Team Work and

Nurse-Physician
Relationship
Team Work
The way in which the team members function
and coordinate to produce synchronized
output ( patients outcomes ).
Team Process
 Poor team work is causal factor underlying
critical care incidents.

Team effectiveness Communication

Performance Leadership

Errors Coordination

Patient outcomes Decision Making

 Team Communication

Definition :
The way in which the team members function
and coordinate to produce a synchronized
output.
Poor team work is a causal factor underlying
critical care incidents in ICU’s
 Team Communication
 information transferred accurately during written
and verbal handover.
 Information disseminated on newly admitted patients.
 Information distributed on patient treatment plan.
 Appropriate information requests during
emergencies.
 Team member acknowledge communications.
 Clear and direct requests made for team assistance.
 Junior team members show speaking –up behavior
 Team Communication/ Literature Review
 Communication is linked to safety and
performance.
 Errors are concentrated after communication
events such as shift changes and hand over.
 37% of these errors are associated with
communication between nurses and physicians.
 Researches demonstrate that the ICU’s with
high level of group development (e.g. mutual
trust and absence of interdisciplinary conflict)
have a lower risk adjusted morbidity rate.
 Team Leadership

Definition :

The guidance of a team and involves defining

goals, expectations, organizing team
resources and coordinating team activities.
 Efficient Leader
 Encourage team input.
Stating and evaluating plans.
Asserting opinions when appropriate.
Listen to staff feedback.
Delegate tasks effectively.
Prioritizing aspects of care.
Ensure team members comfort with assigned
duties.
 Team Leadership/ literature Review

 Real time observation had shown association

between rating of performance and leadership
behavior.
Researches have indicated that the leadership
style of the team leader influence team work.
e.g leader inclusiveness ( Listening and
encouraging Junior nurses ideas) has been shown
to increase team members involvement in PI.
 Team Coordination

Definition:
Concerted and synchronous performance of work
activities by team members with each team
member maintaining an awareness of one
another work.
 Examples of team coordination

Nurses cross check physician

generated patient care plan.

Physicians and nurses providing

“heads-up” alerts to each others.
 Team Decision Making

Definition :
Relates to decision making by the leader by
integrating information and perceptions from the
members of the team.
 Team Decision Making/ Literature Review

 collaborative decision making has been linked to

improved patient outcomes.

 units with higher level of collaboration between

nurses and physicians during transfer decisions
have a lower rates of risk adjusted mortalities and
higher level of nurse and physician job
satisfaction.
 Team Process
T•Team Communication
•Team Leadership
•Team Coordination
•Team Decision Making
• Output
•Patient Outcomes:
•Adverse events
•Patient mortality
• Length of stay
• Unit Efficiency
• Compliance with protocols
•Team Outcomes:
• Team satisfaction
• Job satisfaction
• Staff Morale
• Stress
•Burnout
• Staff turnover
Nurse Physician
Relationship
Is it Important
….WHY?
 Nurse – Physician Relationship

Collaborative Nurse- Physician

Relationships are associated with
improved patients , Nurse and
physician outcomes.
 Patient Outcomes
 Improved patient satisfaction.
Improved patient transferred and
satisfaction decisions.
Improved patient care.
 Decrease length of stay
Reduce medication errors.
 Nursing & Physician Outcomes
 Improved job satisfaction.
 Decrease job associated stress.
 Lower nurse turnover rate.
Improved communication amongst care
giver.
Improve understanding of the nursing role.
Improved Efficiency.
 Barriers to Nurse-Physician
Collaboration

Role misunderstanding: real and precieved

differentials in power.

Position and respect.

Varying perceptions of decision making

input and autonomy.
THANK YOU