Leading Interprofessional Teams Discussion NR703

Leading Interprofessional Teams Discussion NR703

 Purpose

The purpose of this discussion is to explore your interprofessional collaboration skills to sustain a practice change project, manage conflict, and apply a professional practice model effectively.

Instructions

DNP-prepared nurses typically lead and manage interprofessional teams, departments, divisions, and healthcare organizations. Refer to the interactive exercise from this week’s lesson and respond to the following:

1. Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration.
2. Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models.
3. Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

• Link (webpage): DNP Discussion GuidelinesLinks to an external site.

Program Competencies

This discussion enables the student to meet the following program competences:

2. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
3. Appraises current information systems and technologies to improve health care. (POs 6, 7)
4. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Also Read:

NR703 Week 4 Leading Through Ethical Relationships Discussion

Course Outcomes

This discussion enables the student to meet the following course outcomes:

1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Due Dates

• Initial Post: By 11:59 p.m. MT on Wednesday
• Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample Leading Interprofessional Teams Discussion NR703 Week 3 Discussion

Hello Dr. D and class, 

Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration. 

Once a practice change project has been implemented, sustainability will be the focus of the project.  Intra- and interprofessional collaboration from the planning stages through implementation will help to sustain the project.  I am fortunate that as a palliative nurse practitioner I am part of an intra-disciplinary team and thus am used to working collaboratively with multiple disciplines.  

We are all on the same medical team, but we are in different disciplines – nurses, nurse practitioners, physicians, chaplains and social workers. I have learned a lot working in this style of team and I believe it will help me with my project implementation.

I know that my ability to understand and respect the roles of others and to recognize them as the experts in their role will be reflected in the success of the practice change project. Clear and consistent communication with the team will also be necessary and I plan to ask my team the best way for them to receive communications and to adapt to the responses. Continuing to build relationships through trust and collaboration.  

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Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models. 

Relationships will be integral to implementing a practice change project, and so will be awareness of the conflict that is inevitable with relationships. My response to potential conflict can affect the successful outcome of the project. Steen & Shinkai (2020) discuss an example of conflict in the healthcare workplace and how understanding the Thomas-Kilmann Conflict Model is useful to conflict resolution.

The Thomas-Kilmann Conflict Model recognizes five unique responses to conflict that emphasize agenda or relationship or a combination of both (avoiding, competing, compromising, accommodating, collaborating).  People can have any of these responses in different situations but tend to gravitate towards one they are most comfortable with.  Steen & Shinkai (2020) allow that some of the responses are more effective with different types of conflict, so none are inherently “good” or “bad”. 

Since any of these five responses can be appropriate for different situations, Steen & Shinkai (2020) advocate that recognizing and mastering all these styles is important for effective leadership.  Most of the time my own reaction to conflict is collaboration — a method to protect my relationships as they are very important to me. Collaboration comes naturally to me as my palliative medicine team by its nature is highly collaborative both within the team and with the rest of the patient care teams.

If there is conflict that I fear will hurt relationships and there is no other way around it, I tend to sacrifice my own wishes (accommodation) to make others happy. As Steen & Shinkai (2020) discussed, I can remember specific instances when I have had each of these reactions including more assertive means for conflict resolution as the situation required swift and decisive action in order to protect a patient (competing). 

In general, my response to conflict should always ensure that I’m taking into account everyone else’s opinion and also valuing it. I like to address conflict quickly as it makes me uncomfortable, and likely if I’m more patient, the most appropriate conflict reaction would become apparent.  

Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment. 

Potential barriers to implementation of a practice change project are considered in the planning stages of the project, although some barriers that weren’t anticipated are likely to arise during the process.  Using a practice professional model can help overcome barriers that are encountered.

I work for Northwestern Medicine at one of their Magnet hospitals and the nursing model that we use is called the “Northwestern Medicine Interprofessional Relationship Based Care Model”. This professional practice model is pictured below and intertwines interprofessional collaboration among interdisciplinary teams with safety, quality and innovation/research while also encompassing the healthcare systems values which are based on the motto “patient first”. 

(Northwestern Medicine, 2023).  

