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Strength in Numbers: The Importance of Nurse Leader-Medical Director Collaboration

Posted on Wed, Feb 01, 2017
Strength in Numbers: The Importance of Nurse Leader-Medical Director Collaboration

By Ginger Wirth, RN

In general, we have a tendency to work in silos in healthcare. We tend to focus on the jobs in front of us and the tasks that we need to complete to get to the end point of the encounter, visit or procedure. There are times when we forget or appear to ignore those around us and their contributions to what we are accomplishing. Perhaps we take for granted that the preliminary work gets done, or that the follow up gets completed when we are finished with our part. The reality is that nothing would actually happen without all of the moving parts and the entire team doing exactly their jobs at the right time and place.

We have an opportunity in healthcare to recognize and strengthen those relationships and teams. It’s important to support and thank the parts of the team that may be far in the background, but are crucial to making our task happen or making it easier.

One relationship that is key is the nurse leader-medical director team. This is parallel to a marriage in many ways. Both managers have to be reaching for the same goals and setting the action items together to get to the finish line. There are times when they will not agree on the tactic or maybe even the goal, but there needs to be a constructive way to debate, discuss and ultimately come to an understanding on how to get there.

It’s key that these discussions happen in a private, confidential and safe environment. If they are conducted in the open, the rest of the team may interfere, see any discontent as rationale not to follow the directive, or even use the negativity to undermine the leadership as a whole. To mirror the “marriage” example, the “kids” will try and use “dad” against “mom” to get what they want. It is so important that this key relationship presents a unified front and send clear goals, expectations and the same message.

The other benefit of a healthy, strong and collaborative relationship between the nurse leader and medical director is the support that they can offer each other. Often, there are the same administrative pressures on the nurse leader as the medical director, so it helps to be able to candidly share frustrations, challenges and ways to cope with each other. In the ED world, these key leaders have been selected for their roles due to their strong personalities and leadership qualities. Why not tap into each other’s skills and potential? Share your strengths with each other and hopefully you’ll feel comfortable enough to take feedback to improve yourself or the message you are sending to the team.

The most effective healthcare team works together. It takes every part working well and collaboratively to get results and reach your goals.

Ginger Wirth, RN

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.
 

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10 Tips for Emergency Medicine-Hospital Medicine Collaboration

Posted on Wed, Jan 13, 2016
10 Tips for Emergency Medicine-Hospital Medicine Collaboration

By Ginger Wirth, RN

According to Merriam-Webster, the full definition of collaborate is:
 

  1. To work jointly with others or together, especially in an intellectual endeavor
  2. To cooperate with or willingly assist an enemy of one's country and especially an occupying force
  3. To cooperate with an agency or instrumentality with which one is not immediately connected

I know that collaboration in healthcare can sometimes seem like assisting another country. The relationships between departments, disciplines, practices and partners have both rewards and challenges. Collaboration is key on so many levels to achieving the best outcomes and delivering the overall best care for patients. This is essential between nursing and providers in the emergency department when planning and executing care. Effective communication and collaboration plays into the safety, clinical quality and satisfaction of each patient’s visit.

Another important collaborative relationship is the emergency physician and the hospitalist. Continuity of care and the handoff of the admitted patient are essential to those same aspects of the patient’s overall experience: safety, satisfaction and clinical quality. This collaboration should happen not only when directly dealing with a patient, but also when processes, order sets or clinical pathways are being developed and reviewed. Healthcare is unique in the fact that we have governing and regulatory bodies that have standards, guidelines and measures that set basic expectations for outcomes. However, ultimately it is the provider-to-provider relationship and collaboration where the “magic happens.” Strong relationships among emergency medicine and hospital medicine teams have proven not only to meet standards but exceed them. Best practice is to have regular team meetings between these specialties to discuss opportunities and share the wins and outcomes of cases. Again, strong collaboration is a “win-win” for all – especially for the patients to which we provide care.

10 Lessons in Collaboration

Regardless of your industry, collaboration is so important. Here are some tips from Deborah B. Gardner PhD, RN, CS:
 
  • Lesson #1: Know thyself. Many realities exist simultaneously. Each person's reality is based on self-developed perceptions. Requisite to trusting yourself and others is in knowing your own mental model (biases, values, and goals).

  • Lesson #2: Learn to value and manage diversity. Differences are essential assets for effective collaborative processes and outcomes.

