arrow_up-blue blog branches consultations events facebook-icon facebook-icon2 factsheet forum-icon forum hands key link location lock mail measure menu_plus news pdf pdf2 phone policies publications related search share subjectguide twitter-icon word youtube-icon

Team working

Principle G

As a member of the nursing team, you will be required to work in collaboration with other staff and patients in order to provide the best possible care.

Collaborative working can mitigate patient safety risks. It is dependent on the contributions of many people from patients and service users, carers and families to volunteers, caterers and healthcare staff.

This page explores how nutrition and hydration challenges organisations to work across team boundaries and build better relationships to facilitate improvements (2).

The role of team structure

Teams have structures and dynamics which can impact significantly on nutrition and hydration (3). The structure of a team consists of: a hierarchy, accepted behaviours and roles. The performance of a team and the outcomes the team is striving to achieve, can be influenced by any of these elements.

Role clarity will give staff the confidence to undertake tasks. This applies not only to formal roles (nursing staff, dietician, catering staff, team leader) but also to informal roles that team and inter-team working may require (co-ordinator, motivator, critical friend).

The role of team dynamics

Team dynamics refer to the “psychological processes describing the interactions that occur in a group, evidenced by behaviours associated with coordination, communication, cooperation, conflict management, and decision making” (3). Organisations working in high risk environments such as health care, invest heavily in these areas and look for ways to embed tools that support good team work.

The Team Self Review (TSR), for example, provides support for structured briefing and debriefing sessions. Originally developed for surgical teams it has potential for wider application (4).

Improving coordination is about relationships between people. Achieving greater integration of services is likely to result in people working across organisational boundaries in multi-disciplinary teams which will challenge current work practices (5).

This is particularly difficult in a climate where time is at a premium and staff may be uncertain about the benefits for patients or service users. But this is worth striving for when, in the future, healthcare "needs to operate as a value improvement system, which makes the whole healthcare outcome for the patient greater than the sum of the help that each carer provides, and which supports a patient to be independently healthy or more active in their care" (6).

References

These references were last accessed 7 December 2015.

  1. RCN (2010) Principles of Nursing Practice. RCN.
  2. Health Foundation (2010) Safer Clinical Systems. Health Foundation website.
  3. World Health Organization (2009) Human factors in patient safety. Review of topics and tools (PDF 1.10MB). Geneva: WHO.
  4. National Patient Safety Agency (2008) Team Self Review. London: NPSA.
  5. National Voices (2011) Principles for integrated care (PDF 187.63KB). London: National Voices.
  6. Øvretveit J (2011) Does clinical coordination improve quality and save money? Volume 1: a summary review of the evidence. London: The Health Foundation.
  7. National Patient Safety Agency (2009) Nutrition factsheets. 10 characteristics of good nutritional care. London: NPSA.
    Factsheet 03: Good nutritional care.
    Factsheet 09: Monitoring and implementing.
    Factsheet 10: Policy.