AACN News—February 2009—Opinions
Vol. 26, No. 2, FEBRUARY 2009
Caryl Goodyear-Bruch RN, PhD, CCRN
‘Beacon-ize’ Your Team
There is something going on in your hospital and we don’t know where it is coming from.
— David and Connie Bergsven
This touching quote is from an effusive thank you letter to the president of a Minnesota hospital. David Bergsven is a former hospital administrator who received much of his care for a life threatening medical emergency in St. Cloud Hospital’s ICU, a 2006 recipient of the Beacon Award for Critical Care Excellence, and its progressive care unit.
The quote reminds me of the first time I walked into the University of Kansas Hospital’s MICU. I sensed something special in this unit which, not coincidentally, received the state’s first Beacon award. I soon recognized that the unit’s teamwork makes it special. Not only its nurse team, but its interdisciplinary team as well.
When chief nursing officer Karlene Kerfoot first read the Beacon award criteria, she challenged her hospital to “Beacon-ize” every unit, critical care or no. She recognized the award’s power to strengthen teams by galvanizing around a shared goal.
Beacon teams like this don’t become special by chance. What powers them? Above all, excellent teams are powered by Trust — Effective energy — Attitude, action, accomplishment — Mission, vision. Underlying these are leaders and clinicians confident in the knowledge that they are never alone. The team always has their back.
Trust: Building trust among team members takes time. The key is to become personal and connected, creating the closeness and respect of a second family. In one study team members in 14 units defined norms to strengthen positive relationships and trust. The teams’ priorities for norms fell into three categories: effective communication, positive attitude and accountability. The norms included no gossiping, discussing issues in private, giving positive feedback, active listening, can-do attitudes and being a team player. All were written up as a code of conduct and signed by each team member.
Effective energy: In effective high energy teams everyone knows their roles and can be relied on to deliver on their accountabilities. Skilled communication is the lifeblood of effective energy and includes good listening to understand others’ perspectives. These teams set ground rules that may include sharing all relevant information (that includes thoughts and feelings), inviting questions, testing one’s assumptions and asking others about theirs, and forging new ground by discussing the un-discussable.
Attitude, action, accomplishment: “Attitude is everything,” Keith Harrell reminds us. It sets the tone for working together and is essential for confident action. A confident team works like a well-oiled machine because individual competencies are matched to a patient’s needs. Something happens and everyone jumps into action, knowing exactly what to do. These are highly reliable teams whose significant accomplishments are always celebrated.
Mission: Confident clinicians and leaders come together to identify their shared core values and a vision of what they want to achieve. The words vary, but excellent healthcare teams describe a vision that seeks to “create a healing environment with patients and their families at the center.” The team’s shared mission is to achieve the mission. Mission and vision define what matters most. Excellent teams cannot function without them, something Eric Klein expands on in his learning programs about choosing core values and creating what matters most (www.dharmaconsulting.com).
Engage you colleagues in “Beacon-izing” your unit. Your team should be an excellent team even if you aren’t yet on the Beacon journey. Rate yourselves using the Beacon audit tool (www.aacn.org/beacon). What do you need to start working on? What are you already working on? Where are you on target or better? It’s a practical way to match your team against a national standard. When you do rate yourselves, I would enjoy knowing what you learned. Were you surprised? Were you reassured? Please write to me at firstname.lastname@example.org.