  • Lesson #3: Develop constructive conflict resolution skills. In the collaborative paradigm, conflict is viewed as natural and as an opportunity to deepen understanding and agreement.

  • Lesson #4: Use your power to create win-win situations. The sharing of power and the recognition of one's own power base is part of effective collaboration.

  • Lesson #5: Master interpersonal and process skills. Clinical competence, cooperation and flexibility are the most frequently identified attributes important to effective collaborative practice.

  • Lesson #6: Recognize that collaboration is a journey. The skill and knowledge needed for effective collaboration takes time and practice. Conflict resolution, clinical excellence, appreciative inquiry and knowledge of group process are all life-long learning skills.

  • Lesson #7: Leverage all multidisciplinary forums. Being present both physically and mentally in team forums can provide an opportunity to assess how and when to offer collaborative communications for partnership building.

  • Lesson #8: Appreciate that collaboration can occur spontaneously. Collaboration is a mutually established condition that can happen spontaneously if the right factors are in place.

  • Lesson #9: Balance autonomy and unity in collaborative relationships. Learn from your collaborative successes and failures. Becoming part of an exclusive team can be as bad as working in isolation. Be willing to seek feedback and admit mistakes. Be reflective, willing to seek feedback, and admit mistakes for dynamic balance.

  • Lesson #10: Remember that collaboration is not required for all decisions. Collaboration is not a panacea, nor is it needed in all situations.


To read more about emergency medicine-hospital medicine integration and collaboration, read our recent white paper, “Integration Changes Everything.”

Ginger Wirth

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.

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Generation Gaps: How to Use Generational Differences to Create More Positive Healthcare Outcomes

Posted on Tue, Nov 04, 2014
Generation Gaps: How to Use Generational Differences to Create More Positive Healthcare Outcomes

By Rosilyn Rayborn
Social Media Specialist


Do you cringe at the sight of casual work attire? Do you crave a team environment and mentoring others? Or, are you tech savvy and hate to be micromanaged?

If you told me which one of the above statements you chose, I could determine whether or not you grew up as a latch-key kid, what time you prefer to leave the office and even which president was in office when you were born. It’s not mind-reading — it’s understanding generational differences.

This was the topic that captivated physician leaders during the 2014 EmCare leadership conference.

The interactive session, “Generational Differences in the Healthcare Workplace,” was led by Dr. Greg Rose, CEO of EmCare Radiology Services, and Envision Healthcare’s Senior Vice President of Human Resources, Kim Norman.

According to the presentation, there are four distinct generations currently active in the American workforce. Each generation has unique preferences for work/life balance, career motivation and communication, which can be key in determining how they interact with team members.

Understanding these generational differences, according to Dr. Rose and Norman, can create better healthcare outcomes for leaders and clinicians.

According to the session, the four generations that are currently in the workforce are Traditionalists (b. 1924-1946), Baby Boomers (b. 1946-1964), Gen X (b. 1964-1982) and Gen Y (b. 1982-2000).
 
Although humans can’t be completely summed up merely by birth year, extensive research has revealed clear distinctions that can be drawn about people when you know when they were born.
 
Why does knowing generational differences matter to health care professionals? Well, Dr. Rose said that as a healthcare leader, one question that is always on his mind is “How does a great leader support the needs of many?”

Imagine that you’re a baby boomer medical director who manages a team member who is a traditionalist.
 
All of a sudden, you understand that a pay raise isn’t as important to this person as feeling valued and you can provide the proper incentives for a job well done. Or how about that Gen-X-er who can’t survive without her smartphone? It’s not that she’s not paying attention – she’s simply a product of her generation.
 
How would you respond if someone asked you what time the workday ended? Would you say “whenever the work is finished” and assume this person is lazy and doesn’t want to work?
 
How “Boomer” of you.

If you knew the dynamics of generational differences, you could identify whether this person is from Gen-Y and if so, you’d know that no, this person isn’t trying to pass the buck on their workload, but that work/life balance is important to this generation and you could respond by taking their concern into consideration.

In short, understanding generational differences helps you recruit, train and interact with fellow healthcare professionals. And it helps us all more effectively communicate and collaborate to create better healthcare outcomes like the team at Lakeland Regional Medical Center who recently shared how they worked together to drastically decrease wait times in their Genesis Cup winning presentation “Optimizing the Emergency Department for Patient Flow.


 

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