I will use this practice model in implementing my project as it can help overcome barriers as it stresses the importance of interprofessional collaboration in order to improve patient outcomes and safety. I work in a Magnet hospital (one of the first in Illinois) and was one of the writers of our first Magnet re-designation documents (when the entire submission was paper and had to measure “x” height), and therefore I am comfortable and confident in using the Northwestern Medicine practice professional model. Working in a research-based facility with a highly collaborative culture will also help me overcome barriers.  

References 

Northwestern Medicine (2023). Delnor Hospital professional practice model. https://www.nm.org/for-medical-professionals/for-nurses/nursing-at-delnor-hospital/delnor-professional-practice-modelLinks to an external site.  

Steen, A. & Shinkai, K. (2020). Understanding individual and gender differences in conflict resolution: A critical leadership skill. International Journal of Women’s Dermatology, 6(1), 50–53. https://doi.org/10.1016/j.ijwd.2019.06.002Links to an external site. 

NR703 Week 3: Leading Interprofessional Teams Student Lesson Plan

Overview

Program Competencies

2. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
3. Appraises current information systems and technologies to improve health care. (POs 6, 7)
4. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Weekly Objectives

1. Characterize nursing professional practice models. (PCs 2, 4; PO 6; COs 1, 2)
2. Create an approach to lead sustainable improvements. (PCs 2, 4; PO 6; CO 2)
3. Appraise principles of interprofessional collaboration in advanced nursing practice. (PCs 2, 4, 6; POs 6, 8; COs 2, 3, 4)
4. Explore conflict management in an interprofessional environment. (PC 6; PO 8; CO 4)

Main Concepts

1. Interprofessional collaboration models (PC 6; PO 8; CO 4)
2. Professional practice models (PC 6; PO 8; CO 4)
3. Leading sustainable improvements (PCs 2, 4; PO 6; COs 2, 3)
4. Conflict management & leadership style (PCs 2, 4; PO 6; CO 1)

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Schedule

Section	Read/Review/Complete	Course Outcomes	Due
Prepare	Assigned Readings	COs 1, 2, 3, 4	Wednesday
Explore	Lesson	COs 1, 2, 3, 4	Wednesday
Translate to Practice	Discussion: Initial Post	COs 1, 2, 3, 4	Wednesday
Translate to Practice	Discussion: Follow-Up Posts	COs 1, 2, 3, 4	Sunday
Reflect	Reflection	COs 1, 2, 3, 4	No submission

Foundations for Learning

Start your learning this week by reviewing the following:

Interprofessional Education Collaborative. (2011). The core competencies for interprofessional collaborative practice.Links to an external site. https://ipec.memberclicks.net/assets/2011-Original.pdf

Interprofessional Education Collaborative. (2016). The core competencies for interprofessional collaborative practice: 2016 update.Links to an external site. https://ipec.memberclicks.net/assets/2016-Update.pdf (Original work published 2011)

World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice.Links to an external site. https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice

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Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

• Read Chapter 4
  • Section: Understanding Professional Practice Models
  • Section: Basic Elements of a Professional Practice Model
  • Section: Building the Case for Innovative Practice Models
  • Section: Care Delivery Practice Model Influencers
  • Section: Cultural Competency of Healthcare Professionals: Leading Through Diversity
• Read Chapter 7
  • Section: Shared Leadership and Managing Team Conflict
  • Section: Leaders Strive for Consensus

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

• Read Chapter 9
  • Section: Interprofessional Collaboration
  • Section: Sustaining the Change
  • Section: Setting Expectations for EBP

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

• Read Chapter 15
  • Section: Interprofessional Collaboration and Teamwork for Translation

Zaccagnini, M., & Pechacek. (2021). The Doctor of Nursing Practice essentials: A new model for advanced practice (4th ed.). Jones & Bartlett Learning.

• Read Chapter 6
  • Section: Interprofessional Collaboration
  • Section: Barriers to and Drivers of Effective Collaboration in Interprofessional Healthcare Teams

Required Articles

Scan the following articles on Professional Practice Models:

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center.Links to an external site. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing.Links to an external site. Nursing Economic$, 28(3), 171-189.

• Please review the figure on page 172 of this seminal article.

