HEALTH TEAM
I - DEFINITION:
Pritchard: define the team as a group of people performing different tasks contribute to the achievement of an objective and común.Davis Newstrom: define the task force as a small group whose members work together and are in contact and engaged in a coordinated, responsible and enthusiastically responding Polliack tarea.Para to as organizational model that is, the team can be considered as a working system that allows several people from different professions and skills to coordinate their activities, in which everyone contributes their knowledge to achieve común.Bajo purpose this perspective, a team must fulfill the basic principles of organizational theory, namely: Because each team member has different skills, there should be no duplication of funciones.Un member can not replace other so it is expected that each plays its role corresponda.La need for coordination requires the existence of adequate channels of communication that favors work eficiente.Como whole and each member must contribute their expertise, presumably also assume its responsibility and address the aspects of their area.The essential that all team members agree on common objectives and agree, as a group responsibility to achieve these overall equipment objetivos.La must be greater than the sum of its componentes.Finalmente, the team is not a goal in itself but a means to achieve the objectives propuesto.Hemos past, therefore, the team concept to describe the conditions that must be met for the work done by a group of people is truly a team effort, I might add that there is no hierarchical functioning of the equipment, should be the absence of a specific professional domain. This involves the recognition at an equal level of technical competence of all team members and that the actions of each are driven by them and not by orders of another, for a team or group to be efficient, members of the same should have a supportive environment, clarity of roles, goals and appropriate superior leadership, supportive environment based on organizational climate, trust and support that its members have had the opportunity to know and understand the roles and functions those with whom there are higher goals trabajando.La help keep the teams more focused, to unify efforts and promote group cohesion, team members need time to meet, but then is customary to close the new ways of analyzing problems as they is isolated from its environment. To prevent this deadlock, it may be convenient entry of new members as well as a careful combination of leadership with the new environment creado.Para De la Revilla, is summarized in four main characteristics that define a good operation of any group organization: A good interpersonal skills.
The correct classification of professional roles; The existence common goals and their relationship, knowledge of the functions themselves and others; Finally, good communication between members of equipo.Las formula of teamwork with a range of advantages both for the professionals of the same , and for users of the system salud.El ill get better care, reduce the prevalence of diseases in the community, encourages education for health in a coordinated way and provides greater job satisfaction for team members; The care provided by the team is greater than the sum of the individual care of their members to address the challenges both from many causes, but keeping unity of action for resolution; unifies concepts and techniques, and avoid contradictions between the various professionals, prevents duplication of effort, making profitable use of both local and materials, and even professionals themselves, it allows to cohesion health programs in its different facets, achieving greater efficiency thereof; The joint work with other professionals in the same discipline allows the exchange of knowledge and action guidelines and keep up more easily work with other types of professionals (nurses, social workers, health personnel, etc.) provides a perspective very different, making the biopsychosocial approach and allowing the team to perform all the functions intrinsic to primary care: promotion, prevention, care and rehabilitation of the population adscrita.Es obvious that in the reality of each day the teams do not always work as a coordinated and teamwork has all the features that have been described, in addition, it would be naive to assume that several people with different professional backgrounds and interests can work together without friction.
TEAMWORK CHALLENGES-
limited experience Lack of incentives, too rigid in some members, lack of interest- Difficulty in management control in times of study and research
II - HEALTH TEAM
The Royal College of General Pratitioners, in 1970, to make an assessment of current status and future needs of general practice, and was pronounced as follows: the concept of integrated community care, family-oriented, requires a multidisciplinary approach and involves communication and cooperation between various health professionals within a framework of allowing work to focus on total health needs of the patient. Within this context, these needs can not be satisfied by a doctor working in isolation, but require the formation of a Primary Care Team, whose members provide each one a different perspective on knowledge, attitudes and habilidades.El health team is defined by WHO in 1973 as a non-hierarchical association of people with different professional disciplines, but with a common goal is to provide in any field to patients and families the most comprehensive health care posible.De the Revilla based on the definition of team Pritchard, the team defines health as a group of health professionals and non health professionals involved in various activities aimed at achieving an elevation health community that is affected.
