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Leading a healthcare team

Copyright © 2010 Society of Hospital Medicine

Introduction

Leading a pediatric inpatient healthcare team requires maintaining advanced current knowledge of diseases and healthcare systems. A leader must recognize, support and encourage active participation by all team members to attain the highest level of group performance while creating a positive work environment. A leader should set a strategic direction and motivate others to work towards defined goals. More patients are cared for in ambulatory settings. As a result, pediatric patients who are admitted to the hospital often have more complex diseases or are more acutely ill. Children with special healthcare needs comprise more of the inpatient pediatric population. Care must be coordinated in an efficient, effective, and safe manner both during the hospital phase of care and at transitions of care. Pediatric hospitalists need to develop leadership skills to assure care is rendered in a collaborative and interdisciplinary manner.

Knowledge

Pediatric hospitalists should be able to:

  • Distinguish between the goals, methods, and styles of a leader and those of a manager.

  • Describe methods used to strengthen leadership skills, such as role playing or attendance at leadership conferences.

  • State the importance of clear communication between all members of the healthcare team when collaborating to care for children.

  • Give examples of skills needed to be an effective team leader, including critical thinking, evidence‐based decision‐making, and use of continuous quality improvement principles.

  • Compare and contrast potential healthcare team members in various settings such as community, tertiary care, academic, and non‐academic.

  • Discuss pediatric hospitalists' role as team leader in coordination of care, particularly where other physician subspecialists are involved in co‐management.

  • List issues that impact team dynamics, such as personalities, perceptions, and varied individual clinical skills of team members.

  • Recognize how conflict or enmeshment can be created within a team or between team members and patients and the family/caregiver.

  • Articulate the skills needed to lead a healthcare team that includes trainees.

  • Describe methods that enhance team efficiency.

  • Explain the roles of key personnel, facilities, and equipment in various clinical settings.

  • Define the team relationship between pediatric hospitalists, the primary care provider, patients and the family/caregiver in the context of the medical home and family centered care.

  • Define terms related to documentation, billing and coding such as compliance, Relative Value Units (RVUs) and authorizations and articulate why it is important for healthcare team members to understand them.

Skills

Pediatric hospitalists should be able to:

  • Lead family‐centered rounds in an effective manner promoting communication and participation by team members.

  • Maintain strong diagnostic and relevant procedure skills and be able to provide mentorship in these skills.

  • Lead patient throughput in a way that optimizes bed flow and care.

  • Maintain proficiency in administrative skills such as documentation, billing and coding compliance, RVU collection, and contracting and mentor other team members in attaining these skills.

  • Demonstrate excellent communication skills, including expressive and listening ability, in all interactions with other members of the healthcare team.

  • Build consensus within the health care team on evidence‐based care management algorithms, hospital policies and related issues.

  • Identify when healthcare team members may have a conflict affecting patient care delivery and offer appropriate support in a discrete manner.

  • Delegate team responsibilities in an effective and equitable manner.

  • Deal constructively in managing conflicts with and among supervisors, staff, and trainees, seeking resolutions that promote productivity and good will.

  • Effect systems change through use of quality improvement tools such as Plan‐Do‐Study‐Act (PDSA), Failure Mode Effects Analysis (FMEA) and others.

  • Establish skills in time management.

  • Run an effective meeting to accomplish outlined goals in a defined time period.

Attitudes

Pediatric hospitalists should be able to:

  • Demonstrate a consistent level of commitment, responsibility, and accountability in rendering patient care.

  • Consistently display honesty, integrity, humility, and fairness in working with patients and the family/caregiver, and all members of the healthcare team.

  • Respect the skills and contributions of all members of the healthcare team.

  • Pursue continued development of leadership skills through additional training opportunities.

  • Maintain a professional manner at all times.

Systems Organization and Improvement

In order to improve efficiency and quality in their organizations, pediatric hospitalists should:

  • Identify and work to resolve barriers to teamwork between healthcare professionals.

  • Lead interdisciplinary collaboration at the bedside to promote patient safety, quality improvement, and cost‐effective care for children.

  • Proactively work to assure the healthcare team integrates and sustains family centered care principles.

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