation, and lack of trust among the workers. Conflict flashpoint issues also result from multiple respondents to vital health questions that lead to disconnection of the formal communication among workers, lack of coordination before undertaking essential health discussions, and lack of interdisciplinary rounds among others (Hilliard, Powell, & Anderson, 2016).

Structural frames

The structural frame of a management organization majorly focuses on the organizational architecture. It hence involves the structure, goals, roles and relationships, as well as technology and they are all coordinated to promote effective healthcare. In his study, ////// points out that the structural frame widely involves division of labor, responsibilities, procedure, rules and policies, and hierarchies that coordinate the diverse activities within the healthcare into unified efforts. The management challenge for many healthcare organizations involves the design, maintenance, and alignment of structural forms with current tasks, circumstances, technology, tasks, and health environment goals (Hilliard, Powell, & Anderson, 2016).

When these structures are not aligned effectively, management problems may arise among team members as well as the employees hence resulting to poor teamwork among them. As a result, Defoe (2013) points out that redesigning and reorganizing these factors requires effective teamwork so as to remedy any possible structural misalignment effectively.  Lack of teamwork in decision-making among the managers themselves as well as poor coordination among the employees can result in the poor development and implementation of tasks and work roles. The result is poor coordination as well as the integration of group or individual efforts as pointed out by Pettigrew et al. (2016).

Human resource frame

In the healthcare setting, the human resource frame involves emphasis to understanding people and their relationships within the working environment. For instance, the healthcare setting is made up of patients with different health complications, where others require counseling so as to motivate them. Different patients have needs, fears, feelings, development opportunities, prejudice, and skills. Human resource frame hence requires managers and clinicians to understand the fit between individuals and the organizational responsibilities (Karanovi? & Stoši?, 2016). By attending to different individuals (patients, employees, and managers), human resource frame requires the managers as well as other stakeholders to focus on this frame in meeting the needs of the organization as well as that of the patients. Effectiveness in performance can only be achieved by individuals who feel good about themselves as well as the work they do. However, these strategic goals cannot be achieved without teamwork amongst the employees as pointed out by Defoe (2013).

Is a managerial responsibility, the performance of an organization relies on different external and internal human factors. Every healthcare is setting faces challenges regarding the effective communication and good working relationships with the clinicians and patients. For instance, Munechika et al. (2014) point out that it is essential to have a good relationship and teamwork between health workers and patients to promote free information sharing that is vital for effective healthcare. In this manner, human resources frame is greatly affected by poor working relationships and lack of teamwork amongst between the healthcare providers as well as the management.

Political frame

The political frame views a healthcare setting as a jungle, an arena, or a contest that requires power and competition to win the scarce resources. Diverse beliefs, values, behaviors, interest, and skills provide a rich context to allocate power and resources within an organization (Haerkens et a., 2016). In such environments, people tend to set agendas, build coalitions, negotiate, bargain, compromise and coerce in different ways. These are the complexities of a real organizational environment especially a clinical setting that involves diversity in culture and gender. Managers face competition and struggle for power among themselves resulting in conflicts and poor teamwork. These realities can be toxic to teamwork and good relationships or even a source of creativity and good management skills that can lead to innovation and creativity in the healthcare environments. Poor teamwork and lack of coordination among the leaders lead to improper disbursement or influence and power resulting in poor performance and ineffectiveness of the organizations (Jones, Livingstone & Hawkes, 2013).

In their study, Munechika et al. (2014) point out that teamwork is a vital health intervention for several reasons. With the high level of cultural diversity in the clinical setting, health care has become more specialized and complex forcing the medical staff to attempt learning new methods and adopting complicated interventions. Increasing chronic complications such as diabetes, cancer, and heart diseases among others as well as increasing aging population requires managers and clinicians to adopt multidisciplinary health approaches. Teamwork is hence necessary to the stakeholders so as to increase effectiveness by reducing medical errors and increase safety to patients. Politicizing such vital responsibilities affects teamwork in the clinical settings leading to poor performance and lack of trust among the employees as pointed out by Jones, Livingstone, and Hawkes (2013).

Symbolic frame

The symbolic frame views the life of the organization as a drama and an arena of theater, carnivals, and temples with a major focus on faith and meaning. It mainly focuses on stories, rituals, plays, ceremonies, and cultural differences of the organizational setting. The frame vies reasons of the meaning of the certain way of life rather than the results of such responsibilities. In his study, Defoe (2015) points out that the faith build-up as we as the meaning shared by members infuses creativity and passion amongst the employees.  It hence has less dependence on the roles, rules, or managerial authority. Instead, Aitamaa et al. (2016) point out that the cultural behavior and spiritual attitude of clinicians greatly influence the effectiveness of the healthcare services and organizational effectiveness. It hence challenges leaders to create beauty, meaning, and faith on their diverse workforce so as to be effective in performance. With the cultural diversity in the clinical setting, it is the responsibility of leaders, policy makers, and managers to design strategies that will promote effective working relationship amongst the diverse workforce. However, achieving this goal has is a difficult issue as a result or poor teamwork and collaboration amongst the diverse workforce as pointed out by Hass and Mortensen (2016).

Solution to the to be adopted for effective teamwork in a healthcare setting

Transforming the working environment of the health care setting requires the responsibility of healthcare organization managers. Policy makers and system managers need to make significant attempts in transforming the healthcare workplaces into effective team-based environments. Managers need to engage in various efforts on decision-making and research so as to keep its role to support evidence-based and informed teamwork decisions and management skills. These skills are vital as it will enable the workers to exchange ideas towards achieving a common goal freely. Teamwork is a great challenge for many healthcare managers since the interprofessional conflict between health practitioners is well-documented and widespread. Even though managers and practitioners tend to adopt team training, Pettigrew et al. (2016) point out that it is not efficient in overcoming obstacles that affect the health workers.

