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Group Development

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Kate Avery

on 26 January 2014

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Transcript of Group Development

A. Speech therapist

B. Physical therapist

C. Social Worker (case manager)

E. Occupational therapist

IOM Interdisciplinary & Collaborative Teamork,w Group Dynamics, Stages of Group Development, &IPE
Interdisciplinary Teamwork/Collaboration
Group Development
Group Dynamics & Leadership
Collaborative Learning is the Main Concept or Theme in Group Development
Develops higher level of academic achievement

Develops higher level of critical thinking

Improved analytical skills

Improved teamwork and interpersonal skills

Many employers value collaboration skills

Problem Solving Activities
A well structured problem solving activity will give a group clearer guidelines and result in a clearer path to a solution
Allows ideas, experiences, and concerns to be shared among group members
Learning occurs here, and develops within the group
Constructive arguments occur that lead the group to come up with the best possible solution

Tuckman’s 5 Stages of Group Development
How this Relates to
Nursing Practice
Nurses will work with teams to come up with problem solving ideas

When working on specific units you become part of a team and are assigned certain roles

Nurses can be a part of different group organizations

Teamwork, problem-solving, and collaborative learning are used by nurses every day

Stage 1: Forming
Personal relations are developed
Group leader is assigned/determined and looked to for help, direction, and coordination
Rules of behavior developed
Tasks are assigned – scope of task and how to accomplish it
Risk of conflict is a possibility in this stage

Stage 5: Adjourning
Termination of tasks
Release from group relations
Saying goodbye
Recognition for accomplishments and participation

Stage 3: Norming
Group issues and conflicts begin to resolve and the group itself starts to pull together and become one
Group members acknowledge contributions and problem solving skills of the group
Exchange of ideas and information takes place as well as asking questions about other groups members
Leadership becomes shared
Feeling of relief and group belonging occurs here because of resolving interpersonal conflicts
Data flow between group members
Creativity is high
Information is shared and feedback is given

Stage 2: Storming
Competition and conflict in personal relations
As tasks are accomplished, conflict will inevitably arise in some way
Ideas, feelings, and concerns are molded and formed to suit the group rather than the individual
Some group members will start to silence themselves while other dominate
In order to move on to next stage, group must be able to apply problem-solving strategies and mentality
Ability to listen is also very important in this stage

Stage 4: Performing
May not be reached by all groups
Start leaning towards optimum solutions
Must be highly tasked oriented and people oriented
There is unity among the group
Interdependence among the group occurs
Group members can start to work independently, with subgroups, or as a whole with equal work per member
Roles start to change to fit the needs of the group and individuals

Five Personal Values:




Nurses’ Role in Team
Foster open communication between all members

Remain assertive and act as the patient advocate in all situations

Apply critical thinking in each scenario to create the best results

Overall Goal
As the nurse we are the patient’s advocate in every situation and at all times. We must work with all members of the interdisciplinary team to create the optimal treatment regimen and to promote health and wellness.

From a Team of One...
"The clinician operating in isolation is now seen as undesirable in healthcare— a lone ranger, a cowboy, an individual who works long and hard to provide the care needed, but whose dependence on solitary resources and perspective may put the patient at risk"
Institute of Medicine (IOM)
Mission: Adviser for the nation to improve health

Two Major Reports:

To Err is Human: Building a Safer Health System (1999)
First report
Gained national attention

Crossing the Quality Chasm: A New Health System for the 21st Century (2001)
Second report
Lengthy & hard to read
Too Err is Human:
Building a Safer Health System
Medical Errors

Medical Errors Due to a Variety of Factors

What is an Interprofessional or Collaborative Approach to Care?
Interdisciplinary interactions between health care providers from numerous disciplines

Open Communication
Shared Decision-Making
Mutual Respect

To improve safety of the patient's care, and provide the best care to the patient

Essential to include patient, and their family, in the team as well!

Five Principles for Team Cohesiveness:
Shared Goals

Clear Roles

Mutual Trust

Effective Communication

Measurable Processes and Outcomes
As Stated Prior,
Interprofessional Team Approach is...
Collaboration with health care providers from numerous disciplines

Beneficial communication and collaboration implemented to provide optimal patient care

Essential to include patient in the team as well

What Characterstics Allow for a Team to Flourish and Act Cohesively for the Best Care of the Patients?
Difficulties That May Arise
Members who do not wish to collaborate

Conflict between the members

What to do…
Strategies to incorporate the difficult member(s)

Assess the member

Approach the member

Move forward
Created By: Liz Fredbloom- freden01@students.ipfw.edu
Ally Lepley- bootar01@students.ipfw.edu
Kari Hackley- hackk01@students.ipfw.edu
Kate Avery- averke01@students.ipfw.edu

(Model is Hierarchical)
Six Aims for Improvement:
1. Safety


3. Patient-Centeredness

4. Timeliness

5. Efficiency

6. Equity

Chronic threat to public health
As lethal as BC, MVAs, or AIDS
Biggest problem = Systemic factors
Information Gap- lack of information or communication between variety of providers
Too complex and uncoordinated
Ten Rules of Microsystem Redesign:
1. Care is based on continuous healing relationships.