Olender, L., Capitulo, K., & Nelson, J. (2020). The impact of interprofessional shared governance and a caring professional practice model on staffʼs self-report of caring, workplace engagement, and workplace empowerment over time.Links to an external site. JONA: The Journal of Nursing Administration, 50(1), 52-58. https://doi.org/10.1097/NNA.0000000000000839

Review the following images/drawings of nursing professional practice models and consider how you would create a similar one:

Keleekai-Brapoh, N., & Toresco, D. (2020). Anchoring a professional practice model: Success through collaboration.Links to an external site. Nurse Leader, 18(6), 552-556. https://doi.org/10.1016/j.mnl.2020.08.007

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

The Myers-Briggs Company. (2019, July 31). Four tips for managing conflict [Video]. YouTube. https://www.youtube.com/watch?v=hsBOVhj9hYc

Silverstein, W., Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration.Links to an external site. American Nurse Today, 12(9). https://www.americannursetoday.com/adapting-professional-practice-model/

Learning Success Strategies

• As you review many familiar concepts in this week’s lesson and readings, reflect on their applications for you in your current and prospective practice settings.
• Look ahead to the Week 5 assignment. Begin an outline using the assignment guidelines, and start collecting ideas and evidence now.
• Develop your ideas and thoughts through the interactive discussion (Review the discussion guidelines and rubric to optimize your performance).
• You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
• Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

• Link (video): Looking at FeedbackLinks to an external site.(2:26)

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

• Link (video): Word: Track Changes and Comments(4:19)

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Week 3 Lesson Leading Interprofessional Teams

Interprofessional Collaboration Models

The American Association of Colleges of Nursing’s (AACN, 2021) revision of The Essentials: Core Competencies for Professional Nursing Education emphasizes the importance of interprofessional partnerships and intentional collaboration across professions. At the advanced nursing education level, specific competencies are being reframed to guide nursing leaders and DNP-prepared nurses. These competencies address several areas to facilitate person-centered care by professional teams. In this draft (AACN, 2021), there are four primary competency categories:

• Communicatein a manner that facilitates a partnership approach to quality care delivery.
• Perform effectivelyin different team roles, using principles and values of team dynamics.
• Use knowledgeof nursing and other professions to address healthcare needs.
• Work with other professions to maintain a climate of mutual learning, respect, and shared values. (pp. 43-45)

Interestingly, the core competencies of Interprofessional Education Collaborative, itself a collaboration of leaders from many different healthcare education professions, developed a similar set of competencies (IPEC, 2011/2016, p. 10).

Click on the segments in the following interactive form more information on the competencies.

IPEC Domains Interactive Transcript

An exciting study of Swiss medical and nursing interprofessional collaboration found that role clarification in interprofessional teams is crucial since leadership can change depending upon the function of the team (Josi et al., 2020). It corroborated other interprofessional collaboration models in emphasizing six domains of interprofessional care:

1. Patient-centered care
2. Interprofessional communication
3. Role clarification
4. Team functioning
5. Collaborative leadership
6. Interprofessional conflict resolution

Escape From the Isolated Silo!

Now that you have been introduced to leading thought trends of interprofessional collaboration, navigate your way from the nursing silo in which you are trapped into the fresh air of interprofessional collaborative practice.

Silo Interactive Transcript

Nursing Professional Practice Model

The American Nurses Credentialing Center (ANCC, 2020) historically has led the way in the development of nursing professional practice models. Most are based on, or modeled after, the ANCC’s own five components of magnet (excellent) healthcare organizations within which are embedded the 14 forces of magnetism (excellence). Notice that, while not one of the five components, the global issues in nursing and healthcare represent the global challenges faced by both. This is known as the Global Burden of Disease.

Click on each of the ANCC components to compare to the Forces of Magnetism.

Five Components Interactive Transcript

The magnet model stimulates individual organizations to create their own professional practice model tailored to their cultures, values, philosophies, quality methods, research methodologies, nursing theories, management styles, and communities.

Nursing professional practice models are usually displayed graphically throughout the organization in all units to remind teams that they are all professionally performing within the same operational methods and framework. In some organizations, the model is adopted by the entire organization (not just the nursing service) to align the efforts of all.

Three explanations or examples of organizations that have implemented a professional practice model and can inform your professional understanding and leadership practice are Al-Ruzzieh and Ayaad (2020), Silverstein and Kowalski (2017), and Miles and Vallish (2010).

