Skill Building & Capacity I:
Developing and Maintaining the Collaborative Team
Welcome to the Developing and Maintaining the Collaborative Team Workshop brought to you by The Network Environments for Aboriginal Health Research BC (NEARBC – Northern Node) in collaboration with the University of Northern British Columbia, BC Rural and Remote Health Research Network and Northern Health.
In today’s world the role of collaboration has become the most effective way of conducting research and in the provision of services. The collaboration between organizations, communities and individuals is often done through the formation of “teams”. However, the formation of a team moves beyond just a group of individuals with “good intentions” but is a delicate balance of relationships between each other, the organization and community. Leadership style, trust, sharing information, and problem solving are key areas in the establishment of effective team work. A team is also a sliding continuum and in a constant state of change. The influence of obvious and subtle factors has a rebound effect on team functions and can quickly turn an effective and established team into chaos. The measurement of a teams' developmental stage is not a reflection of “negative” or “positive”; it is but a sliding scale of growth and development.
This workshop brings together researchers, community, organizations, students and concerned individuals in an effort to provide a foundation, or a bridge of skills, to create increased capacity in team work.
The format of the workshop is one of integrated team building skills, knowledge and education. This workbook is a supplement to your workshop instruction.
Several icons will draw your attention to specific actions throughout the day:
Means a group or individual exercise A section for your notes Take away
skill building
9:00 am – 4:00 pm / October 13, 2009Learning objectives : DAY ONE
□ Identify the need for and importance of collaboration
□ Describe the different types of teams
□ Describe the phases of team development
□ Demonstrate components of successful teamwork
9:00 am – 9:40 am / 1. Greetings and Introduction
2. Housekeeping & Structure of the Workshop
3. Respect
4. What YOU want to learn at this workshop (Charting)
9:30 am – 10: 15 am / Round Table team introductions
(5 of 5) / Workbook Page 6: Exercise in team formation
10:15-10:30 / BREAK
10:30-11:30 / Team Basics 101 / Workbook Pages 7-14
11:30 – 12:00 / The Plan / Practice Plan Exercise
12:00 pm – 1:00 pm / Lunch Break
1:00 pm – 3:00 pm / Theory and Principles / Workbook Pages 15-24
3:00 pm – 3:15 pm / BREAK
3:15- 3:45 / Practice Skills Breakout / Practice Plan Exercise
3:45- 4:00 / Debriefing & Closure for Day / Evaluation
MODULE ONE
Table of Contents Pages
Language and Meanings ……………………………………………………… 5
Team Basics 101 ………………………………………………………………………… 6-8
1. Team Working Exercise
2. Team vs Work Group
3. Types of Teams
4. Structure of Teams
The Collaborative Team ……………………………………………………………… 9-14
1. Types of Collaboration
2. Characteristics of Collaboration
3. Seven Essential Elements for Collaboration
4. Challenges of Collaboration
5. When to Develop a Collaborative Team
6. Team Essentials (Chart)
7. Elements of Team Formation
8. A Collaborative Team is / is not (Group Exercise)
9. Where would you find the Collaborative Team?
Theory & Models ……………………………………………………………………… 15-20
1. Phases of Team Formation
2. Aspects of Team Formation
3. Sliding Continuum of team Development Stages (Chart)
4. Aspects Affecting Team Development
5. Team in Context of environmental variables (Chart)
Principles of Successful Teamwork ……………………………………………… 21-23
1. Characteristics of Effective Teams
2. Developing Team Member Vision and Rules
Language and Meaning
Drinka & Clark (2000) note that “each discipline views themselves as somewhat exclusive, unique and special” and there is a certain culture of language that is used to separate and divide—to maintain discipline status. The goal of inter-professional practice is to understand that no single discipline can address complex health problems.
Team Formation Team is a process that is structured and guides the actions of two or more individuals within both the expectations of the organization and that of the patient (client, participant)
(Drinka & Clark, 2000).
