Collaboration and Healthcare
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