team composition PRIMARY (EAP)
The composition of an EAP is to suit the specific community it serves. Therefore there are no universal models that allow us to define a composition which is valid for all computers and circunstancias.Los factors that influence the composition of the EAP are summarized in Table 1, taken from Martin Zurro and we have added the field ( urban or rural) where the center sits 1Factores saludTabla influencing the composition of primary care teams. Political and economic situation country .. Existing health infrastructure .. Health problems and needs .. Availability of health and non health professionals .. Professional structure .. General Organization of the country's health system .. Functions assigned to EPA professionals .. Urban or rural area where it will be at the health center.
Source: Martin Zurro
equipment operating PRIMARY
have a clear role and priority over others and that there is another to promote qualitative changes in attitudes and habits of the population all fields that have a direct or indirect relationship to health.
Composition
Primary Care Team
basic EAP Core Family Physicians and pediatras.Enfermeras / os and nursing assistants. Workers
sociales.Personal especializadoTécnicos support administrativo.Celadores.Elementos radiology / radiologists.
laboratory technicians.
Odontólogos.ginecólogos consultants.
Midwives.
mental health team. Technical
public health.
Pharmacists. Veterinary
.
Source: Zurro Zurro Martín Martín et al.
distinguish, as the composition of the EAP is concerned, between the core and specialty items to support EAP equipo.El basic core is formed by those professionals necessary for the performance of its functions, such as doctors, nurses and social workers. The other professional, technical and non-health care, which can integrate into it, act as elements of infrastructure or specialized support, such is the case for specialists in Public Health and Community Medicine, as well as the dental, holistic health , obstetrics and gynecology, laboratory, radiology, pharmacy and veterinary medicine, etc..
Making health diagnosis community.
Making health diagnosis community.
direct care functions:
_ Health Promotion.
_Prevención of the disease.
_Asistencia or curative.
_Rehabilitación.
salud.Funciones _Educación for this database.
_Docencia and research.
_Administrativa.
_Organización and management.
_Coordinación with other levels of care.
Source: Martin Zurro, as amended
distinguish, therefore, the following functions to fulfill the primary care teams:
1 - HEALTH PROMOTION Ideally it should be the first important function, but in practice this is not always the case, may be common, for example, that the implementation of a health center, by faulty planning, EAP is a large mass that forces you to care arise, assistance and role. It is obvious that the activities of health promotion should be developed both in the population enferma.Sus sound as the instruments are adequate healthcare, environmental performance and promoting community participation in solving health problems.
2 - DISEASE PREVENTION: The activities related to this function is aimed at specific problems and methodology for each of them, unlike the role of health promotion is more general and nonspecific. Examples: program of childhood immunizations, influenza vaccination campaign to control risk groups and healthy child.
3 - ATTENDANCE: The role care or EAP Healing is for those users who, given the deterioration of his health, decided to sue the health services. It aims to detect and treat disease, as well as track this enfermo.La assistance will be a primary function of physicians and nurses of CAS and will be held both on an outpatient (clinic) and home .}
4 - REHABILITATION: This function is completed the range that defines integrated care: promotion, prevention, care and rehabilitation. It is aimed at that group of people after an illness has been a loss or reduction of their physical, psychological or social.
5 - EDUCATION for HEALTH:
must always be present in all health activities, with the purpose of acquiring knowledge, developing healthy habits by the population, changing habits and negative attitudes to health, promoting ongoing, conscious and responsible people in solving their problems salud.Existen also other functions to be developed by the EAP, and that some authors grouped as the support functions or complementary. Among them include the siguientes.Docencia and investigación.Formación gestión.Coordinación continuada.Administrativas.Organización and with other levels of the network relationship salud.La sanitaria.Diagnóstico of diagnosis of the health of the community is an activity prior to any other. Its purpose is to know what are the specific health problems of the community, which involves measuring the health status of our population and the study of the factors that determine the level of health. The information obtained will allow to raise consistent targets to improve health status while that offers some valuable tools to assess progress in achieving such objetivos.Él doctor as a member health care team must fully understand that working together means having common goals, to accept the agreed standards of operation and sharing of roles and tasks, acknowledged in an equal level technical skills of other team members, since their contribution should be beneficial for achieving the above objectives the team.
