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Team Building for Healthcare Professionals working with Older Adults


Title: Person-Centered Caring Leadership Series II: Building the Team Author: Dwight T. Colley Last modified by: whitejt2 Created Date: 7/19/2013 5:09:14 PM – PowerPoint PPT presentation

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Title: Team Building for Healthcare Professionals working with Older Adults

Team Building for Healthcare Professionals
working with Older Adults
  • Curriculum developed by Jay White, MSG, Jennifer
    Pryor, MSG and Enid Butler, MSG Student

  • What will today look like?
  • Breaks and Lunch
  • VCU DoG and DSS
  • Certificates of Attendance/CEUs
  • CGL/VCU Continuing Education

Learning Objectives
  • Introduction to the basic tenets of
    Person-Centered Care
  • Importance of empowered work teams
  • Identify diverse types of work teams and their
  • Techniques to enhance team communications,
    decision-making, and leadership growth
  • Strategies of early adopters regarding work teams
  • Application of Person-Centered Care through Case
  • Review of Evaluation models

Who are we and why are we here?
What is Person-Centered Care?
  • Person-Centered Care is an approach to care that
    respects and values the uniqueness of the
    individual, and seeks to maintain, even restore,
    the personhood of individuals. We do this by
    creating an environment that promotes
  • Personal Worth Uniqueness
  • Social Confidence
  • Respect
  • Truthfulness
  • Independence
  • Engagement
  • Hope

What is Person-Centered Care?
  • Rooted in the work of Tom Kitwood, a British
  • Core Values
  • Choice,
  • Dignity,
  • Respect
  • Self-Determination
  • Purposeful Living
  • Fosters optimal aging for the individual
  • Empowering
  • Care is driven by the individual

The Importance of Teams in Person-Centered Care
Just what defines a team?
  • Some times teams are mandatory
  • Teams might be floating or informal
  • Self-Directed

Importance of Teams
  • Empowering
  • Diverse
  • Knowledge-based
  • Responsive
  • Collaborative
  • Autonomy
  • Consensus-Based
  • Continued Reflection/Evalution

Effective Teaming
  • Common goals and mission
  • Attention to issues of leadership skills
  • Respect for team members expertise

True/False Quiz about Teams
  • An interdisciplinary team approach to health care
    is viewed as unimportant by the changing health
    care industry.
  • True or False?

Answer False
  • Diversity of EACH team members experience
  • A team approach supports to person-centered care
  • Each member of the team becomes more of a
    generalist in the care plan or service plan

True/False Quiz about Teams
  • Health care professionals on a newly developed
    team have clear understandings about each others
  • True or False?

Answer False
  • Diversity can some times be a hurdle
  • Legacy of the Medical Model
  • Silos

True/False Quiz about Teams
  • Health care professionals need to be
    knowledgeable about cultural issues among team
    members and those to whom they are giving care.
  • True/False

Answer True
  • A hallmark of person-centered care
  • Familiarity does not breed contempt
  • Cultural Competence vs. Cultural Humility

One final question to think about
  • Which technique (s) can help overcome
    communication barriers within a health care team?
  • Insight into anothers culture
  • Confrontation
  • Developing trust among different disciplines
  • Active listening about care/service plans

Answer A,C, and D
  • Lack of communication and understanding hurt a
  • Lack of appreciation of anothers opinion and
    expertise can also hurt a team
  • The more diverse the input, the better the outcome

Any questions or comments so far?
Phases of Team Transition
Phases of TEAM Transition
  • Forming
  • Storming
  • Norming
  • Confronting
  • Performing
  • Leaving

  • Group is created
  • Sharing of names and background information
  • Members size up and test each other
  • Members are guarded
  • Some are passive, others active
  • Uncertainty over purpose
  • Conflict is neither discussed nor addressed

  • Initial difficulty in understanding goals and
    purpose of the team
  • Attempts to establish common goals
  • Caution and conformity
  • Turf wars
  • Conflicts are present, but initially covered up
  • Initial attempts at bonding

Norming (continued)
  • Team establishes ground rules
  • Team begins to clarify mission
  • Leaders emerge
  • Strategies for equity in leadership
  • Increase in defensive/disruptive behavior
  • Frustration
  • Projection of blame

