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Chapters 14, 15, and 16 explain 3 different means for improving the effectiveness of healthcare teams. These means—training, team building, and process improvement—all require a methodical approach and are often time consuming. Sometimes the necessary time is not available, and sometimes the problem at hand will not yield to these methods. This chapter provides a fourth approach to problem solving, namely, troubleshooting, which is more direct and usually faster. It also commonly carries more risk.

Troubleshooting involves responding to specific problems and solving them. There are many different avenues available to individuals who do troubleshooting, ranging from making gentle suggestions to disbanding teams. This chapter deals with 9 different actions that can be used to address problems; the actions are listed in Table 17–1. Other actions could be added to the list. The actions chosen for presentation are ones that hold promise in circumstances commonly encountered in teams.

Table 17–1. Troubleshooting Actions for Healthcare Teams

Troubleshooting is an activity to be performed by team leaders and team sponsors and only very occasionally by team members other than the leader. Sometimes more senior leaders in an organization need to troubleshoot problems in a team within the organization, but troubleshooting from afar tends to be ill-informed interference or tampering, and so senior leaders are usually more effective when they prompt action by a team leader or a team sponsor instead of taking action themselves.

Team leaders often have occasions to correct problems in the team by coaching individual team members. Individual team members can provide coaching too.

Granite Hills Health Center, a rural hospital, was considering expanding its cardiovascular service line to provide more emergency heartcare services, possibly including a medical intensive care unit (ICU). An ICU would enable Granite Hills to care for patients with myocardial infarction (heart attack), eliminating the need to transfer these patients by air ambulance to a larger hospital. The advent of ICU telemedicine had made this expansion of Granite Hills' service worthy of consideration. With telemedicine, cardiologists can provide ICU care at a distance by using electronically communicated x-ray images, electrocardiograms, and other information. The senior leadership of the hospital had charged a task force with considering the medical ICU as well as other possible additions to the cardiovascular service line.

The task force was led by Gita Juntasa, RN, MSN, the hospital's Director of Nursing. The other members were mainly nurses and physicians, including Peter Olsen, MD, a general internist. The discussion quickly focused on providing ICU care for patients ...

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