Innovation and Change: Tools for Practice Development - Assignment Example

COLLABORATIVE WORKING RELATIONSHIPS by Student’s Name Code + Name of Course Institution City/State Professor Date Table of Contents Introduction 3 The Principles of Collaborative relationships between Nurses and Other Professionals 4 Benefits of Improved Collaboration 8 Implication of Collaboration between Nurses and Other Health Care Team Members 10 Ways of Building Collaborative Relationships 12 Conclusion 13 Reference List 14 Introduction Collaborative relationships refer to the responsibilities and activities that nurses’ share with the health care team members (Gottlieb & Nancy 2006). Such relationships are shared and the nurses’ work with other professionals to form a new relationship, which is collectively more than the sum of the individual and which lead to improved patient outcomes. There is need for nurses to facilitate cooperation and coordination among the varied members of the health care team. Offering optimal healthcare to patients’ requires skillfulness as well as the proficiency of numerous different healthcare providers. The nurses and physicians are the cornerstone of the health team as they coordinate and lead the other professionals engaged in managing numerous aspects of every patient’s care. Collaboration among physicians and nurses is regarded as a very critical the most important interaction in health care setting at present. It is the shared decision making among diverse groups who share responsibility and ownership for outcomes and decisions (Disch, Beilman & Ingbar 2001). The capacity to be aware that two individuals will have two viewpoints and probably two methods to attain optimum case for the patient, provides the health care providers the chance to share the perspective and come up with plans of care that are suitable for the patients. These collaborative relationships provide nurses a chance for practice development. When done appropriately, collaborative relationship between nurses and other health care professional help add value for them, in the introduction of innovative work practices, more effective provision of services to patients as well as removing risks from an established process. Nurses learn new skills from the other professionals especially the physicians and this boosts their capacity to offer high-quality patient care. Collaborative relationship also plays an important role in fostering the morale of the nurses. Jackson, Long & Swartz et al. (2003) noted that research supports the idea that when physicians and nurses use a collaborative approach to offer patient care, the care outcomes are of a better quality compared to when the model is not used. Research has also shown that poor relationship between nurses and other health care professionals can be unfavorable to patients’ care. Espin and Lingard (2001) study focussed on faults made in the Perioperative context and discovered that in a setting whereby relationship between nurses and physicians were not shared, the number of errors was very high. The components of a highly efficient practice setting surpass the surface of shared objectives to something more humanistic and deeper around what professionals needs to work together. Collaborative relationships between nurses and the other health care professionals improve access to care, improve the safety and quality of care, improve the efficiency and coordination of care, and improve the providers’ morale. It can also reduce burnouts in healthcare professions. To realize the full potential of the collaborative care model, the nurses have to acknowledge and accept that they have an important role in the creation of a team-based strategy to patient care. Maximizing nurses and other providers’ collaboration hold the promise of creating satisfying work roles as well as improving patient care. The Principles of Collaborative relationships between Nurses and Other Professionals Principles usually guide nurses of their synergistic position of creating, improving, and sustaining collaborative relationships in the healthcare setting. According to Gottlien and Nancy (2006), the principles and idea of collaborative partnerships have taken hold in diverse clinical practice settings with different populations. When working relationships are effective and strong, nurses and other care providers work as a team and they deliver on their collective objectives of high value care. These principles are effective communication, authentic relationship, and learning environment and culture. The ability to communicate is one of the fundamental elements of human interaction. Communication, especially in the high-intensity environment like healthcare does not only entail the transaction of words. Effective communication necessitates an understanding of the underlying situational context, the appreciation of emotions and tone of a conversation, as well as the accurate information. When implemented continuously, the principles, which related to effective communication can play a critical function in bridging the figurative divide of “us vs. them,” and ensure a dynamic and reliable way of relaying information as well as feedback. The principles of communication entail engaging in active listening in order to full comprehend and contemplate the information being relayed; knowing the intention of the message, its purpose and expectation; fostering an open and safe environment, ensuring accuracy of information; and ensuring that the right information gets to the right person. According to Way, Jones, and Busing (2000) collaborative practice is an “inter-professional process for communication and decision making that enables the separate and shared knowledge and skills of care providers to synergistically influence the client/patient care provided” (p. 3). Communication is thus an important element in the collaborative process. Every health care personnel should share with other providers’ important information on patient and matters regarding decision-making (Way, Jones & Busing 2000). The ability to present information in a concise, appropriate, and well-timed way is important to collaborative association development. Through positive communication, all team members get the combined input required to formulate valuable patient care decisions. Way, Jones & Busing argued that mutual support as well as affirmation that a partnership is working well in an important element of effective communicative and also noted that successful collaboration individuals build such opportunities into their practice. Authentic relationships are also an important principle in the collaborative practice. Professional nurses usually cultivate caring relationships with their patients, support them in meeting their physical, spiritual, and mental needs related to health. To strengthen the profession as well as quality of care received by patients, nurses should reciprocate that kind of relationship with one another and other healthcare professionals. The principle entails being true to oneself-matching actions with words; empowering others to have ideas, to share them, and to take part in projects that enact or leverage those ideas; to identify and leverage each other strengths; being honest with self and others; respecting other people needs, personalities and wants; and assuming good intention from other people words and actions. A learning environment and culture is also an important principle in building collaborative relationship. A well-developed practice environment usually support great nursing care and offer the nurses the satisfaction of acknowledging that their work is consequential and important. The principles related to a learning environment enable nurses and other professionals to thrive and do well at their work, as they are not afraid of failing. The principles entail inspiring creative and innovative thinking; committing to a cycle of assessing, improving, celebrating, and valuing what is going well; creating a culture of safety, both psychologically and physically; sharing knowledge and learning from mistakes; and questioning the status quo. These principles play an important role in nurses practice development. The other important elements in successful collaboration are coordination, responsibility, accountability, assertiveness, cooperation, autonomy, mutual respect, and trust (Way, Jones & Busing 2000). Accountability and responsibility entails both shared and independent liability. Joint accountability entails active participation in decision making by both partners and accepting shared responsibility for the care plan outcomes. Co-ordination refers to the effective and efficient organization of the required elements of the treatment plan. Referral, transfer of care, and bi-directional consultation are some of the methods, which play an important role in care coordination. Appropriate application of these mechanisms enables provision of comprehensive primary health care and guaranteed that the best-qualified professionals address the patient problem. Cooperation entails recognizing and respecting other care providers’ viewpoint and opinions while being reading to evaluate and change one’s own professional perspectives and views. This principle goes hand in hand with assertiveness. Assertiveness entails individual providers supporting the perspectives and views of their own line of work confidently. The respect that the partners have for each other professional approach entails the capability to offer viewpoints as well as opinions in a way that encourages the incorporation of the two methods leading to a synergistic or unique result. The assertiveness and cooperation of every partner means that consensus is the basis of decision-making (Way, Jones & Busing 2000). Autonomy is the ability of healthcare team members to formulate decisions and implement the treatment strategy in an independent manner. Autonomy complements shared work. According to Way, Jones and Busing (2000), without the capacity to work in an independent manner, the providers become inefficient, and the work become unmanageable. Shared trust and respected brings together every aspect of collaborative work together. Kramer and Schmalenberg (2003) argued that effective professional collaborative relationship requires mutual respect. Every provider has to depend upon the other provider integrity and this serves as the basis of the professional relationship. These principles and elements are important tools in promoting practice development for the nursing professionals. They are essential for optimum collaboration and should serve as a structure or structure. Benefits of Improved Collaboration Collaboration between nurses and other health care providers ensures that nurses excel at their work and that they deliver on the ultimate and most important objective of high value patient care. It is a complex process, which requires intentional sharing of knowledge as well as joint responsibility for patient care, this in turn plays an important role in practice development as nurses learn new things from the other professionals on patient care. Collaborative partnerships lead to better patient outcomes and personal growth for the partners in the collaboration. When all the members in the group take credit for the improved patient outcomes, professionalism is strengthened. Collaboration supports the development of a strong and effective nursing orientation to advanced practice characterized by holistic, patient-centered, and health focused care; it provides the nurses with adequate data for supporting the need as well as identifying objectives for a clearly defined role. It promotes the full use of a wide range of nursing knowledge, expertise and skills in various role domains and scope of practice and also creates an environment that support the nurse role development in the wider health care structure, practice