Norming (continued)
  • Competition
  • Members may come late or miss meetings entirely

  • Conflicts can no longer be avoided, especially in
    areas of leadership, equality and commitment
  • Anxiety over expression of affect/influence
  • Some conflicts are directly addressed
  • Attrition
  • Search for mediators among the team

Confronting (continued)
  • Functional leaders emerge
  • Realization that power is not always equal
  • Realization that every member of the team can
    contribute to power and equity
  • Positive conflict
  • Goals and rules are evaluated and modified
  • Coalitions form/change

  • Diversity of team is appreciated
  • Encouragement and helpfulness among team members
  • Reality testing grows
  • Self-initiated active participation
  • Relationships grow. Trust emerges.
  • Attendance at meetings becomes more regular

Performing (continued)
  • Positive conflict is normalized and seen as
    performance improvement
  • Productivity and problem solving are emphasized
  • Leaders are seen as teachers and their skills are
  • Continued evaluation and process improvement

  • One or more members of the team leave
  • Anger toward the team in general
  • Denial of termination
  • Disbelief/Regret at termination
  • Wishing to remain a member
  • Regression to an earlier stage
  • Possible happiness over leaving team

Leaving (continued)
  • Whole team may terminate
  • Expression of teams superiority
  • Feelings expressed as testimonials
  • Affirmation of team membership as a valuable

Case Study 1
  • Initial Meeting for the
  • Geriatric Interdisciplinary Team

Focus on Long Term Care
The Ideal Team Environment in Long Term Care
  • Commit to consistent staffing
  • Involve direct care staff in care planning and
    care meetings
  • Ensure cross-training of staff at all levels
  • Enable work teams to set their own schedules
  • Modify hiring, orientation, and retention
  • Develop self-directed work teams.

Thinking Differently
  • Consistent, self-directed work teams which are
    free to form relationships with our residents are
    the heart of person-centered caring.
  • Only when we achieve this objective, will a
    resident or participants quality of life be

Work Teams in Long Term Care
Just what defines a team?
  • Some times teams are mandatory
  • Teams might be floating or informal
  • Self-Directed

Mandatory Teams
  • Leaving is not an option!
  • Necessary for employment
  • Can still follow usual stages of development with
    new initiatives or new members

Floating Teams
  • Meet PRN (as needed)
  • Members usually already have an affinity for one
  • Less formal
  • Less opportunity to review and evaluation

Self-Directed Work Team
  • Self-directed work teams, also known as
    self-managed or empowered work teams, include
    employees with similar job titles and
    responsibilities who make decisions and
    recommendations on aspects of their jobs and
    perceive their position as being meaningful.
    This may include planning, scheduling, and
    management of others.
  • Yeats Cready, 2007

Overview of How Teams Operate in a Healthcare
  • Team looks at issue
  • Identifies solution
  • Management provides resources to team to help
    them make decision (information they need, right
    people to talk to, etc.)
  • Presents solution to management
  • Management accepts, declines, or asks team to
    rework solution
  • Always consider an evaluation model

Resident Benefits of Consistent, Self-directed
Work Teams
  • As a result of a stronger relationship, care
    staff know the resident as an individual.
  • Care staff know residents best. When care staff
    are the decision-makers, residents decisions are
    more likely to be heard and acted on.
  • Potentially more staff available to the resident
    for care and quality of life activities
    (universal worker).

Employee Benefits of Consistent, Self-Directed
Work Teams
  • Increased employee satisfaction
  • Feelings of empowerment
  • Reduced turnover
  • Ability to use strengths and develop new skills
  • Improved relationships with co-workers
  • Better information-sharing regarding residents
  • Others (supervisors) rate performance higher
  • Yeatts Cready, 2007

Benefits of Consistent, Self-Directed Work Teams
For the Employer
  • Reduced costs due to increased employee
    satisfaction and reduced turnover
  • Improved consistency and follow through in
    resident care
  • Increased resident and family satisfaction and
  • Improved performance/efficiency.
  • Yeatts Cready, 2007

