Week 7: The Role of Teams in Quality Improvement
The success of any quality improvement (QI) endeavor depends on the team working on it. It is not the number of people, but rather how well they function and work together, that makes a team successful. QI team members must respect each other, and share common goals, a vision, agendas, and timelines to be successful.
—Lendermen et al., 2014, p. 1
Quality improvement cannot be achieved without the use of teams. One person cannot enact change for an entire organization or practice, so the use of teams is an integral component for quality improvement initiatives. However, how teams are created and managed aligns directly with the success of the initiative being proposed and implemented within an organization or practice.
This week, you will examine the use of—and building of—teams for quality improvement initiatives. You will analyze the strengths and weaknesses of teams, as well as explore strategies to build the most effective team for the promotion of quality improvement.
Reference:
Lenderman, H., Reffett, H., Moran, J., & Beaudry, M. (2014). Selecting quality improvement team members. http://www.phf.org/resourcestools/Documents/Team_Member_Selection_Tool.pdf
Learning Objectives
Students will:
Recommend strategies for building effective quality improvement teams
Evaluate membership and roles of stakeholders in quality improvement teams
Analyze potential challenges in becoming a member or stakeholder in a quality improvement team
Learning Resources
Required Readings (click to expand/reduce)
https://academics.waldenu.edu/catalog/courses/nurs-1/8302
Discussion: Strategies for Building Effective Teams
You have been assigned to work on a team to support a new quality improvement initiative at your nursing practice. The initiative is designed to support and improve patient care, and the team is tasked with leading the initiative. The team is comprised of the best and the brightest the nursing practice has to offer, selecting only the leaders of each department. However, after the first team meeting, you discover the team dynamics might lead to more argument than action.
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If this concern manifests this early in the planning process of a quality improvement initiative, is this team the most effective for this task? What strategy might work best to ensure that the right team is composed for the task ahead?
Working in teams provides an important benefit to addressing a problem. A team can provide nuanced ideas and strategies that might be missed by working individually. Teams help to lessen the load on an individual, as well as provide different perspectives to spark ideas. However, working in teams is not without its challenges.
A mix of personalities, experiences, and styles can make or break a team, so what are the best ways to build an effective team? What strategies can be utilized to minimize any adverse effects of working in teams?
For this Discussion, consider what makes an effective team. What strategies might you use to build an effective team? Who might need to be included in a team? Consider the use of teams for quality improvement, and analyze what would make an effective team for a quality improvement initiative.
To Prepare:
Review the Learning Resources for this week, and consider the potential impact and role of teams in quality improvement.
Reflect on potential strategies for building effective teams in promoting quality improvement initiatives for nursing practice and/or healthcare organizations.
Consider the type of stakeholders that might comprise these teams and potential challenges for “earning a seat at the table” of such a quality improvement team.
When faced with a situation where the dynamics of a team might lead to more argument than action, it’s essential to evaluate whether the current team composition is the most effective for the task at hand. While the team may consist of the leaders of each department, being a leader in one’s department doesn’t necessarily translate to being effective in a cross-functional team setting. In such cases, it might be necessary to reassess the team composition and consider additional criteria beyond individual leadership roles.
To ensure the right team is composed for the quality improvement initiative, consider the following strategies:
**Diverse Skill Sets and Perspectives**: Look beyond leadership titles and aim to assemble a team with diverse skill sets and perspectives relevant to the initiative. Include individuals with expertise in quality improvement methodologies, data analysis, frontline nursing experience, patient advocacy, and change management.
**Team Compatibility**: Assess compatibility among team members beyond professional qualifications. Consider interpersonal dynamics, communication styles, and conflict resolution abilities to ensure a cohesive team that can work well together.
**Inclusive Decision-Making**: Involve relevant stakeholders from different levels of the organization in the decision-making process. This not only promotes transparency but also ensures that the team benefits from a broad range of insights and experiences.
**Clear Goals and Roles**: Establish clear goals for the quality improvement initiative and ensure that each team member understands their roles and responsibilities. Clarity in expectations can help prevent misunderstandings and conflicts.
**Effective Communication**: Foster open and transparent communication within the team. Encourage active listening, constructive feedback, and regular updates on progress and challenges.
**Conflict Resolution Mechanisms**: Implement mechanisms for resolving conflicts promptly and constructively. Provide training or resources to help team members develop conflict resolution skills and promote a culture of respect and collaboration.
**Continuous Learning and Improvement**: Create opportunities for ongoing learning and skill development within the team. Encourage feedback loops, reflection on outcomes, and adaptation of strategies based on lessons learned.
In terms of stakeholders that might comprise a quality improvement team, consider including representatives from various departments, such as nursing, administration, quality assurance, patient advocacy, and frontline staff. Each stakeholder brings a unique perspective and expertise that can contribute to the success of the initiative.
Challenges in “earning a seat at the table” of such a quality improvement team may arise due to factors such as hierarchy, resistance to change, or competing priorities. To overcome these challenges, emphasize the value proposition of including diverse perspectives in the decision-making process and demonstrate a commitment to collaboration and shared goals. Additionally, actively engage stakeholders early on, address concerns openly, and provide opportunities for involvement and contribution to foster buy-in and support for the initiative.
By Day 3 of Week 7
Post a brief explanation of a strategy you might recommend for building effective teams to support a quality improvement initiative in your healthcare organization or nursing practice. Be specific. Briefly describe the stakeholders you would recommend to make up this quality improvement team, and explain why. Be sure to define the roles of the members making up the quality improvement team. Then, explain any potential challenges or considerations you should keep in mind that may affect who might “earn a seat at the table” to comprise this team. Be specific and provide examples.