setting and health care team. Apker, Ford, and Fox (2003) in their research on the effects of teamwork among nursing functions, noted positive results, such as helpful communication and reliance on and positive reception for each other role in taking care for the patient all through the continuum of care. Collaboration also leads to outcomes such as reinforcement of importance and worth among health care team, development of a nurturing and supportive environment; interprofessional cohesiveness, support of a “win-win” outlook, increased employee satisfaction, better use and productivity of responsibilities and better patient upshots. It also leads to increased communication amongst the group, sharing of information, practice incorporation alterations, creation of multi-disciplinary standards, and elimination of “we versus them” attitude.” Collaboration introduces changes in nursing practice because of the new knowledge and skill gained from cooperating with other health care professionals and leads to quality improvement in patient care. Through collaboration, nurses are able to have increased understanding of the complex practice environment dynamics, which help in attainment of more meaningful change and innovation. Borill, West, and Dawson et al. (2002) noted that practice development usually focuses on the interface issues and inefficiencies between professions, departments and organizations and the importance of team working and that the collaborative approach is important in maximizing the creative potential of different perspectives and skills. Tschannen (2004) study focused on teamwork and collaboration amongst health care providers and reported that the joint processes lead to improved patient outcomes, such as an improved level of patient health as well as less care fragmentation. Collaboration mostly entails joint communication as well as decision-making process with the express objective of facilitating the patient wellbeing and ill health requirements while valuing the exceptional abilities and qualities of every team member. This process usually empowers the nurses because of the shared authority and power based on expertise and knowledge instead of role, function, or non-hierarchical relationships. Recognition and acknowledgement of the exceptional knowledge of the different disciplines and an apparent appreciation of the exceptional inputs on nursing care can show that nurses have a critical function in attaining positive patient results, which result from shared efforts. Nurses and the other health care team members bring diverse viewpoints to patients’ care, when these exceptional disciplinary viewpoints are recognized; the exceptionality of every line of work can be viewed as a benefit instead of harm to patient care. Interdisciplinary teamwork in the healthcare setting usually involve individuals with different knowledge bases and skill sets may lead to practical and creative solutions which would not otherwise occur. Other than nurses practice development, improved collaboration also leads to improved patient outcomes. Kramer and Schmalenberg (2003) argued that healthy shared associations between nurses and doctors are directly connected to best possible patient outcomes. Collaboration is important for the benefits of the patients and satisfaction of the healthcare providers. Implication of Collaboration between Nurses and Other Health Care Team Members Collaborative associations are founded on providers’ equality. They are not hierarchical and they do not depend on the control of a group by another. This approach distinguishes the integrity and strength of all professional co-workers to delivery of care. In a clinical setting, which encourages collaborative relationship, no one individual is responsible for the team success and knowledge needed by an individual patient. In such settings, individual health care team members have a common objective of caring for the patient. To facilitate success, the team individuals have clear roles and responsibilities; understand the range of competencies and practice of each member of the team; understand the decision-making and leadership roles within the team; have set clear communication processes; and have mutual trust and respect amongst its members. The collaborative practice model between the nurse and other care providers reduce fragmentation and advance the quality and safety of care offered to patients. In a collaborative healthcare setting effective and efficient health care necessitates active participation and involvement of all the team members. Mutual respect is important for the success of the functional teams and develops from recognizing and appreciating the contribution of the other team members. Trust between the different providers evolves as knowledge as well as understanding of skills, competencies and scopes of practice are acquired. Trust also ensures that team function in an efficient manner and maximizes all the members’ contributions. To serve the patients’ health care needs, there has to be a respectful and collaborative interaction among the different healthcare professionals, with understanding and recognition of input of every provider to the team. Nurses and other health providers thus help to offer improved coordination, service delivery, and patient outcomes. However, the collaboration has to be done in an inclusive manner and the knowledge, skills, and competency of every member to the team has to be respected. One of the most significant collaborative relationships in the healthcare context is that of the physician-nurse relationship. Collaboration between nurses and physicians is important for patient care as well as self-confidence. Every team member in this relationship usually have an individual perspective on assessment as well as plan of care for the patients and only through exchanging information and collaboration can proper treatment approaches be crafted. Maximizing the nurse-physician