{"id":19702,"date":"2024-09-24T11:24:17","date_gmt":"2024-09-24T15:24:17","guid":{"rendered":"https:\/\/ssaquebec.wp.vortexdev.com?p=19702"},"modified":"2024-09-24T11:33:20","modified_gmt":"2024-09-24T15:33:20","slug":"teaming","status":"publish","type":"post","link":"https:\/\/ssaquebec.wp.vortexdev.com\/en\/news\/teaming\/","title":{"rendered":"Teaming\u00a0"},"content":{"rendered":"\n

Teaming<\/h3>\n\n\n\n

To take our full place <\/h4>\n\n\n\n
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\"Denis_cote\"<\/figure>\n<\/div><\/div>\n\n\n\n
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By Denis C\u00f4t\u00e9,<\/strong> regional continuous quality improvement agent (ARACQ in French), RUISSS Universit\u00e9 Laval<\/p>\n<\/div>\n\n\n\n

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Recently, I started a quality improvement (QI) project in a FMG (Family Medecine Group). Such an approach begins with a workshop bringing together the people concerned by the envisioned changes. At this meeting, there were four doctors, a nurse and two secretaries. At the beginning of the meeting, the co-medical director noted that it was the first time that they had come together in different trades. This anecdote illustrates the transformation of organizational culture to be carried out or accelerated: moving from a culture of cooperating professionals without strong cohesion to an intrinsically collaborative organization united around inspiring common intentions. <\/p>\n\n\n\n

A team is a group in a state of perpetual helping<\/em>. <\/em>
Edgar Schein <\/p><\/blockquote><\/figure>\n\n\n\n

Clinic professionals face multiple challenges. Many of these challenges are systemic and involve political and institutional action, beyond the reach of local power to act. However, for many of these challenges, clinic members have the power to substantially improve care, their work environment and their personal satisfaction at work through a deeply collective and collaborative approach, without expecting anything from the state or their unions. They can improve their working environment substantially by collaborating more closely. <\/p>\n\n\n\n

Being under the same roof is not enough to become a team. It is essential to cultivate collaborative relationships and skills (teaming) in order to be able to create transformative organizational changes, which can only emerge through proposals developed and decided collectively. Quite the opposite of working in silos, alone or micromanaged. This is even more crucial in the context of labour shortages, overwork and transformation of primary care. <\/p>\n\n\n\n

Strategically, taking care of team dynamics is important to improve patient service delivery and other elements of the quintuple aim, including staff well-being <\/strong>(1). <\/strong>Moreover, one of the syntheses places the recognition of the criticality of teamwork <\/strong>and <\/strong>the creation of a psychologically safe environment<\/strong> as prerequisites for the other teaming skills (2).  <\/p>\n\n\n\n

Unique challenges<\/strong> <\/h3>\n\n\n\n

Multidisciplinary teams are inevitable and despite the many prescriptions to value teamwork, many challenges remain to be met in order to transform a culture that is still focused on the professional and technical skills of individuals, and little concerned with teaming skills (3). Too often, when faced with the challenges of collaboration, we choose to deal with it<\/em> rather than team up.  <\/p>\n\n\n\n

We often speak of “interprofessional collaboration” as if this skill were specific to the health sector. However, collaboration is necessary in almost all professions, and it is a fundamental subject of management. The world of health has a lot to import from the sciences of collaboration while taking into account its particular challenges.  <\/p>\n\n\n

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    \n
  1. The inherent complexity of primary care health services<\/strong>: belonging to multiple teams, changing or distributed teams across multiple sites, patient partnership, technological changes, changing institutional and regulatory environments, labour shortages, etc. <\/li>\n\n\n\n
  2. Different professional cultures<\/strong>. The different professionals working in a clinic have not been trained together and often have different conceptions and motivations of teamwork. <\/li>\n\n\n\n
  3. A culture of care that is still centered on the doctor<\/strong>. Great efforts are underway to develop interprofessional collaboration and there is still a long way to go to improve interprofessional collaboration and collaboration between physicians. <\/li>\n\n\n\n
  4. Hierarchy and power dynamics<\/strong>. Through regulation and a lot sociologically, doctors hold a lot of formal and informal power. And that’s not to mention the hierarchical structure of the health and social services network, which often demobilizes staff. <\/li>\n<\/ol>\n<\/div>\n\n\n

    Overcoming these challenges will be possible through the sustainable development of teaming skills. Let’s be ambitious and cultivate powerful collaborations beyond “interprofessional collaboration”, i.e. between people gathered around inspiring goals. <\/p>\n\n\n\n

    Gradually, the medical literature integrates the best knowledge for pragmatic teaming by proposing syntheses of basic skills as in (2) and (3). <\/p>\n\n\n

    \n Accordion<\/span>\n

    Example of a team-building competency framework<\/h3>\n \n\n
    \"\"<\/figure>\n\n\n\n

