00:00
So let's talk a little bit about leadership in healthcare
and having effective teams means having effective leaders.
00:10
So the leader has to do a variety of things.
They have to set priorities.
00:14
They have to make decisions and once they make the
decisions the rest of the team has to agree to those.
00:21
They have to check in with the team
members and making sure the workload is,
you know, relatively fair in
terms of how it's being shared.
00:31
So there's a bouncing of that
workload within the team.
00:36
There may be team members that
are monitoring the situation,
but the leader is also responsible
for that and always checking in
and making sure that things
are working smoothly.
00:45
They need to know how
to utilize resources.
00:48
So, some teams are going to be with limited
resources, others will have more resources.
00:54
The leader has to figure out a way to bring
in resources to maximize performance.
01:00
And there may be times where the leader
needs to call on, you know, for help.
01:04
Need to go to others within the
organization or maybe, you know,
work with other teams to get the help that they need so
that their particular team can function effectively.
01:17
And as I mentioned already, the
idea of resolving team conflicts.
01:21
We're human beings, there is going to
be possibility of having conflict,
but having someone that can be there to help
resolve those things work out the differences.
01:33
So these are the things that an
effective team leader will have to do.
01:36
They have to coordinate and facilitate the teamwork.
So that means delegating task or assignments.
01:43
It means conducting meetings
or huddles or debriefs.
01:46
There may be pre-meetings
before you start the work.
01:49
There may be huddles as you're doing the
work to check in how things are going.
01:53
After our task has been accomplished, there
might be a debrief of how did we do.
01:59
There's a need for a team leader to empower
team members to speak freely and ask questions
so that openness to communication is going to be
very necessary for there to be an effective team.
02:12
So, making sure the leader says "Yes, I
want you to speak up if you have concerns."
As I mentioned, there should be
quality improvement activities.
02:21
There should be
training of the teams.
02:23
So if they see that there are deficiencies
in any kind of skill or task performance
that there's a training opportunity
to get that quality improvement.
02:34
And lastly, there has to
be a vision by the leader.
02:36
So inspiring the team members, making
sure there is a positive group culture,
really making sure that everyone
is committed to the same goal.
02:48
There are going to be teams that fail.
Why can that happen?
Well, one reason is unclear
definition of roles.
02:55
If people really aren't sure what
they're supposed to be doing,
there hasn't been that, you know,
forming approach and, you know,
getting to a stage where you
understand your responsibilities,
that might mean that
the team fails.
03:11
There may not be someone that is
exquisitely coordinating the team.
03:14
So that checking in whether it's a
particular leader or all members
being responsive for this coordination,
another reason why teams might fail.
03:24
And then the biggest, you know, which we see
in healthcare is inadequate communication.
03:29
People don't talk to each other.
03:31
If people aren't listening to each other,
that can be a reason that teams fail.
03:39
This brings us to the question of well "What if
there's a medical mistake or a medical error?
How should the team
approach that?"
In the old days, it might be blame the person
that had the error," blame the individual.
03:57
But it's really been recognized
that that's not a good approach.
04:00
It makes people more defensive and not
going to be open to sharing when things
haven't gone right or there's
been an actual mistake.
04:08
So, this idea of a just culture means
everyone is committed to learning,
everyone is committed to open and honest
reporting, and everyone is going to work towards
improving the system so that the error mistake
doesn't happen in the future to another patient.
04:27
And really the focus comes not on
the individual, but on the system.
04:31
So how can you design the system to prevent the human
errors that are just naturally going to happen?
How do you set up a system that has
accountability when the error does occur?
How do you figure out, you know, how to work
with team members to shape the behavior
so that when they have choices to
make, the easy way or the harder way
but what's the safest way that they
figure out a way to accomplish the task?
The just culture mentality also means
that there's mindfulness of team members
towards making a culture
that is focused on safety.
05:12
So it says that there may not be this hierarchy
that we often talk about in healthcare
that really it's not deference to a rank or
status, but more deference to expertise.
05:22
If there is a team member that has the more salient
expertise for a particular task, you rely on that person.
05:32
It's also a way to
flatten the hierarchy.
05:34
So, you know, when there are concerns about,
you know, things being dictated from above,
maybe there's an opportunity say "Well,
we have to alter or flatten the hierarchy
to fit the specific situation so that there can
be this openness of team members to talk."
There also has to
be adaptability.
05:55
So, when the unexpected occurs, when
things you didn't anticipate happened
that you're able to adjust and adapt
to respond to the new situation.
06:07
And always, you know, if it's you
know safety or patient well-being,
whatever the core goal is, that
that sense of the big picture
is always kept in mind as you're completing
each individual task as a team member.
06:23
And also when we're thinking about the system as a
whole, this is an opportunity to promote innovation.
06:29
So team members that are always doing
the same thing and it always, you know,
is a hard task, if they can innovate and
figure out ways to make it a simple task
or less prone to error, they share that and
then that gets moved up into, you know,
the administration and others
in the institution to make sure
that the just culture has that learning
opportunity and innovation is foster.