Team - A team is a group of people who collaborate and interact to reach a common goal
Inter-professional – A fully integrated practice by a team of professionals from a diverse background of disciplines. Each member of the team has an integrated knowledge of the other team members’ roles, and all work from an equally valued team mandate. “When two or more professions purposely interact in order to learn with, from and about each other to improve effectiveness and the quality of care” (Gilbert, 2001).
Collaboration – An effort to consult and co-operate as a group or team in developing a shared direction or vision. Each member still maintains a separate functional identity. A collaborative practice is an active and often ongoing practice partnership between professionals, teams or organizations” (Gilbert, 2001).
Integration – The merging of differences into a single vision – a dependency between the parties where all hold equal value.
Patient-Centered - Patient-centered practice recognizes that the patient’s participation in the development and implementation of his/her care plan is integral. A patient-centered approach recognizes that health care is influenced by genetic, environmental, social and behavioural factors.
Person (people) Centered— Describes that not only are patients at the center but also healthy community members. It is a term “most often used to refer to health care systems that offer service to healthy individuals, as well as those with acute or chronic health concerns” . . . “understood for what it is not—technology centered, doctor centered, hospital centered, disease centered”. (Vancouver Coastal Health, 2006).
Determinants of Health - The Public Health Agency of Canada states the determinants of health “are: income and social status; social support networks; education; employment/working conditions; social environments; physical environments; personal health practices and coping skills; healthy child development; biology and genetic endowment; health services; gender; and culture. Each of these factors is important in it’s own right. At the same time, the factors are interrelated” (Cited on web site:http://www.phac-aspc.gc.ca/ph-sp/phdd/determinants/determinants.html#unhealthy).
Team working moment
Consider these questions:
1. What are your experiences with team work?
2. What types of teams can you indentify?
3. Who were members of these teams?
4. What were the qualities that made the team work?
5. What were the challenges?
6. What impact does your past experience have on your perception of team work?
Your Notes:
Team Basics 101:
Team vs. Work Group
Work Group / TeamOne “boss” each member reports too group does not necessarily collaborate with each other / The leader is not a boss but a coach or facilitator to the team
Each person completes tasks as per job description and Boss directives. / A group of individuals with complementary skills committed to a common/shared goal/vision
Emphasis on individual performance / Interdependence and accountability between team members is encouraged
Uni-directional: Communication flows down from boss to individual / Dual directional: Communication is both top down and bottom up
Boss is the authority and directs work processes / Team has the authority to manage it’s own work processes
Goals set by organization / Clear boundaries and tasks
Types of Teams
1. Working Team
2. Project Team
3. Special Team
4. Research Team
5. Multi-purpose Team
6. Independent Team
7. Management Team
8. Trouble Shooting Team
Structure of Teams
Unidisciplinary:
A group of people from the same discipline who work together.
Multidisciplinary:
A group of people from different disciplines who develop plans independently.
Generally, each discipline conducts an independent assessment of their interest group. Often one discipline is the case manager, orders the services and coordinates the care. The group may meet but, in general, each discipline implements its independent plan as an additional
layer of services.
Interdisciplinary:
A group of people from different disciplines who assess and plan care in a collaborative
manner. A common goal is established and each discipline works to achieve that goal.
Care is interdependent, complimentary, and coordinated. Joint decision making is the
norm. Members feel empowered and assume leadership on the appropriate issue
(depending upon needs and their expertise).
