PRINCIPLES OF PARTNERSHIP,

COLLABORATION, AND
TEAMWORK

by GLADYS C. YARES, RN RM
Objectives
Define partnership, collaboration, and teamwork
Discuss the types of health care groups: self-awareness, dyad, group, and team
Definition
1. Partnership – state of being a partner & an
association of two or more people as partner. Or
the nurse responsibility to be prepared to partner
with client, family, & community to provide quality
& access to appropriate health care services.
2. Collaboration – a collegial working relationship with
another health care provider in the promotion of
health care.
3. Teamwork – the ability to function effectively within
the nursing and interpersonal team, fostering
open communication, mutual respect, & shared
decision-making.
Types of health care groups:
1. Self-awareness
 Relationship between one’s perception of oneself &
others perception of oneself.
 Purpose: to develop or use interpersonal
strengths.
 They learn the group process through
participation, involvement, & guided exercises.

2. DYAD
 Two person’s groups.
Types of health care groups:
3. Group
◦ - Two or m o r e p e o p l e who h a v e s h a r e d n e e d s & g o a ls , who take e a c h
o t he r into a cc ou nt in their ac tions & s e t a p a r t fro m o t her s b y virtue
of their interactions.
Group dynamics – comm unication that
takes place between mem bers of any
group.
Function of group dynamics:
 Develop & modify its structure for
effectiveness.
 Maintain a degree of unity and
cohesion.
 Accomplish the goals.
Types of health care groups:
4. Team
 Delivery of coordinated care to
individual clients by a group of health
providers.
Nursing Care Delivery Systems
• Provide structure for delivering care
• Assess care needs
• Formulate plan of care
• Implement plan
• Evaluate patient’s responses
Challenges of Delivery Systems
• Effectiveness
• Cost efficiency
• Quality
• Needs of consumers and practitioners
Nursing Care Delivery Systems
Functional Nursing
• RNs, LPNs, and UAPs are assigned different tasks
• RNs assess patients
• Other staff give baths, make beds, take vital signs, administer treatments

Advantages: Disadvantages:
• Staff become efficient at performing • Uneven continuity
assigned tasks • Lack of holistic understanding of patient
• Problems with follow-up
Nursing Care Delivery Systems
Team Nursing
• Team of nursing personnel provides total care to a group of patients
• RN leads team that may include other RNs, LPNs, and UAPs
• Team leaders must be skilled in delegating, communicating, problem solving
• All members of effective teams are good communicators
Advantages: Disadvantages:
• LPNs and UAPs perform tasks that don’t • Time needed for communicating, supervising,
require RN’s expertise and coordinating team members
• Care is more easily coordinated • Affect of changes in team leaders, members,
• Saves steps and time and assignments on continuity of care
• Total patient not considered by any one
person
• Role confusion and resentment
• Less control for nurses over assignments
• Possibility of unequal assignments
Nursing Care Delivery Systems
Differentiated Practice
• Structure of roles and functions differentiated by nurses’ education, experience, and
competence
• Roles, responsibilities, and tasks defined for professional nurses, licensed practical nurses, and
unlicensed assistive personnel

Patient-Centered Care
• Nurse coordinates team of multifunctional, unit-based caregivers
• All patient care services are unit based
• Focus is decentralization, promotion of efficiency and quality, and cost control
TEAM/MODULAR NURSING
Total Patient Care
• RN is responsible for all aspects of care for one or more patients

Advantages: Disadvantages:
• Continuous, holistic, expert nursing care • RNs perform tasks that could be done
• Total accountability more cost-effectively by less skilled
• Continuity of communication persons
TEAM/MODULAR NURSING
Primary Nursing
• RN designs, implements, and is responsible for nursing care for duration of the patient’s stay
on the unit

Advantages: Disadvantages:

• Knowledge-based practice model • Excellent communication required

• Decentralization of decisions, authority, and
responsibility
• 24-hour accountability
• Improved continuity and coordination of care
• Increased nurse, patient, and physician satisfaction
• Accountability of associate nurses
• Patient transfers disrupt continuity of care
• Compensation and legal responsibility for
staff nurses
• Unwillingness of associates to take direction
TEAM/MODULAR NURSING
Practice Partnerships
• RN and partner (UAP, LPN, or less experienced RN) work together on same schedule with same
group of patients

Advantages: Disadvantages:

• Improved continuity of care and accountability • Decreased ratio of RNs to

for care nonprofessional staff
• Potential for junior team members to
assume too much responsibility
TEAM/MODULAR NURSING
Case Management
• Case manager supervises care provided by licensed and unlicensed nursing personnel
• Critical pathways provide direction for managing care of specific patients

Clinical Microsystems
• Small unit of care that maintains itself
• Dynamic, interactive, self-aware, and interdependent
• Proven to improve teamwork, communication, and continuity of care

Other Innovative Systems of Care

• Segmenting hospital into smaller units
• Primary Care Team model
• Collaborative Patient Care Team model
• Transitional Care model • Hospital at Home model
 HOW TO BUILD A COLLABORATIVE TEAM ENVIRONMENT
DEVELOP AND PRACTICE THE FOLLOWING:
1. Trust: Be honest; work to eliminate conflicts of interest; avoid talking behind each other’s back; trust
teammates (you must trust them before they will trust you); give team members the benefit of the doubt.
2. Clarify Roles: Review team member roles frequently; clarify responsibilities when action planning; relate team
member expectations to team’s overall purpose; figure out ways to help each other.
3. Communicate Openly & Effectively: Work to clear up misunderstandings quickly and accurately; seek to
understand all perspectives; err on the side of over communicating; reinforce and recognize team member
efforts. Learn to listen well.
4. Appreciate Diversity of Ideas: Evaluate a new idea based on its merits; remember that reasonable people can
and do differ with one another; avoid remarks that draw negative attention to a person’s unique characteristics;
don’t ignore the differences among team members; try to learn as much as you can from others.
5. Balance the Team’s Focus: Regularly review and evaluate the effectiveness of team meetings; design individual
performance goals that emphasize both results and teamwork; praise individual effort; assign specific team
members to monitor task needs and others to monitor relationship needs; hold team celebrations for achieving
results.
—Adapted from Belgrad, W., Fisher, K., & Rayner, S. (1995). Tips for Teams: A Ready Reference for Solving
Common Team Problems. McGraw-Hill: New York.
 THE NURSE AS A COLLABORATOR
WITH NURSE COLLEAGUES
• Shares personal expertise with other nurses and elicits the
expertise of others to ensure quality client care.
• Develops a sense of trust and mutual respect with peers that
recognizes their unique contributions.

WITH OTHER HEALTH CARE PROFESSIONALS

• Recognizes the contribution that each member of the
interprofessional team can make by virtue of his or her
expertise and view of the situation.
• Listens to each individual’s views.
• Shares health care responsibilities in exploring options,
setting goals, and making decisions with clients and families.
• Participates in collaborative interprofessional research to
increase knowledge of a clinical problem or situation.
WITH PROFESSIONAL NURSING ORGANIZATIONS
• Seeks opportunities to collaborate with and within
professional organizations.
• Serves on committees in state and national nursing
organizations or specialty groups.
• Supports professional organizations in political
action to create solutions for professional and health
care concerns.
WITH LEGISLATORS
• Offers expert opinions on legislative initiatives
related to health care.
• Collaborates with other health care providers &
consumers on health care legislation to best serve
the needs of the public.
Key elements necessary for
collaboration:

1. Communication skills
2. Mutual respect & trust
3. Decision-making
THANK YOU