Steps for Implementing Self-Directed Work Teams
  • Introduce concept of SDWTs to management
  • Determine management initial support of SDWTs
  • Provide detailed information to management re
    How they work cost, time and resident benefits
  • Identify several managers to serve as team
  • Provide detailed information to nurses re How
    they work cost and time and resident benefits
  • Orient care staff to SDWT concept
  • Begin weekly meetings
  • Train team on interpersonal skills,
    decision-making procedures etc.
  • Have facilitators gradually reduce attendance
    until team can meet independently
  • Yeatts, Cready, Ray, DeWitt, Queen, 2004

Getting on the Same Page
What is a Mission Statement?
  • A formal summary of the aims and values of a
    company, organization, or individual.
  • Example
  • It is our mission to improve the health of those
    we serve with a commitment to excellence in all
    that we do. Our goal is to offer quality care and
    programs that set community standards, exceed
    patients' expectations and are provided in a
    caring, convenient, cost-effective and accessible

And after the Mission Statement?
  • After we all agree on a mission statement, how
    does team development progress?

The Five Dysfunctions of a Team
Dysfunction I Absence of Trust
Dysfunction 2 Fear of Conflict
Dysfunction 3 Lack of Commitment
Dysfunction 3 Lack of Commitment
Dysfunction 4 Avoidance of Accountability
Dysfunction 5 Inattention to Results
Summary of the 5 Dysfunction of a Team
Building the Team
  • The Learning Circle

The Learning Circle
  • Learning Circle Rules
  • Identify the facilitator who will pose the
  • Ask the question
  • Ask for a volunteer to start
  • Go around the circle. Go to the right or left of
    the first volunteer. Then continue around the
    circle to give everyone a chance to answer the
    question. Allow people to pass if they are not
  • Once everyone has had the opportunity to speak
    return to anyone who has passed.
  • Open up for discussion. Encourage others to
    comment and you comment. Try to LISTEN more than
    you TALK.
  • Acknowledge how this group has a lot to offer and
    how the group has been able to enrich one

Learning Circle Case Study
  • What would have to change at the
    residence/community where you work for you to
    live there the rest of your life?

Building the Team
  • What is our vision?
  • What are we trying to accomplish?

What is the Vision/Mission of the Team?
Examples of Person-Centered Caring Visions
  • Eden Alternative
  • Video
  • Mission To eliminate loneliness, helplessness,
    and boredom.

Examples of Person-Centered Caring Missions
  • Our Mission As a faith-based charitable
    organization, we will provide services, specific
    to need, in a compassionate,  professional,
    holistic manner, through an inspiring environment
    and dynamic leadership for our residents, employee
    s and others we serve.

Examples of Person-Centered Caring Missions
  • Improving life every day by igniting hope,
    instilling pride, and offering compassionate
    support for adults with disabilities and their
    caregivers. And in so doing, we will promote a
    more civil and humane society.

Examples of Person-Centered Caring Mission
  • To provide high-quality residential and assisted
    care and services for older adults of limited
    financial means in a home-like environment where
    independence, dignity and self worth are nurtured.

Once we have the mission/vision...
Lets Talk about the I in TEAM
Building the Team Honoring Individual
  • I Look Like

My Mission Statement
Building the Team Ground Rules
  • It is important for the team to determine the
    qualities needed to build and maintain a team.
    The team should establish ground rules for
    behaviors of team members.

Examples of Team Ground Rules
  • Shahbazim Code of Ethics
  • A Shahbaz will work with each other as a
    respectful, supportive, flexible team.
  • A Shahbaz will keep their word.
  • A Shahbaz is dependable, honest and trustworthy.
  • A Shahbaz continues to grow, learn and commit to
    the well-being of elders.
  • A Shahbaz includes elders in the decision-making
    as much as possible.
  • A Shahbaz never crosses the line between
    providing care and providing clinical treatment.
  • A Shahbaz is patient with elders, each other, and
    all members of the organization and community who
    come to the Green House.
  • A Shahbaz is a good communicator.
  • A Shahbaz shows responsibility to the elders and
    the other members of the team by practicing good
    work habits including
  • Coming in when scheduled and being on time.
  • Completing their work.
  • Leaving personal problems at home.
  • Giving complete reports about the elders to the
    other Shabazim.

Created by the Shahbazim of Tupelo, MS
Further Examples of Team Ground Rules
  • To be open, forgiving, and patient with one
  • To be understanding of both staff and residents
  • To be considerate of other shifts. We will leave
    our shifts in ways that we would like to be
    welcomed to our shifts. We will fully
    communicate information about the residents and
    our team with incoming shifts.
  • To provide good care to the residents, and just
    as importantly, to find ways to enhance their
    quality of life.