WHY TEAMWORK?
is assumed that the professional groups most involved in providing health services are those who communicate more closely and effectively. In fact, many times that communication existe.Por other hand, multidimensional challenges social and health affects adolescents and reduction of human affection (chronic diseases, accidents, alcoholism, etc..) are not problems that can be managed by primary care professionals in health well-intentioned, not even for institutions high complexity health disciplinario.La experience working in isolation of medical schools, as well as other professions, is obsolete for this: the health professionals generally lack an essential preparation for work as a team. However, health services require increased collaboration with experts from various disciplines working together, sharing information, knowledge and skills, so these interdisciplinary skills are important as m {nunca.Sin however, few professionals, health care or social service agencies that are prepared to work effectively and use appropriate resources to provide services necessary, comprehensive and integrated, to provide quality care to these patients.
Nomenclature ·
collaboration between disciplines can be done in multiple ways. Interdisciplinary teamwork is just one of these modes: conscious in a group of people have different abilities that depend on each other to function efficiently, to achieve common goals and objectives.
In the primary health care ATS this translates into a group of people who contribute skills, talents and diverse skills in a coordinated manner, and depend on each other to work efficiently to achieve a common goal in caring health. These targets determine and justify the very existence of the team.
INTERACTION BETWEEN DISCIPLINES
Elichiry emphasizes that the problems are not disciplinary boundaries, the rigid disciplinary boundaries are fixed and unproductive. Multidisciplinary and Interdisciplinary terms are often used synonymously in the description of collaborative efforts. But these concepts are not interchangeable and the distinction is crucial. Multidisciplinary work is comparable to a web formed with patches or patches, while the interdisciplinary would be a seamless garment, or in chemical terms, is the difference between a body and a compuesto.El school curriculum tends to fragment knowledge isolated and compartmentalized disciplines, and more particularly to excessive specialization that prevents understanding of the plurality and complexity of the multidisciplinary approach realidad.En each discipline individual is engaged in his specialty area without any need to coordinate efforts with other disciplines, nor any evidence of modifications or changes in it. The work can be done by individuals from different disciplines, working separately, not necessarily in the same place you, or with more trade outside a referral or interconsultation. The results can be integrated by someone other than mismos.Por professionals across the interdisciplinary approach is the result of social demand, faced with increasingly complex problems and the internal evolution of the basic ciencias.La Interdisciplinary collaboration is guided by the problem and performs level of convergence problems. Recognizing the potential to ease the integration and production of knowledge, it is important that the problem itself, not the individual disciplines, contribute to the starting point.
JOINT INTERDISCIPLINARY:
Each discipline is important in its function as specified and individuality, and more interdisciplinary creates a link that leads to processing and cross-fertilization that determines a whole early mayor.Los joint based on joint correspondence, at intersections and links between disciplines, particularly on interdependence. All this enables the exchange of instruments, procedures or techniques, and facilitates the cremation of shared conceptual frameworks. The border issue or point of contact between two disciplines is not mentioned that interdisciplinary interdisciplinaridad.Elichiry achieved its best when participants are experts in their respective disciplines, affirmed in their identity and disciplinary specificity. "The system works if each of the disciplines performing its role individually but not independently. This integration, together with the creation of a new conceptual framework common to all disciplines, transdisciplinary ORIENTATION allows
BASIC DIMENSIONS
1. Interaction : Based on the development of cooperative behaviors and attitudes.
2. Recurrent Cooperation (iterative): requires "continuity of cooperation between disciplines."
3. Intentionality The relationship between the disciplines are brought.
4. Flexibility: Avoid dogmatic attitudes, allowing the exploration and use of models, working methods, new techniques. Explore their differences through dialogue.