To effectively engage in finding solutions to this teamwork as a challenge among health care practitioners, managers need to actively facilitate group dynamics such as the Robert’s Rules of Order as well as ground rules for collaboration and constructive communication. Leaders should be open to change and have strong leadership skills that can promote the forward team progress. Lovelace, Eggers, Dyck (2016) pint out that the process requires an active involvement from chief nursing and medical officers to use their positions in reinforcing the importance and need for a change. In that manner, they will promote effective overarching patient goals to promote quality improvement and safety so as to mentor progress among the employees and patients as well. Coombs (2013) also points out that it is vital to once in a while invite external organizational consultants who can consistently demonstrate confidentiality, fairness, and objectivity so that the management and employees can build trust amongst themselves. Such external consultants tend to implement different profiles of conflict dynamics that promote self-awareness, self-assessment, as well as knowledge of conflict-related behaviors according to Kalish and Kalish (2011).

The management should also promote training and coaching on professional subgroups, individuals, and whole group levels that can promote consistency, trust, good behaviors, and good working relationships. Barbara (2015) points out that successful intervention, as well as multilevel coaching among the health workers, help in the survey as conflict behavior assessments that can help in increasing self-awareness, positive behavior, and openness. Adopting these strategies will help managers to achieve a major breakthrough in the process of complex workflow process implementation (Sorensen et al., 2016). These strategies will promote working together towards achieving agreed-upon goals of health care provision so as to promote effective clinical decision-making, family-focused communication, better patient’s satisfaction, and effective nursing professional development (Haerkens et al., 2016).

Conclusion

Teamwork is an essential component of health care that promotes effective working environment amongst healthcare providers and patients. However, it is a challenge to many leaders owing to the many intra- and professional interpersonal conflicts between clinicians, patients, and even managers. It is hence very essential that managers embrace strategies that will promote trust, teamwork, and good relationships with the workers and the patients as well. To effectively promote teamwork, managers have the responsibility of delegating the roles of every team member. The manager should practice collaboration, handle conflicts without partiality and with clearly defined management and collaborative approaches to the healthcare.

References

Aitamaa, E., Leino-Kilpi, H., Iltanen, S., & Suhonen, R. (2016). Ethical problems in nursing management. Nursing Ethics, 23(6), 646-658. doi:10.1177/0969733015579309

Barbara, E, (2015), Improving Physician-Nurse Teamwork, Retrieved from https://www.hhnmag.com/articles/3626-improving-physician-nurse-teamwork

Bolman, L, & Deal, T. (2013). Reframing organizations:  Artistry, choice, and leadership (3rd ed.). San Francisco: Jossey-Bass [Chapter 1.].  

Coombs, M. (2013). Power and conflict in intensive care clinical decision making.Intensive and Critical Care Nursing, 19, 125-135.

Defoe, D (2013). Understanding Organizations Using the Four Frame Model: Factories or Machines [Structure], Family [Human Resources], Jungle [Politics], and Theatres, Temples or Carnivals [Symbols], Journal of Nursing Administration, 37, no. 2: 77-84. https://www.psycholawlogy.com

Haas, M., & Mortensen, M (2016). The Secrets of Great Teamwork. Harvard Business Review, 94, 6, pp. 70-76,

Haerkens, M. M., van Leeuwen, W., Sexton, J. B., Pickkers, P., & van der Hoeven, J. G. (2016). Validation of the Dutch language version of the Safety Attitudes Questionnaire (SAQ-NL). BMC Health Services Research, 161-8. doi:10.1186/s12913-016-1648-3

Hilliard, M. E., Powell, P. W., & Anderson, B. J. (2016). Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. American Psychologist, 71(7), 590-601. doi:10.1037/a0040359

Jones, F., Livingstone, E., & Hawkes, L. (2013). 'Getting the Balance between Encouragement and Taking Over' - Reflections on Using a New Stroke Self-Management Programme. Physiotherapy Research International, 18(2), 91-99.

Kalish, B.J., & Kalish, P.A. (2011). An analysis of the source of physician-nurse conflict.Journal of Nursing Administration, 7, 50-51.

Karanovi?, N., & Stoši?, S. (2016). The impact of motivation, personal traits of managers and management education on the performances of public healthcare facilities. Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal Of Serbia, 73(9), 831-837. doi:10.2298/VSP150121070D

LOVELACE, K. J., EGGERS, F., & DYCK, L. R. (2016). I Do and I Understand: Assessing the Utility of Web-Based Management Simulations to Develop Critical Thinking Skills. Academy Of Management Learning & Education, 15(1), 100-121. doi:10.5465/amle.2013.0203

Munechika, M., Sano, M., Jin, H., & Kajihara, C. (2014). Quality management system for health care and its effectiveness. Total Quality Management & Business Excellence, 25(7/8), 889-896. doi:10.1080/14783363.2014.906112

Pettigrew, M. m., Forman, H. P., Pistell, A. F., & Nembhard, I. M. (2015). Innovating in Health Care Management Education: Development of an Accelerated MBA and MPH Degree Program at Yale. American Journal Of Public Health, 105S68-S72.

Sexton, J. B . (2016) Looking back on teamwork challenges, Receivables Report for America's Health Care Financial Managers, 31(5), 8-9.

Sorensen, T. D., Pestka, D., Sorge, L. A., Wallace, M. L., & Schommer, J. (2016). A qualitative evaluation of medication management services in six Minnesota health systems. American Journal Of Health-System Pharmacy, 73307-314. doi:10.2146/ajhp150212

The ICD-10 Transition: Good News and Bad News. (2016). Receivables Report for America's Health Care Financial Managers, 31(5), 1-9.