Safety culture is a facet of organizational culture that captures attitudes, beliefs, perceptions, and values about safety. A culture of safety is essential in high reliability organizations and is a critical mechanism for the delivery of safe and high-quality care. It requires a strong commitment from leadership and staff. In this course, a safe culture is promoted through the use of identifying and reporting patient safety hazards, accountability and transparency, involvement with patients and families, and effective teamwork.
Leadership
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Setting the Stage for Success: An Eye on Safety Culture and Teamwork (Patient Safety II)
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Strengthening Safety Culture Through Teamwork
Research shows that many errors can be attributed to breakdowns in teamwork and communication. In this module, participants will learn how safety culture can be strengthened though teamwork and communication. Participants will learn skills critical in the prevention and mitigation of medical errors.
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Eileen Kasda
Hello, and thank you for watching this video on team leadership.
Here, we're going to talk about some of the skills that are
necessary for leaders to support teams and their performance.
And that really is one of the core roles of a team leader,
is to be there to ensure that the teams have what they
need to be successful in their work.
As we've introduced in previous videos,
there's a number of sets of processes that we can
talk about that teams need to be effective at.
One of these is interpersonal processes,
again how we treat each other as human beings and manage our relationships.
Another set of skills is transition processes,
how we prepare for performance,
our action processes, how we actually execute a task
together in an interdependent task and then transition process at the end, right?
So, reflecting on our performance,
seeking to understand what went well,
how can we improve,
how can we create an environment where we're learning and getting better over time.
And the leadership's role in all of these are
pretty fluid depending on what the team is doing.
But we can talk through each of these and identify
some key things that a leader needs to focus on
to help the team and to support the team in each of
these interpersonal transition and action process phases.
So starting with the transition process of preparing for performance,
so we're not yet conducting our task but we're getting ready to do so,
the team leaders responsible for selecting team members.
In healthcare, in many situations,
this is not something we have a lot of control over
but team leaders can influence who gets hired,
and scheduling, and trying to understand those issues of who needs to be on the team,
who needs to be informed,
who needs to be formally a part of the team are really very important.
Leaders also define the vision for the team,
trying to pull people together.
Again, we have a tendency in healthcare to not be
as cohesive as a team as the work maybe requires So,
leaders that can create a vision where people understand that they are
a part of a team and feel a part of the team is really important.
In establishing expectations and goals is very important, of course.
Starting the work a team needs to make sure that everyone is clear about what's
going on and what we're trying to achieve together.
For a project management team,
this can be the outcomes we're trying to improve or the goals of that project team.
For patient care team,
it can be understanding what all the patients' needs
are and how we kind of need to work together to support those needs.
On the structure and the plan of the work,
the team leader doesn't need to develop all of this, of course,
by him or herself but does need to ensure that there
is one there and that it's shared among all the team members.
We understand roles and responsibilities.
We understand what our approach to managing,
all the demands are and really reaching our goals together.
And the last piece is a really responsible for
training and developing team members over time.
And this makes most sense in the context of a project team trying to
understand who has skills they can develop and connecting them to those skills.
Whether that's a mentor,
whether that's development or
training programs within the organization or outside the organization.
A good team leader understands where people on that team are in terms of
their development and helps connect them to resources to
improve their ability to work effectively on the team.
We think about the action phase of a team's work where we're actually executing a task
where you're taking care of patients or we're in the middle of implementing a project.
If we're an improvement team,
some of the things that matter for team leaders to focus
on are monitoring the team and managing
boundaries so that really is keeping tabs on how the team is performing,
who is struggling, who is not,
in the boundaries between work.
Making sure people aren't reduplicating efforts or not having conflict
between people but that the work overlaps effectively.
Challenging the team.
So, good teams respond well to challenging environments.
So we want to make sure that we're testing our ideas, our assumptions.
We want to make sure that we're pushing
ourselves to be better than we've been in the past
and a team leader can help create that environment where we're trying to do better,
where we're critically evaluating our approach and all of our assumptions.
And the team leader helps the team solve its own problems.
A good leader not only comes in and solves
problems when necessary but tries to create the environment where people are responsible,
and people feel empowered to solve their own problems,
because that's what you want to see over time,
is more of a self-managed team,
where the leader is really there to help when things go off
the track or new things come up that the team needs help integrating into their plan.
But realistically, the team should be addressing a lot of these things.
Of course, providing resources.
If this is a project management team,
a quality improvement team, safety improvement team,
that means identifying whatever equipment or supplies or
time we need and working to make those available for the team.
If it's a patient care team,
it's thinking through what we'll need for this patient or these sets of
patients today and making sure that those are available to the team members,
so everyone is efficient and as effective as possible.
And as we kind of touched on with the solving problems,
really great leaders help encourage teams to self-manage,
to do a lot of these leadership behaviors on their own.