5. Reciprocity and diversity: determined by the interactions between disciplines, sharing and / or modifying methods, conceptualizations, etc..
6. Institutional insertion / environment
7. Participation of members and other participants
The aspects of this joint interdisciplinary highlight the need for continuity, interdependence, flexibility to make the most of the participants.
This conceptualization makes clear that casual contact does not constitute or free basic integrative approaches interdisciplina.Los contributions different disciplines include various mechanisms such as.
a) The common group learning: the group shares the global understanding, exchange components or methodologies and produces a bump or a single product.
b) The modeling: there is an explicit model that links the various contributions.
c) Negotiation: Between experts or members whose responsibilities intersect efforts, discuss their work in detail but retain their unique expertise and
d) The integration of the leader: that is completely in charge of integration, what appears to be the least effective.
INTERDISCIPLINARY TEAM - LIFESPAN
EtapaCaracterísticasTarea of \u200b\u200bMiembrosTarea of \u200b\u200bEquipoResultados1. Orientation (position on the institution and circumstances) Definition of the situation. Exploration. Aprendizaje.Entender expectations and relate with each other. Addressing the lack of familiarity, anxiety, lack of confidence, estrés.Definir limits. Provide apoyo.Conocer colleagues. Understand the system. Top of confidence. Top of participation and identification.
2. Accommodation (adaptation and arrangements leading to a unit) handling. Moving and changing positions. Power struggles. Rearrangement todo.Hallar parties and an appropriate place for you, both personally and profesionalmente.Proporcionar structure and environment for maximum freedom. Facilitate the process of language and communication adaptación.Desarrollar common. Develop values \u200b\u200band norms. Affiliation with team development.
3. Bargaining (transaction and concluded by mutual agreement) Bargaining and conclusion. Setting limits and content of expertise in relation to other especializaciones.Usarse himself as a team member able to communicate, defer, to compare, using colaboración.Definir conflict and limits of purposes and expertise. Establish contracts. Designate targets, tasks, roles.Establecer dependence and differentiation. Development unit. Completion of work arrangements.
4. Operation (action purposes) gestalt.Relacionarse Achieving complementarity with the team and its members. Using knowledge and expertise. Scope of individual decisions. Relationship of balance and vitality tareas.Mantenimiento of internal and external. Decision making, planning and execution of trabajo.Aumentar collaboration towards the achievement of goals and implementation of propósitos.5. Solution (component separation) Evolution of the process, problems, opportunities and achievements in relation to the purpose and objective metas.Evaluación individual performance and equipo.Apoyo open and critical assessment and review of personnel and equipment resultados.Cambio. Awareness of success / failure and appropriate use of such información.Deben address the problems created by the need to coordinate their work: · need to set goals · You need to make plans · You need to join · You need to talk "to accomplish the work, it requires efforts combination of two or more people?
you are a team not a team Uds.son IF NOT
Do We Need Training? miembrosdel is important that the team raised the need for training in teamwork.
Training areas include: Leadership
:
Training areas include: Leadership
:
Setting goals and objectives
Troubleshooting:
decision-making process
Conflict management and dispute
clarification and negotiation
roles then discusses some of the topics to be developed further in the training sessions using specific exercises for each
LEADERSHIP:
Leadership is defined by the tasks and functions required by the team. Stimulation of the responsibility and authority of team members is essential for career development and job satisfaction, and contributes to enriching the experience of teamwork. Effective teams are headless, but show many "acts of leadership" by its members, and is characterized by shared leadership in which the computer's role is determined by the tarea.El leadership must be understood and practiced by all team members as a temporary, dynamic. Changes as it changes the predominant care needs. The focus should be the patient, not the individual disciplines, the academic degrees to the administrative hierarchy.
