Collaboration and Healthcare

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intrapersonal conflict

conflict that occurs within an individual, is stress or tension that results from real or perceived pressure generated by incompatible expectations or goals

Secondary prevention

diagnose and treat disease

lack of health insurance, lack of usual source of care, perceptions of need, uneven distribution of service, health illiteracy

Barriers to healthcare access

reach and maintain the individual's optimal level of health, quality of life, and ADLs

Case manager responsibilities

lack of knowledge on part of patient/family member, poor coping skills, fear or anxiety resulting in patient/family member expressing frustration, failure of nurse to assess or meet patient needs or promote the therapeutic relationship

Causes of conflict in nurse-patient relationship

Lack of confidence on nurse' part, attempt to save face, fear of repercussion, deference to the physician, attempt to preserve a patriarchal nurse-physician relationship

Causes of conflict in nurse-physician relationship

Relationship-based Care

Empowers the people within the organization to align the processes and structures of care delivery with the way they intend to relate to each other as people 6 Core Components: leadership, teamwork, professional nursing practice, patient care delivery system, resource-driven practice, and outcomes measurement Focuses on 3 key relationships: relationship with self, with colleagues, and with patients/families

support by key members of the organization, a qualified nurse case manager, collaborative practice teams, a quality management system, established critical pathways

Five elements essential to successful implementation of case management

Functional nursing

Head nurse delegates tasks to team members who complete these specific tasks rather than caring for specific patients Best used in emergent situations or LTC

Primary prevention

Health promotion and illness prevention

With patients: acknowledge, support and encourage their active involvement in healthcare decisions; encourage patient autonomy; help patient set mutually agreed-on goals With Peers: Shares personal expertise with other nurses and elicits expertise of others; develops a sense of trust and mutual respect with peers With other healthcare professionals: recognize contribution of each person; listen to each individual's viewpoints; shares healthcare responsibilities; participates in collaborative interprofessional research

How does the nurse collaborate within the nursing profession?

Peplau's Theory of Interpersonal Relations

Nature of nurse-patient relationship strongly influences the outcome for the patient. Using the interpersonal environment as a therapeutic tool for healing and in reduction of anxiety. Ex: Sitting quietly beside a new father who has recently lost his job and attempted suicide and does not want to talk. Process steps: orientation, identification, exploitation, and resolution

Primary nursing

One nurse has 24/7 authority and responsibility for the care of an assigned group of clients

Interpersonal conflict

conflict that occurs between two or more individuals

Team nursing

RN serves as team leader, is accountable for care provided to patients, but assigns tasks to UAP

Interdisciplinary teams

Team members from multiple disciplines interact and use each other's suggestions and information in interpreting data

Be self-aware, collaborate with all parties, state issue objectively, avoid emotion-based discussions, be open to hear all individual's viewpoints and avoid passing judgement, allow all to express concerns without interruption, apply active listening techniques, focus on identifying solutions

To effectively respond to conflict, the nurse should:

miscommunication, inaccurate information, mistrust, ambiguous role expectations, ineffective teamwork, inadequate project planning, ineffective leadership, resistance to change

What are causes of conflict among individuals and groups?

teamwork, mutual respect, true sharing of power and control, trust, effective communication skills, giving and receiving feedback, decision making, conflict management, one-way communication

What are the competencies needed by healthcare professionals for effective collaboration?

parallel communication, parallel functioning, information exchange, coordination and consultation, co-management and referral

What are the steps within the process of interprofessional collaboration?

engage employees in institution-wide programs, use nondisciplinary approaches to resolve issues, increase nurse self-awareness

What strategies are implemented by healthcare executives to assist employees with managing conflict?

Kim's theory of collaborative decision making

collaboration between nurse and patient is influenced by their attitudes and beliefs which they bring into the situation, as well as the nature of the situation in which decisions are made

Dalton's theory of collaborative decision making

collaborative decision making process is influenced by the client, nurse, and family members role expectations, attitudes, knowledge, personal traits, and definition of the situation

interorganizational conflict

conflict that involves competition between two organizations that exist within one market

intergroup conflict

conflict that occurs between teams that are in competition or opposition to one another

Patient-focused Care

organizes healthcare around the expressed physical and emotional needs of the patient

Managed Care

provides cost-effective, high-quality care for groups of patients from the time of their initial contact with the health system through the conclusion of their health problem

Tertiary prevention

restoration of health following an illness or accident and includes rehabilitation and palliative services

Intradisciplinary (interprofessional)

team that seeks to achieve a common goal with team members from the same background

Case Management

the coordination of patient care over time using the combination of health and social services necessary to meet the individual patient's needs


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