2. Care is customized according to patient needs and values.

3. The patient is the source of control.

4. Knowledge is shared and information flows freely.

5. Decision making is evidence-based.

6. Safety is a system property.

7. Transparency is necessary.

8. Needs are anticipated.

9. Waste is continuously decreased.

10. Cooperation among clinicians is a priority
Crossing the Quality Chasm:
A New Health System for the 21st Century
Levels of Redesign:
Financial Aspect
Dangerous Data

Interprofessional Education (IPE)
Patient Benefits of Healthcare Providers Practicing IPE
Improved patient care and safety.

Enhanced practice and client outcomes.

Reduced health care costs.
Barriers to Practicing Effective IPE
Lack of clear role definitions among healthcare staff.

Lack of time for team building.

Effects of healthcare professionals' socialization.

Feelings of inferiority from staff, which has been identified as a particular barrier for nursing staff.
Healthcare Provider Benefits of Practicing IPE
Improved job satisfaction

Interprofessional awareness and empathy

Changed attitudes and perceptions

The reduction of negative stereotypes

Enhanced motivation to collaborate in practice

Establishment of common values, knowledge, and terminology

Understanding differing theoretical perspectives
IPE occurs when two or more professions learn with, from, and about each other to improve collaboration and the quality of care.

Presents opportunities for education providers and clinicians to forge close relationships as the foundation for developing effective interprofessional care.
What is IPE?
Factors for Increasing Team Effectiveness

Team roles and responsibilities


Communication strategies

Professional boundaries and values

Encompassing broad aspects of collaboration
Introducing IPE Early
In order to increase the utilization of IPE in the clinical setting, it is important to introduce the concept as early as students in nursing school.

Some benefits of introducing IPE to students include; an improved sense of professional autonomy and competence, a stronger sense of clinical self-confidence, and a better understanding of other professions.

These benefits have been shown to improve team dynamics and prevent the carryover of negative stereotypes into the workforce.
In conclusion...
Effective utilization of interprofessional education (IPE) CAN have an impact!

A lack of teamwork in the clinical setting, not only negatively impacts our patients, but also impacts the nurse's satisfaction, health and well-being, and preservation.

Nurses and other healthcare providers must ensure the utilization of IPE in order to give the most exceptional care to our patients!
Question 2
IPE is based on three concepts:

IPE has been identified as a priority area for improving team-working and interprofessional communication in clinical practice settings.

Unfortunately, IPE is something that has not been practiced efficiently by past health care providers. However, now IPE is an expectation that is to be practiced by all health care providers.

The ultimate aim is collaborative practice!
Florence Nightingale and William Farr were friends and colleagues. William Farr was a physician and self-taught mathematician, and considered one of the founders of modern epidemiology. His contribution was that of the broader population statistics. Nightingale's recorded health conditons during the Crimean War, leading to her contribution of data of the frequency of mortality among groups.

"The professional liaison between Nightingale and Farr is a wonderful example of collaborative practice in addressing public health; the merging of expertise from these two disciplines results in much more than either could accomplish individually." (Allender, Rector, & Warner, 2014)
Question 1
Which two historical health care figures
together for health care reform to improve patient safety and health, by combining their data on frequency of mortality among groups and broader statistics, so that the information could be applied to the whole population at risk?
A. Lillian Wald & Jakob Henle

B. Louis Pasteur& Florence Nightingale

C. Dorthea Dix & Robert Koch

D. Florence Nightingale & William Farr
D. Florence Nightingale & William Farr
(Mitchell, Wynia, Golden, McNellis, Okun, Webb, Rohrbach, & Kohorn, 2012)
(Smith, 2012)
(Smith, 2012)
(CQHCA & IOM, 2001)

Which of the following best represents improvement in the aim of efficiency?

A. A nurse who wants to reduce their time wasted going between the linen closet and patient’s rooms grabs enough bedding to make all of the beds, and ends up with a few unused pillow cases that must be placed in the wash.

B. A nurse who organizes and plans their patient care for the day, and decides that the order of patient care should be completed by visiting the patient in the room furthest from the nurses’ station and work their way back to the nurses’ station.

C. A nurse who fills their pockets with gloves, so that they don’t have to spend time searching for gloves when caring for a patient, even if it means having to throw out a few unused gloves forgotten in the nurse’s pocket at the end of shift.