PROBLEM RESOLUTION PROCESS
Stage Critical Roles
Locks
1.DEFINITIONS the problem:
ClarificaciónResumen
abstraction PruebaUso
unclear
Goals broad generalizations
Role playing
2. Collection
information Inquiry data
Survey
Posted timetest necessary
Letard
premature decisions
baseless
Options investigatory teams
Person / Member resource
Special Subcomitpes 3. Identification of alternative solutions
Tips: Getting
data
Customizing ideas
arguments or fights Brainstorming
Role playing
4. Alternative test.
Posted experienciaPrácticaRealidad pruebaRealidadesClarificaciónSugerenciasArmonizaciónFalta of practice
5. Determination of the action (s) and responsibilities
This may manifest as lack of clarity or information required for the development of intra-group communication problems (critical climate, competitive) premature closure of the section or implementation strategies, lack of proper motivation, lack skills for investigation and resolution of problemas.La decision making includes the following steps:
1. Assessing the problem (which is defining the problem);
2. Analysis (explore alternatives for action);
3. Selection (choosing the "best" alternative);
4. Action (implementation of the solution deciding who does what, then do it);
5. Re-evaluation (ensuring that the solution is implemented, and assess whether it is effective). The screening of the decision important to define exactly: • What is the the team tries to decide and at what stage of the resolution of the problem is. This requires defining for each stage: · Who should attend · How to participate? (Directly, is consulted, it is reported), and • When to do it. • Finally, it is necessary to identify who will be responsible for ensuring that tasks are performed.
main factors that can block the decision-making and the quality of these are:
1. Lack of clarity in defining the problem and / or designation of responsibilities.
2. Myopia (see the first alternative as the only possible).
3. Hasty decisions.
4. Decisions without rationale or adequate data.
5. Lack of commitment to action.
6. Allocation of responsibility for decision-making in very high levels in the organization.
7. Allowing a person in a position of power / authority to express their opinions or positions in very early stages of decision-making process.
8. Inability to experiment with alternative solutions. Fear of failure.
9. Confusion between generating ideas with the task of examining ideas.
10. Size inadequate decisiones.El group taking the process of negotiating roles can be triggered by a "feeling" or "uneasiness" that indicates the existence of a problem in this area.
The model consists of five phases:
1. list of role expectations (producing the most valid, sharing mutual expectations, exchanging "messages roles");
2. identify conflicts and ambiguity in roles, expectations analyzing and identifying problems - ambiguity and conflict;
3. production solutions alternatives and negotiation (give and take to find the "best" alternative: a realistic solution accepted by all);
4. implementation of a contract roles (developing a "contract" between the participants stating the expectations agreed by them, including a commitment to evaluate its usefulness in a given date, and review the contract if warranted) and
5. renegotiation if necessary.
CONCLUSIONS:
work in interdisciplinary teams of health should be considered as a form within a range of collaborative practices. Important to recognize the benefits that this method provides not only patients but also to team members. Periodically, the team should focus not only on specific tasks, but also devote time and effort to ask "How are we working together?" And "What areas need training to improve our effectiveness?"
REFERENCES: · De la Revilla L. The family doctor's office, the organization in daily practice. Ed Jarpyo, Madrid, 1992: 91-100. · Martin Suresh A, Palet Ferrero x, Sola Bas C. The Primary Care Team. In Martin Zurro A and Cano JE Pérez Primary Care Manual, 2nd ed. Ed Doyma, Barcelona, \u200b\u200b1989: 29-39. · EDISA: UBA. Kellogg Foundation. Distance Education
REFERENCES: · De la Revilla L. The family doctor's office, the organization in daily practice. Ed Jarpyo, Madrid, 1992: 91-100. · Martin Suresh A, Palet Ferrero x, Sola Bas C. The Primary Care Team. In Martin Zurro A and Cano JE Pérez Primary Care Manual, 2nd ed. Ed Doyma, Barcelona, \u200b\u200b1989: 29-39. · EDISA: UBA. Kellogg Foundation. Distance Education
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