    Source: static.cambridge.org<\/a><\/p>\n\n\n<\/div>\n\n \n\n\n\n

    Towards “communityship”<\/strong> <\/h3>\n\n\n\n

    In his recent book, Henry Mintzberg describes the different forms of organization and the forces that can operate in them (4). Traditionally, a clinic takes the form of a professional assembly<\/em>, not very tightly knit, focused on the expertise and autonomy of the doctors around whom the “support” professions revolve. Teaming and the challenges mentioned above encourage migration to the organizational form that Mintzberg calls communityship<\/em>. In such an organization, members are empowered in their roles and brought together by a strong common mission. Such an organization still needs leaders, but at the service of teaming and the leadership of all. For doctors and managers, to become aware of one’s power, to listen, to develop one’s humility and to invite others to take their place, to occupy their zone of power (5). This same idea of communityship<\/em> is found in the orientations of the GMF apprenant (6) and the Learning Health Community (7). <\/p>\n\n\n\n

    Let’s take the path of communityship and collective leadership by deliberately developing our teaming skills. <\/p>\n\n\n

    \n Accordion<\/span>\n

    Some references for the development of teaming<\/h3>\n \n\n

    Edmondson AC. The fearless organization: creating psychological safety in the workplace for learning, innovation, and growth<\/a>. Hoboken, New Jersey: Wiley; 2019.<\/p>\n\n\n\n

    Edmondson AC. Teaming: how organizations learn, innovate, and compete in the knowledge economy<\/a>. 1st ed. San Francisco: Jossey-Bass; 2012.<\/p>\n\n\n\n

    Greilich PE, Kilcullen M, Paquette S, Lazzara EH, Scielzo S, Hernandez J, et al. Team FIRST framework: Identifying core teamwork competencies critical to interprofessional healthcare curricula<\/a>. J Clin Trans Sci. 2023; 7(1):e106.<\/p>\n\n\n\n

    Coop Network.\u00a0The Self-Management Exploration Manual<\/a> [Internet]. 2023. (in French) <\/p>\n\n\n\n

    Slade S. Going horizontal: creating non-hierarchical organizations, one practice at a time<\/a>. First edition. Oakland, CA: Berrett-Koehler Publishers; 2018.<\/p>\n\n\n\n

    Zajac S, Woods A, Tannenbaum S, Salas E, Holladay CL. Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance<\/a>. Common Front. 2021 Mar 17;6:606445.<\/p>\n\n\n\n

    Books \u2013 Amy C. Edmondson<\/p>\n\n\n\n

    A post from Savic Rasovic on Amy C. Edmondson provided by: https:\/\/amycedmondson.com<\/a><\/p>\n\n\n<\/div>\n\n \n\n\n

    \n Accordion<\/span>\n

    Bibliography<\/h3>\n \n\n

    1. Mission and Vision<\/a> | SSA Support Unit [Internet]. SSA Quebec Support Unit. [cited 2024 Sep 6]. <\/p>\n\n\n\n

    2. Greilich PE, Kilcullen M, Paquette S, Lazzara EH, Scielzo S, Hernandez J, et al. Team FIRST framework: Identifying core teamwork competencies critical to interprofessional healthcare curricula<\/a>. J Clin Trans Sci. 2023; 7(1):e106.  <\/p>\n\n\n\n

    3. Zajac S, Woods A, Tannenbaum S, Salas E, Holladay CL. Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance<\/a>. Common Front. 2021 Mar 17;6:606445.  <\/p>\n\n\n\n

    4. Mintzberg H. Understanding organizations … finally! Structuring in sevens<\/a>. First edition. Oakland, CA: Berrett-Koehler Publishers, Inc; 2023. 243 p. <\/p>\n\n\n\n

    5. Mintzberg H. Reorganising our heads for the care of our health<\/a>. BMJ Leader. Feb 26, 2024; leader-2023-000912.  <\/p>\n\n\n\n

    6. Groulx A, Bouffard-Dumais C, Boies S, Belval-Nadeau V, Drolet M, L\u00e9vesque M, et al. GMF apprenant\u202f: Orientations<\/a> [Internet].  <\/p>\n\n\n\n

    7. Mullins CD, Wingate LT, Edwards HA, Tofade T, Wutoh A. Transitioning from learning healthcare systems to learning health care communities<\/a>. J Comp Eff Res. June 2018; 7(6):603\u201114.  <\/p>\n\n\n<\/div>\n\n \n\n\n\n

    <\/div>\n","protected":false},"excerpt":{"rendered":"

    Denis C\u00f4t\u00e9 is a regional continuous quality improvement agent. He is a facilitator in the RUISSS Universit\u00e9 Laval territory. In this article, he evokes the transition from a culture of health and social services professionals cooperating without strong cohesion to an intrinsically collaborative organization united around inspiring common intentions. 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