6 Steps NPs Can Take to Create High-Level Patient Care Teams

Before becoming a nurse practitioner, I worked as an emergency department (ED) and flight nurse. Most days, I was excited to go to work. I enjoyed learning and experiencing new patient adventures with the support of my "work family," which encompassed my colleagues, ED technicians, registration personnel, physicians, and other staff members. We knew that we all played a role in keeping the department flow organized, creating a positive experience, and ultimately providing the best possible care to patients.

When I transitioned to a nurse practitioner role, this team-centered dynamic changed with it. Working in a different department and new position, I began to feel somewhat isolated from the rest of the team. While finding my place took a level of trust and relationship-building, it allowed me to successfully redefine my professional goals. Career development requires a practitioner to work among strangers, gaining familiarity with an unknown culture and establishing trust with a different "work family." However, NP evolutions also offer the opportunity to create a new team leader.

Benefits of Patient Care Teams

Nurse practitioners are able to create and lead patient care teams. Essential to delivering patient-centered care, these teams offer the following benefits:

• Improved coordination of patient care
• Enhanced patient satisfaction
• More efficient use of healthcare services
• Shorter and fewer hospitalizations
• Reduced medical errors
• Better patient treatment compliance

Patient care teams consist of at least two people interacting in a dynamic and interdependent relationship. They engage in effective communication and share the common goal of providing the best care for patients. Although a shared level of responsibility is understood and routinely practiced in healthcare, the absence of high-quality teamwork leads to poor patient outcomes, medical errors, provider burnout, and increased healthcare costs.

Personal Values of Team Members

NPs must establish effective patient care teams in their practice. Before doing so, there are five personal values to consider. The Institute of Medicine identifies the following personal values as integral to high-level patient care team success.

• Honesty: Team members strongly value effective communication within the team. This includes continuous transparency around aims, decisions, uncertainty, and mistakes. Honesty is critical for ongoing improvement and maintaining the necessary mutual trust for a high-functioning team.
• Discipline: Team members carry out their roles and responsibilities with discipline— even when it seems inconvenient. Similarly, members seek out and share new information to enhance individual and team functioning—despite potential discomfort. This level of discipline allows teams to develop and abide by their standards and protocols while finding ways to improve.
• Creativity: Team members are excited about the possibility of tackling new or emerging problems in a creative manner. They also view errors and unanticipated negative outcomes as valuable learning opportunities.
• Humility: Team members recognize differences in training, but do not believe that one type or perspective is superior to another. They also acknowledge that they are human and mistakes are inevitable. A fundamental value of working in a team is the opportunity to rely on each other and help avoid failures—regardless of where they are in the hierarchy.
• Curiosity: Team members reflect on the lessons learned in their daily activities and use these insights to continuously improve their individual work and the functioning of the team as a whole.

Principles of High-Level Patient Care Teams

After identifying these personal values in colleagues, the NP can move forward with developing a team.

The principles of high-level patient care teams include:

1. Defined leadership– Effective leaders must facilitate, coach, and model effective communication skills.
2. Shared goals– All members are involved in defining the team's purpose. This encompasses patient and family goals, as well as shared interest and ownership.
3. Clear roles– Each team member has a clearly defined expectation of their role, responsibility, and accountability.
4. Mutual trust and respect– Team members earn each other's trust and respect, allowing for diversity in opinions and continuous open-mindedness in reaching consensus.
5. Effective communication– High-functioning teams make communication a priority and consistently seek ways to improve these skills among all members.
6. Measurable processes and outcomes– Team members participate in a timely review and feedback of successes and failures. An impartial review enables process improvement and identifies any educational needs.

Studies show that healthcare teams are associated with the following professional advantages:

• increased job satisfaction
• more productivity
• decreased stress levels
• enhanced support for inexperienced workers

Creating a "work family" is a key priority for NPs. These tools allow NPs to lead, develop a strong team, and engage in effective communication. Leading to provider longevity, forming high-level patient care teams ultimately saves patients by improving the healthcare workforce.

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Fran Fasching, DNP, RN, FNP-BC

Fran Fasching is the owner of Nurse Practitioner Professional Medical Writing (NP2 Medical Writing). She is an assistant professor of nursing at DeSales University, PA and a practicing emergency nurse practitioner. She is passionate about continuing education and advocacy in nursing.

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