One effective strategy for building a quality improvement team in a healthcare organization or nursing practice is to implement a cross-functional team approach. This involves assembling a team with representatives from different departments and disciplines who collectively possess the necessary skills, expertise, and perspectives to drive meaningful change and improvement.
For example, in a hospital setting, the quality improvement team might include the following stakeholders:
**Nurse Managers**: These individuals provide frontline insights into patient care processes, workflow inefficiencies, and staff challenges. Their role involves representing nursing staff concerns, implementing changes at the unit level, and monitoring progress.
**Physicians**: Physicians bring clinical expertise and can provide input on evidence-based practices, clinical guidelines, and medical protocols. Their involvement is crucial for ensuring medical staff buy-in and adherence to quality improvement initiatives.
**Quality Assurance Specialists**: Quality assurance specialists possess expertise in data analysis, performance metrics, and regulatory compliance. They play a key role in collecting and analyzing quality data, identifying areas for improvement, and monitoring outcomes.
**Patient Advocates**: Patient advocates represent the voice of patients and families, advocating for patient-centered care and ensuring that quality improvement efforts prioritize patient safety, satisfaction, and outcomes.
**Administrative Leaders**: Administrative leaders, such as hospital administrators or department heads, provide strategic direction, resource allocation, and organizational support for quality improvement initiatives. They facilitate communication, remove barriers, and champion the importance of quality improvement within the organization.
Challenges or considerations in composing this quality improvement team may include:
**Hierarchy and Power Dynamics**: Some stakeholders may feel marginalized or hesitant to contribute if they perceive a lack of influence or recognition within the team. Addressing power differentials and fostering an inclusive culture where all voices are valued can mitigate this challenge.
**Resistance to Change**: Resistance to change is common in healthcare settings due to ingrained practices, professional autonomy, and fear of the unknown. Engaging stakeholders early, providing education and rationale for the initiative, and involving them in the decision-making process can help overcome resistance.
**Competing Priorities**: Healthcare professionals often juggle multiple responsibilities and priorities, making it challenging to dedicate time and resources to quality improvement efforts. Aligning quality improvement goals with organizational priorities, offering incentives or recognition for participation, and streamlining processes can help alleviate this challenge.
By addressing these challenges and leveraging the diverse expertise of stakeholders, the quality improvement team can effectively drive positive change and improve patient outcomes within the healthcare organization or nursing practice.
Week 7: The Role of Teams in Quality Improvement
By Day 6 of Week 7
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or offering an alternative strategy recommendation and/or alternative stakeholders to take part in the quality improvement team described by your colleague.
Absolutely, I’ll provide feedback on your colleague’s response:
—
**Colleague’s Response:**
I appreciate your thorough approach to building a quality improvement team in a healthcare setting. Your emphasis on including stakeholders from various departments and disciplines is crucial for ensuring a comprehensive approach to driving improvement initiatives.
One additional stakeholder I would recommend including in the quality improvement team is frontline staff representatives. These individuals, such as registered nurses, nursing assistants, and other direct care providers, offer invaluable insights into daily operational challenges, patient care experiences, and potential areas for improvement. By involving frontline staff members in the quality improvement process, the team can foster a culture of ownership, engagement, and continuous improvement at the grassroots level.
Moreover, considering the potential challenges you mentioned, such as hierarchy and resistance to change, frontline staff representation can help bridge the gap between leadership initiatives and frontline implementation. They can serve as champions for change, advocating for practical solutions that address real-world challenges faced by frontline caregivers.
In terms of defining roles, frontline staff representatives could participate in quality improvement projects by contributing input during brainstorming sessions, participating in process mapping exercises, implementing workflow changes on the unit level, and providing feedback on the effectiveness of interventions. Their active involvement can enhance the relevance, feasibility, and sustainability of quality improvement initiatives within the organization.
—
**My Response:**
I completely agree with your suggestion to include frontline staff representatives in the quality improvement team. Their involvement is indeed crucial for capturing the ground-level insights and ensuring that proposed changes are practical and feasible within the daily workflow.
Expanding on this idea, another stakeholder group that could significantly contribute to the quality improvement team is patients and their families. Incorporating the perspectives of those directly receiving care can offer unique insights into the patient experience, identify areas for improvement from the end-user perspective, and help prioritize initiatives that have the most meaningful impact on patient outcomes and satisfaction.
Patients and families can participate in quality improvement initiatives by serving on advisory councils, participating in focus groups or surveys to provide feedback on their care experiences, and collaborating with healthcare providers to co-design solutions that meet their needs and preferences. Their involvement can enhance the patient-centeredness of quality improvement efforts and ensure that initiatives align with the overarching goal of improving patient care and satisfaction.
By including frontline staff representatives and patients/families in addition to the stakeholders you mentioned, the quality improvement team can benefit from a holistic understanding of the challenges and opportunities for improvement within the healthcare organization or nursing practice.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Discussion Rubric
Post by Day 3 of Week 7 and Respond by Day 6 of Week 7
To Participate in this Discussion:
Week 7 Discussion
What’s Coming Up in Week 8?
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Next week, you will explore the application of quality improvement models in organizations and systems. You will also consider the application of these models on adverse events in nursing practice.
Week 7: The Role of Teams in Quality Improvement
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