Westminster-Canterbury of the Blue Ridge Memory
Support Household
Further Examples of Team Ground Rules
  • I will accept responsibility for establishing and
    maintaining good relationships with you and all
    other team members. I will come to you promptly
    and respectfully if I feel we are in
    disagreement. The only time I will discuss our
    difference of opinion with another person is with
    my supervisor when I need advice or help in
    deciding how to communicate with you
  • I will not engage in the 3 Bs (Bickering,
    Back-biting, Bitching), and will not shout, make
    threats, attempt to intimidate, use profanity or
    use words which are degrading to individuals or
    organizationsand I ask you to do the same.
  • I will accept you as you are today, forgive past
    problems and ask that you do the same with me.
  • I will remember that neither of us is perfect and
    that human errors are opportunities, not for
    shame and guilt, but for forgiveness and growth.
  • Wellspring Care

Wellspring Care Resource Team
Building the Team Communication
Best Practices to Observe
Barriers to Communication
  • Perception/interpretation
  • Generalizations/biases/prejudices
  • Jumping to conclusions
  • Assumptions
  • Multiple meanings
  • Dilution
  • Message sent, but not received
  • Physical barriers
  • Social barriers

Non-verbal Communication
  • Body language refers to the way people
    communicate nonverbally, through postures, facial
    expressions, gestures and movements.

Communication Active Listening
  • Good listening is essential to clear, effective
  • Everyone has the capacity to listen effectively
    and can improve through practice.

Good Listeners Do the Following
  • Attend closely by
  • Using good eye contact
  • Blocking distractions
  • Using an accepting expression
  • Asking questions
  • Nodding or otherwise acknowledging the person
  • Dont STARE
  • Rearticulation What I think I hear you saying

Good Listeners Do the Following
  • Attempt to understand by
  • Letting the speaker finish ideas
  • Not interrupting
  • Watching for non-verbal signs
  • Attending to the facts in the statements.

Good Listeners Do the Following
  • Keep personal biases out by
  • Avoiding jumping to conclusions
  • Postponing judgments
  • Focusing on the facts presented

Good Listeners Do the Following
  • Provide feedback by
  • Paraphrasing what was heard
  • Answering direct questions

Listening without Hearing
  • The Selective Listener
  • The Insulated Listener
  • The Defensive Listener
  • The Ambusher
  • The Insensitive Listener
  • The Mind Reader
  • The Dreamer
  • The Rehearser

Ethical Decision Making
Building the Team Decision-Making Skills
  1. Identify the issue/problem
  2. Identify all possible solutions
  3. Identify the pros/cons of possible solutions
  4. Select best solution
  5. Implement solution
  6. Evaluation, Reflection and Adaptation
  7. If not, go back to step 1

Building the Team Unhelpful Interpersonal Skills
  • Making fun of others suggestions
  • Not listening
  • Verbally attacking one another
  • Focusing on blame
  • Dominating conversation
  • Naysaying/consistent negativity

Building the Team Positive Interpersonal
  • Asking for others opinions
  • Showing respect for others opinions
  • Listening
  • Giving credit where credit is due
  • Recognizing all ideas have value
  • Keeping an open mind

Success in Work Teams A Summary
  • Buy-in from all levels of staff
  • Management support crucial
  • Teams have the tools they need to succeed
  • Training, coaching, facilitation
  • Teams understand their person-centered caring
  • It always goes back to the resident
  • Patience
  • Teams take time to develop and it will not always
    be easy!
  • Yeatts, Cready, Ray, DeWitt, Queen, 2004
    Orsburn Moran, 2000

Person-Centered Caring and Teams A Summary
  • Person-centered caring is
  • about creating a community.
  • A true community means
  • inclusion, understanding,
  • shared decision-making and
  • opportunity for growthin other
  • words, participation of all the
  • individuals in the residence and
  • a sense of contributing and
  • having a say.

Where can YOU start in your organization?
  • Phone (804) 828-1565
  • Website http// 
  • Email 
  • Be sure to like us on Facebook
  • https//

Thank you!!