COMFORT* Communication (narrative) Orientation and opportunity Mindful presence Family Openings Relating Team * Wittenberg-Lyles, E., Goldsmith, J., Ferrell, B., & Ragan, S. (2012). Communication and palliative nursing. New York: Oxford.

Objectives Describe the main principles of interdisciplinary team collaboration Recognize team meetings as a place to collaborate and resolve conflict Identify a communication skill to practice with interdisciplinary team members Identify a communication skill to practice to ensure effective team meetings

Interdisciplinary Collaboration Sharing resources Shared power Respect credibility/expertise Focus on task and relational communication

Model of Interdisciplinary Collaboration Interdependence & flexibility – Characterized by interaction in order to: Accomplish Goals and Share information Maintain flexibility for each new case –Psychospiritual care (Grey, 1996) : – meets psychosocial, spiritual, and coping needs of patients/families laboring with terminal illness Grey, R. (1996). The psychospiritual care matrix: a new paradigm for hospice care giving. Am J Hosp Palliat Care, 13(4),

Model of Interdisciplinary Collaboration Newly created tasks & responsibilities – Emerge through information sharing – Collaborate to maximize members’ expertise – Work collaboratively to serve patient & family – Accessibility allows frequency/ease of contact

7 Model of Interdisciplinary Collaboration Collective ownership of goals – Share responsibility to produce holistic care – Team joined by experience – Patient/family viewed as important part of team – Shared common purpose

8 Model of Interdisciplinary Collaboration Reflection on process – Awareness of collaborative processes – Collectively review team processes – Evaluate own process *Least ranked aspect of collaboration

9 Team Meetings Enables communication to produce plan of care for each patient Allows elements of interdisciplinary collaboration to emerge Collaborative process involves conflict

Groupthink Cohesive group members Emphasize unanimity Focus on group cohesion/relations over decision-making Leads to poor decision-making and lack of collaboration Obstructs effective group discussion and conflict resolution

11 When Groupthink Occurs Embrace least effective decisions Suppressed disagreements Perceive conflict as more work Unable to consider: – All aspects of information – Alternative solutions – Fail to understand risk of failure

12 Aspects that influence groupthink Relational Factors Self-Censorship Organizational influences Structural constraints

Ways to combat Groupthink Discussions should start by stating the patient’s goal of care Designate a team member to play devil’s advocate Rotate leadership of team meeting Adapted from: Wynne Whyman (2005). A question of leadership: What can leaders do to avoid groupthink. Leadership in Action, 25(2), 12.

Assessing team experiences Do discussions include family, other healthcare professionals involved? Does the team have designated time for sharing frustrations about plans of care (e.g., specific patient/family)? Does the team address patient safety issues?