This is good for the team but this is also good for
the development of individuals where over time,
we're easing ourselves in to roles,
to more leadership functions,
and perform the role of a leader or the functions
of a leader even if we're not formally designated as a leader.
And supporting a healthy social climate.
Again, building trust.
So we talked about humble inquiry in the last video,
is a great strategy for helping to build a positive social climate where
people feel respected and their ideas are valued.
The leader really role models those types of behaviors to build
a team climate that's going to support everyone in their work.
So the transition process is at the end.
This is where we have completed some piece of work.
This might be a shift. This might be a specific patient, procedure.
This might be a project for a quality improvement team.
The leader is really there to help facilitate sense making.
When we're engaged in work together,
it may be difficult for everyone on
that team to understand the big picture of what happened.
We may not all be present for all pieces of it.
So a team leader that can help pull the pieces together,
understand what happened, and help build
that sense of kind of collective understanding the team is very important.
And then providing feedback both to individuals on what they did that was effective,
and what they did that could use some improvement,
are both key team leadership functions.
And the last piece, how team leaders support interpersonal management skills.
Again, how we treat each other as human beings and as coworkers and colleagues.
So, a lot of this has to do with motivating people.
If we know we're working together and we know we're all
contributing to the common shared goals,
we're more likely to be resilient in the conflict we see from individuals.
So they really help create a vision that is compelling to
people and that is meaningful to
people and they promote this idea of psychological safety,
which we've touched on throughout these videos which is really people's comfort and
their willingness to speak up in the face of
potential adverse consequences for themselves.
So they're not afraid to touch potentially sensitive issues with their team members.
People feel that those types
of conversations are coming from a positive and constructive place.
We trust the people we work with to have
our interests at heart and to be focused on the patient and each other's well-being.
And then we manage emotions and conflict.
Inevitably, there will be conflict around tasks,
around how things should be managed,
and those under high stress can become very emotional.
So having a leader that can support those difficult conversations and turn them
into productive outcomes is a critical leadership function.
So when you're leading a project team,
there's a list of things you can think of that
encapsulates a lot of the ideas we've talked about.
These are things, as a leader,
you should focus on to make sure you're set up to be as successful as
possible to set your team up to be as successful as possible.
The first one, is ensure that your team is a real team.
And we've talked about this notion of a real team before,
but this is a group of people that understand they have a shared goal in common,
understand that they cannot achieve that goal without each other,
and they take the time to effectively manage how they're working together as a team.
We want to make sure people understand
these things and that they don't view themselves as a group of
people with a common meeting schedule or
calendar invitation but they are a cohesive group of people,
a team working towards a shared goal in a meaningful way.
The second piece involves providing
a compelling direction or helping the team to develop that compelling direction.
And this breaks down into three main components.
The first one is clarity.
We need to understand exactly what it is that we're working towards.
The more specific we can get, the better.
We also need to make sure that people feel that this direction,
that these goals are meaningful.
We're all working towards the same thing and
that end goal is important to us, to all of us.
And the third piece is that this direction and
these goals need to be challenging but achievable.
People need to think that they're not just a run-in-the-mill thing we can do in a day,
but they're worth investing time and effort in.
They're going to be difficult but we can do it.
We can climb that hill and we can make it happen.
So challenging and achievable can be
a difficult balance to make but it's something a leader needs
to help do to ensure the team is focused
on something that's going to be rewarding for everyone in the organization.
Providing an enabling structure.
This gets at the issues of resources we talked about,
to make sure the team has the right mix of people and the right set of norms,
the right set of expectations about communicating.
And the most critical one is that the expectation is set that
we're going to proactively identify challenges,
proactively surface information that can lead us down the wrong path.
So we have that open,
trusting environment characterized by psychological safety.
And we ensure that there's a supportive organizational context,
and this means that the work that the team is doing
is valued by the rest of the organization.
We're not doing something that the organization is going to be ambivalent towards,
we're doing something the organization cares
about and it's aligned with the bigger picture,
the bigger plan, the bigger strategy for the organization.
So the leader is really managing the external boundaries
here and making sure what we do as a team,
connects to the bigger picture of what's
happening in our hospital or health system or clinic.
And the last piece has to do with development.
Everyone on the team should have access to expert coaching.
This can be challenging but this gets to,
again, knowing the people who are on the team,
knowing where they are and their development,
and creating some opportunities for them
to improve as an individual and as a member of the team.
This can be connecting people to a mentor,
this can be connecting people to some formal training within the organization or outside.
But we really understand our people and we seek to help to make them better.
So today, we talked about some of the key functions a leader does.
These are relatively the same for patient care,
teams versus project management teams,
though they may look a little different in practice.
In our following video,
we'll dig a little deeper into briefings and
debriefings as another method of improving team performance and health care.
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