• Link (library article): Nursing Professional Practice Model: Development, Implementation, and Evaluation at an International Specialized Cancer CenterLinks to an external site.
• Link (webpage): Adapting a Professional Practice ModelLinks to an external site.
• Link (library article): Creating a Personalized Professional Practice Framework for NursingLinks to an external site.

Conflict Management and Leadership Style

Conflict is recognized as a part of life, so conflict management is an essential tool for leaders to acquire. Conflict resolution involves problem-solving and decision-making. Regrettably, many organizations fail to recognize the value of preparing their leaders in conflict resolution because the costs are significant. Whether it is our profession, a specific institution, an individual, or a group, adverse outcomes from unresolved conflicts are multiplicative.

Before conflict escalates to unresolved anger, depression, and organizational costs such as litigation, it is best to approach conflict from a preventive standpoint. Just as health promotion leads to high-quality and cost-effective outcomes for healthy individuals, conflict prevention can lead to high-quality and cost-effective outcomes for healthy organizations.

Although early conflict management focused on conflict avoidance, such a course is unhealthy at best. One of the most significant conflict examination models and research tools since the 1970’s is the Thomas-Kilmann Conflict Mode Instrument (Thomas & Kilmann, 2007). The model describes five styles of interacting with others and approaching conflict.

The most productive style for interprofessional collaboration is the collaborating mode. Study these five modes and identify your preferred mode of interaction. Next, identify what leadership strengths you may need to develop to reach the collaborative mode. If you reflect deeply enough, you will discover that your default mode aligns highly with your current leadership style. Any surprises?

Thomas-Kilmann Conflict Modes Interactive

Leading Sustainable Improvements

Sustaining change in the healthcare environment can be a challenge, even after the successful implementation of an evidence-based intervention. This is often the case with practice change projects. Even when an organization’s stakeholders are invested in a practice change project, and the DNP student completes the relatively short intervention, the team reverts to its previous behaviors and practices. Sometimes these old practices recur even during the project itself.

For example, a manager may implement walking rounds based on the most recent best evidence, find that they are being implemented by the team, but discover later that they only occur when the manager is in the building and nearby. Such unsustainable improvements are common.

However, there are steps that both the nurse leader and the DNP student can take to improve sustainability. One foundational measure, over which the DNP student may not have control, is creating a supportive organizational culture. Organizations with a robust professional practice model or widely accepted magnet model have a built-in framework to support evidence-based interventions. But what steps might you take as a DNP student to improve the chances of sustainability?

Transactional styles of management should be replaced by transformational leadership using tips like these to sustain change:

• Use a science translation framework or QI model such as one of these:
  • Rogers’s diffusion of innovation
  • Knowledge-to-action
  • Promoting action on research implementation in health services
• Create a project culture
• Create a vision and the need for change
• Enlist the leadership team in supporting the change
• Seek early buy-in
• Use emotional intelligence skills to build relationships
• Lead from an Ethic of Care
• Enlist champions
• Expect barriers and be flexible to modifications
• Communicate clearly, transparently, and frequently
• Monitor the improved process through measurement
• Model the change
• Hold team members accountable

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Week 3 References

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

American Nurses Credentialing Center. (2020). Magnet model—Creating a magnet culture. https://www.nursingworld.org/organizational-programs/magnet/magnet-model/

Interprofessional Education Collaborative. (2020). What is Interprofessional Education (IPE)? https://www.ipecollaborative.org/about-ipec.html

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update.  https://nebula.wsimg.com/2f68a39520b03336b41038c370497473?AccessKeyId=DC06780E69ED19E2B3A5&disposition=0&alloworigin=1

Josi, R., Bianchi, M., & Brandt, S. K. (2020). Advanced practice nurses in primary care in Switzerland: An analysis of interprofessional collaboration. BMC Nursing, 19(1), 1-12. https://doi.org/10.1186/s12912-019-0393-4

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing. Nursing Economic$, 28(3), 171-189.

Silverstein, W., & Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration. American Nurse Today, 12(9). https://www.americannursetoday.com/adapting-professional-practice-model/

Thomas, K. W., & Kilmann, R. H. (2007). Thomas-Kilmann conflict mode Instrument: Profile and interpretive report. Xicom, Inc. http://www.lig360.com/assessments/tki/smp248248.pdf