Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
1
Chapter 13: Improving Teamwork: Collaboration, Coordination, and Conflict
Resolution
LEARNING OUTCOMES AND SUGGESTED CLASSROOM AND CLINICAL
ACTIVITIES
LEARNING OUTCOME 1
Analyze key aspects, barriers, and strategies related to collaboration and their impact on
staff and healthcare delivery.
Suggestions and Strategies for Classroom Experience
• Ask students to define what each of the key aspects of collaboration means to
Suggestions and Strategies for Clinical Experience
• Students can apply the standard on collaboration to their clinical experience.
LEARNING OUTCOME 2
Discuss the skills and strategies needed to improve collaboration and their impact on staff
and healthcare delivery.
Suggestions and Strategies for Classroom Experience
• If a local healthcare organization is doing something proactive to improve nurse–
physician relationships, have a representative from the healthcare organization
Suggestions and Strategies for Clinical Experience
• During post-conference, ask students if they have observed barriers to
collaboration and what they were. What reactions did they observe from staff?
How did they feel about the situation?
LEARNING OUTCOME 3
Analyze key aspects, barriers, and strategies related to coordination and their impact on
staff and healthcare delivery.
Suggestions and Strategies for Classroom Experience
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
2
• Ask students to discuss how collaboration and coordination are related, and why
direct patient contact might or might not occur. Students should identify situations
Suggestions and Strategies for Clinical Experience
• In conference, ask students to identify barriers to coordination that they observe
on the unit. Describe the barrier; possible cause; response from staff, patient, and
LEARNING OUTCOME 4
Explain conflict management, strategies, and their impact on staff.
Suggestions and Strategies for Classroom Experience
• Ask students to respond to the following question: Why might a conflict be an
opportunity?
Suggestions and Strategies for Clinical Experience
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
3
• Ask nurse manager to speak with students about methods used to prevent staff
conflict.
• If a student has a conflict with staff, other students, or faculty, use this
KEY CHAPTER CONCEPTS
1. The American Nurses Association (ANA) defines collaboration as “recognition of the
2. The key aspects of collaboration are partnership, interdependency, collective
ownership, and responsibility. Collaboration requires a cooperative effort from all
3. There can also be confusion about roles among team members, which can lead to
4. Barriers to collaboration: meeting needs of profession, yet supporting collaboration;
6. Competencies that are needed to improve collaboration are communication, awareness
of personal feelings, problem solving, negotiation, and assessment. Nurses and all
7. Collaboration is essential if management and clinical outcomes are to be reached. An
8. Collaborative planning, or joining together to form alliances or partnerships, is an
9. Regular evaluation needs to be built into collaborative planning. Collaborative
10. Interprofessional relationships and activities can result in positive, collaborative
outcomes; however, it is not easy to establish and maintain these relationships. With the
11. Positive collaborative relationships can result in improved interprofessional
12. Coordination is related to collaboration. It is required when there are interdependent
activities that need to be brought together.
13. There is a critical difference between collaboration and coordination when applied to
15. As long as there are different viewpoints—of patients, problems, treatment, priorities
Box 13-2).
16. Examples of some barriers are lack of understanding, inadequate resources, inability
17. In order to provide effective coordination, staff must make decisions that solve
18. The following are some helpful strategies for improving coordination:
communication needs to be clear and timely; all staff should have a clear understanding
19. Coordination is an important part of management within the healthcare setting. This
system has become more complex, (partly due to use of interprofessional teams) which
20. The key approach is to prevent conflict in early stages of responding to a problem. It
21. Nurses and other healthcare professionals should focus on typical causes of conflict—
23. See Figure 13-1.
24. Collegial relationships are those where there is equality of power. Collaborative
26. Negotiation can be used to resolve conflict. This might or might not be a structured
27. Nurses need to develop the skills necessary to participate effectively on the team, this
requires collaboration, communication, coordination, delegation, and negotiation.
28. Not everyone responds to conflict in the same way; responses will also be dependent
29. Four typical responses to conflict are avoidance, accommodation, competition, and
collaboration (Boggs, 2003). Avoidance occurs when a person is very uncomfortable and
30. Accommodation occurs when an individual tries to make the situation better by
cooperating. Accommodation works best when one person or team is less interested in
31. Effective responses to conflict require that the person understands roles and
32. The major goals of conflict management are to eliminate or decrease the conflict; to
33. Conflict is related to powerlessness and empowerment, aggressiveness and passive–
aggressiveness. Powerlessness leads staff to feeling that it cannot make difference and
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
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34. Power can lead to negative consequences—for example, it can affect ethical decisions
35. Legitimate power comes from having a formal position in an organization such as a
nurse manager. Reward power comes from the ability to reward others when they
36. Empowerment is a critical method to manage conflict. This is more than sharing
37. Considerations that are important when staff is empowered are whether the staff can
38. Aggressive and passive–aggressive behavior can interfere with conflict resolution and
can even be the cause of conflict. Hostile behavior can be present and it needs to be
39. There are a variety of conflict management styles that can have an impact on how
40. See Box 13-4.
APPLYING LEADERSHIP AND MANAGEMENT
BSN and Master’s Essentials: Application to Content
Chapter identifies which Essentials apply to the chapter content. This information is
primarily for the instructor, but students should understand the how these nursing
Applying AONE Competencies
The AONE competencies for nurse leaders are found in Appendix A. Ask students to
identify which of the AONE competencies apply to the content in the chapter.
Engaging in the Content: Critical Thinking and Clinical Reasoning and Judgment
See Discussion Questions and Application Exercises at the end of the chapter. Online
options are noted.
Chapter Features: Case Study and Applying Evidence-Based Practice
The Chapter Features: Case Study and Applying Evidence-Based Practice features may
ADDITIONAL CASE
This case is not found in the textbook. It may be used for individual or team assignments:
written assignment and classroom or online team discussions. It may also be used as an
essay question for exams.
Case
Staff in the pediatric unit have reviewed monthly quality improvement data and note that
there seems to be some difficulties with pharmacy. Examples are receiving medications
late, some errors in dosage, and lack of communication. Someone comments that there
seems to be limited collaboration and coordination.
Questions:
1. Why would collaboration and coordination be mentioned?
2. How should this problem be handled? By whom?
3. Is additional information needed? If so, what information?
4. Is it important to look at data other than the previous month? If so, why?