Building Effective Hospice and Palliative Care Teams (P4)

Abstract

1.Discuss several key principles of team theory as it applies to medical teams.2.Demonstrate and modify behavior around three key principles of HPM teams: overconfidence, hidden profiles, and synergy in team decision-making.3.Review a short list of key take home points and available tools for diagnostics and team building exercises. I. Background. Hospice and palliative care medicine (HPM) rely on interdisciplinary teams and team decision-making for patient care and yet very few programs give consideration to team dynamics or team process in decision-making. Our team of junior and senior faculty from both medicine and business will create a team development workshop focused on the unique situations faced by teams in HPM. Our principle presenter (T.C.), using results from a qualitative research study, has identified several ubiquitous features of HPM teams: hierarchical structure, problem solving oriented, highly experiential, attempt to provide optimal patient care, and satisfy federal regulations. II. The Program. We believe an interactive learning experience based upon small-group competitive exercises is necessary to change the behavior of the participants. Our program will use a large-lecture format to introduce and then debrief a series of two to three small-group exercises designed to key principles affecting HPM teams: the problem of overconfidence, assessing for hidden information, and the challenge of making decisions as a team. III. Overconfidence. Teams and experts are grossly overconfident in the assessment of their knowledge and our exercise quickly proves this point to learners. IV. Hidden Information. A process problem in HPM hierarchical teams occurs when key information is hidden with a low-power team member (eg, a bath aide). Our exercise teaches participants to recognize their biases towards common information and to actively seek hidden information. Team decision-making occurs in characteristic ways and has common process problems. HPM teams make better decisions than their average member, but worse decisions than their best member. Teams compete in a wilderness survival game to make the best decisions to illustrate team synergy. V. The Take Home Message. Teams will take home knowledge and resources to explore the dynamics of their own HPM teams. Structure and Processes of Care