collaboration is important in creating satisfying work roles and improving patient care. Lindeke and Diekert (2005) demonstrated that maximizing the collaboration between the doctors and nurses empowers the nurses and lead to improved patient outcomes. They further noted that the relationship between the two professionals between the two is usually stressful and the real and perceive differences in status and power between the two can cause problems when they fail to be in agreement on a care plan for the patient. Usually, the medicine profession usually laid emphasis on autonomy, expertise, and accountability over dialogue, deliberation, as well as interdependence. Alternatively, nursing lays emphasis on bureaucracy and hierarchy, although increased focus on these has weakened with respect to doctors (Davis 2000). The diverse emphasis and perception that nurses and physicians have towards patient care cause edgy nurse-physician relationship, which may hinder the health of patients, unless the nurses and physicians develop collaborative relationships (Zwarenstein & Reeves 2002). Collaborative health care teams formed with the key premise that every team member has diverse knowledge and skills but similar philosophical objectives on care for the patients. Combining nursing and physician skills as well as defining roles allows a comprehensive approach for caring for various groups of patients. The collective responsibility for outcomes and joint ownership of decisions plays an important role in practice development for the nurses. Ways of Building Collaborative Relationships It has been established that collaborative relationships are a means of practice development for the nurses. As a result, health care settings should strive to build collaborative relationship between the nurse and other healthcare care team members especially the physicians. Collaborative relationships can be built by incorporating the principles of Collaborative relationships between nurses and other professionals. Teamwork should be encouraged between the nurses and the other members of the healthcare team. The team individuals should have clear roles and responsibilities; understand the range of competencies and practice of each member of the team; understand the decision-making and leadership roles within the team; have set clear communication processes; and have mutual trust and respect amongst its members. The collaborative practice model between the nurse and other care providers will serve to reduce fragmentation and advance the quality and safety of care offered to patients. In a collaborative health care setting effective and efficient health care will necessitate active participation and involvement of all the team members. Coordination, responsibility, accountability, assertiveness, cooperation, autonomy, mutual respect, and trust are also important elements that should be encouraged in building collaborative relationships. Conclusion Collaborative relationships are important in improving patient outcomes and practice development for nurses and other healthcare team members. Awareness of factors that promote collaborative relationships can enable nurses to understand the role expansion dynamics better to facilitate collaborative partnerships with the rest of the healthcare team. Health care settings and nurse educators and executives should encourage positive communication behaviors between nurses and the healthcare team members. There is also need for organizational policies and measures, which promote practice environments, which exemplify compassion, credibility, collaboration, and coordination amongst team members. Deficiencies in communication and collaboration amongst healthcare professionals have a negative effect on health care provision and patient outcomes. As a result there is need to develop the relationship amongst nurses and other healthcare team members to promote practice development for the nurses and to improve patient outcomes. Reference List Apker, J, Ford, W, & Fox, D 2003, ‘Predicting nurses' organizational and professional identification: The effect of nursing roles, professional autonomy, and supportive communication’, Nursing Economics, vol. 21, no. 5, pp. 226–232. Borrill, C, West, M, Dawson, J & Shapiro, D 2000, Team Working, and Effectiveness in Health Care: Findings from the Health Care Team Effectiveness Project, Aston Centre for Health Service Organization Research, Birmingham. Davis C 2000, ‘la difference: that's what will make collaboration work’, Nurs Times, vol. 96, no. 15, pp.27. Disch, J, Beilman, G & Ingbar, D 2001, ‘Medical directors as partners in creating healthy work environments’, AACN Advanced Critical Care, 12,3, pp.366-377. Espin, S & Lingard, L 2001, ‘Time as a catalyst for tension in nurse-surgeon communication’, AORN Journal, vol. 74, no. 5, pp.672-682. Gottlieb, L & Nancy, F 2006, The Collaborative Partnership Approach to Care: A Delicate Balance, Mosby Elsevier, Canada, Toronto. Jackson, D, Long, J, Swartz, W et al 2003, ‘Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care’, American Journal of Public Health, vol. 93, no. 6, pp. 999-1006. Kramer, M, & Schmalenberg, C 2003, ‘Securing "good" nurse physician relationship’, Nursing Management, vol. 34, no. 7, pp. 34-38. Lindeke, L & Diekert, A 2005, ‘Nurse –physician workplace collaboration’, Online journal of Issues in Nursing, Kent state University college of Nursing, vol. 10, p. 1. Tschannen, D 2004, ‘The effect of individual characteristics on perceptions of collaboration in the work environment’, MedSurg Nursing, vol. 13, no. 5, pp. 312–318. Way, D. Jones, L & Busing, N 2000, Implementation Strategies: Collaboration in Primary care-Family Doctors and Nurse Practitioners Delivering shared care, Toronto, The Ontario. Zwarenstein, M., & Reeves, S 2002, ‘Working together but apart: Barriers and routes to nurse-physician collaboration’, The Joint Commission, vol. 28, no. 5, pp. 242-247. Read More