D. A nurse who fills an empty, available cabinet near patient rooms with various medical supplies, so that the health care providers don’t have to go to the end of the hall each time they need an item for patient care.
D. A nurse who fills an empty, available cabinet near patient rooms with various medical supplies, so that the health care providers don’t have to go to the end of the hall each time they need an item for patient care.
“Efficient: avoiding waste, including waste of equipment, space, supplies, ideas, and energy.”

Both A and C may be showing efficiency in reducing time and energy used by the nurse, but they are not avoiding waste of supplies by doing this. Although the nurse in scenario B is trying to prevent waste of energy, care of patients should never be prioritized on just the nurse’s convenience, but needs of the patient need to be taken into consideration as well. The nurse in scenario D is not only preventing waste of energy of the health care providers having to go further to get supplies, but preventing waste of available space as well.

(CQHCA & IOM, 2001)
Arms crossed? Eyes rolling? Aggressive speech?
Discuss the behavior and provide feedback
Collaborate with difficult member on what would enhance their participation.
Level A: Experience of Patients
Level B: Microsystems of Care
Level C: Health Care Organizations
Level D: Health Care Environment
Reengineered Care Processes

Effective Use of Information Technologies

Knowledge and Skills Management

Development of Effective Teams

Coordination of Patient Care

Better Measurement of Performance and Outcomes
Redesign Imperatives:
(CQHCA & IOM, 2001)
(CQHCA & IOM, 2001)
Compentencies created for all HCP
(Committee on Quality of Health Care in America [CQHCA] & Institute of Medicine [IOM], 2001)
NCLEX Questions & References
B. Norming
Question 4
A nurse is caring for an elderly client, who is confused (related to a urinary tract infection), incontinent, weak, and has difficulty articulating sentences after a prior stroke two years ago. Which of the following members of the interprofessional team should be included in the care of this patient?
Question 5
According to Tuckman’s group development stages, which stage of group develop is occurring when a group of nurses begin to resolve any issues or conflicts that may be occurring between them, resulting in the group finally working as a whole unit?
This type of learning develops higher level of academic achievement and also develops higher level of critical thinking. There are improved analytical skills and improved teamwork and interpersonal skills with collaborative learning as well.
Question 3
A. Independent studies

B. Collaborative learning

C. Research

D. Developing a group leader
What is the main theme in group development?
B. Collaborative learning
A. Speech therapist

B. Physical therapist

C. Social Worker (case manager)

D. Psychologist

E. Occupational therapist

F. Respiratory therapist
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public's health (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Bajnok, I., Puddester, D., Macdonald, C. J., Archibald, D., & Kuhl, D. (2012). Building positive relationships

in healthcare: Evaluation of the teams of interprofessional staff interprofessional education

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Committee on Quality of Health Care in America & Institute of Medicine (2001). Crossing the quality

chasm: A new health system for the 21st century. Washington, D.C.: National Academy Press.

Committee on Quality of Health Care in America & Institute of Medicine (1999). To err is human:

Building a safer health system. Washington D.C.: National Academy Press.

Cowen, M. E., Halasyamani, L. K., McMurtrie, D., Hoffman, D., Polley, T., & Alexander, J. A. (2008).

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Jahng, N. (2012). An investigation of collaboration process in an online course: How do small groups develop over time?

The International Review of Research in Open and Distance Learning, 13(4), 1-19.

Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. E., Rohrbach, V., & Kohorn, I. V. (2012). Core principles &

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A. Speech therapist assist patient who have speech problems. The speech therapist will assist this patient with their articulation difficulties.
B. Physical therapist assist patients who have issues with mobility, and also help patients to regain or retain their strength.
C. This patient and their family may need the assistance of a social worker, to evaluate if they are able to return home , or if they will need assistance ( home health, assisted living facility).
D. Besides the confusion related to the UTI, the patient does not have any psychological issues at this time. If the confusion does not subside after the UTI is resolved, the patient MAY be evaluated for dementia or Alzheimer.
E. The patient will utilize the occupational therapist to assist them with their activities of daily living.
F. The patient does not have any respiratory issues at this time.
(Jahng, 2012)
A. Storming

B. Norming

C. Performing

D. Adjourning

B. Norming: group issues and conflicts begin to resolve and the group itself starts to pull together and become one.

A. Storming: stage in which these is a presence of
competition and conflict in personal relations.

C. Performing: stage in which not all reach, but the group will start leaning towards optimum solutions

D. Adjourning: stage in which there is a termination of tasks (Tuckman, 1965)

(Sommer, Johnson, Roberts, Redding, & Churchill, 2013)
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