The Collaborative Team
Types of Collaboration:
1. Day to day
2. Clinical teams (health or disease focus)
3. Integrated teams
4. Cross integration: mandated and non-mandated
5. Consultative
Characteristics of Collaborative Practice Include (MCFD, 1997):
Ø Active participation of the client
Ø Sharing or transferring of information and skills across traditional boundaries
Ø Participants view themselves as part of a team and contribute to a common goal
Ø Relationship between participants is non-hierarchical and power is shared
Ø Leadership is shared and participants are inter-dependent
Ø Participants work together in planning and decision making
Ø Participants offer their expertise, share in the responsibility and are acknowledged by other members of the group for their contribution to the goal
Ø Clear definition and understanding by team members of participants' roles/responsibilities
Ø Respect for autonomous professional judgement and decision making of the client/family
Ø Effective communication skills and group dynamics
Ø Supported by organizational structures and vision
Seven Essential Elements for Collaboration (Way & Jones, 2001)
1. Responsibility and Accountability
ü Independent and Shared
ü Shared decision making
ü Accept shared responsibility for the outcome of the care plan
2. Co-ordination
ü Joint decisions about who will do what to ensure that the care plan is carried out
3. Communication
ü Sharing with the other providers critical information
ü Information is relevant, concise and timely
ü Clear identification of information sharing expectations
4. Co-operation
ü Respecting other disciplines’ professional opinions and viewpoints
ü Being willing to examine and alter your own professional views and perspectives
5. Assertiveness
ü Opinions and view points presented in a manner that fosters the integration of approaches
6. Autonomy
ü Providers can independently make decisions and carry out the care plan
7. Mutual Trust and Respect
ü Provider able to depend upon the integrity of the other as the foundation for their professional relationship.
Challenges of Collaboration:
Ø “Group Think”
Ø Becoming homogeneous
Ø Becoming too ridged / structured
Ø Slowness
Ø Trust
Ø Not everyone comes to the team with an equal value
Ø Member reward differences
When to Develop a Collaborative Team
When / Benefits / ChallengesNo one individual has the right combination of skills, knowledge and practice to do the job
The situation is multi-faceted, complex and/or a unique / infrequent challenge
Requires a high degree of interdependence, coordination and communication
When the objectives are clear but multi-leveled / Can be creative and unique approach
Teams can bring multi-skills to bear on intractable situations
Enlist more information and ability by tapping into different skill sets and networks
Increased collaboration and communication
Can be more “person focused” / Time to organize
Must be managed with care and skill
Silos
Buy in
Knowing who to involve
Knowing when to involve them
Developing the right combination of skills, knowledge and experience
Balancing time, authority and systemic issues
Your Notes:
Elements of Team Formation
1. Systemic – Management Support
Ø Support from all involved levels of the organization (union, directors, managers, policy etc)
Ø Budget / Financial commitment defined
Ø Environmental structures: works space, supplies, transportation and equipment.
Ø Agreements at the upper levels
Ø Clearly defined reporting, documenting and decision authority
2. Team Vision & Agreement
Ø Provides the means of “how” to meet the memo of agreement and is specific to each team.
Ø Provides the commonality, contribution and direction of the team
Ø Defines the team – clearly outlines roles, times of involvement and expectations
Ø Defines the relationship and interaction of members
Ø Defines reporting, conflict management and communication
Ø The approach to decision making for the team (i.e.: work schedule, plans and holidays)
Ø Clarify objectives – team vs. employer
Ø Environmental Factors: Co-location – work space – equipment – Kitchen
3. Team member selection
Team member selection is the hardest part of team formation, however, membership is critical to team cohesiveness and success.
Three methods of coming to a team:
Factors:
Ø Skills (Technical, problem-solving, interpersonal, organizational)
Ø Potential
Ø Open
Ø Flexible
Ø Collective
Ø Role – short or long term team member
Behaviors:
Ø Attendance
Ø Involvement
Ø Interruptions
Ø Ability to offer and accept constructive criticism
Ø Agree to discuss and share information
Ø Confidentiality
Ø Action oriented
4. Team based Leadership
Ø Every team needs a leader but not necessarily as a “BOSS”
Ø Coach, Mentor, working member of the team
Ø Keep the vision focus
Ø Smooth out conflict
Ø Mediates – in particular “turf” or “Silo” ing
Ø Co-ordination of activities
Ø Act as a liaison between team and community / systemic
Ø Negotiate relationships
Ø Identify gaps and resources
Ø Obtain resources
Ø Set and monitor milestones
Ø Ensure member involvement, contribution and benefits
Ø Keep work on track
Differs from Work Group
1. Decision Maker, delegator, and scheduler
2. BOSS – with bottom line of direction and results
3. Stands outside of the team – or as the top of the hierarchy
YOUR NOTES
A Collaborative Team IS?