Interprofessional Team Conflict Resolution: A Critical Literature Review.

INTRODUCTION: Although concern related to conflicts within health care teams has been discussed in the literature, most studies have focused on individuals' personal conflict management style identification or on managers resolving workplace conflicts between parties. The purpose of this review was to identify significant components in the field of conflict with particular attention to conceptual findings that may be integrated into understanding interprofessional health care team conflict and its resolution. METHODS: A critical review of the conflict literature across many fields was undertaken using the method identified by Grant and Booth, incorporating literature-search, appraisal, synthesis, and analysis. RESULTS: This critical review explored existing models and schools of thought to provide an overview of how conflict is conceptualized, its focus on interpersonal and workplace issues, team conflict application and training in team conflict resolution, and finally a summary of this review's contribution to interprofessional health care team conflict and its resolution. CONCLUSIONS: Team conflict is comprised of three forms-relationship, task, and process. When team building occurs that incorporates training in the use of an adapted constructive controversy approach, there is a greater opportunity to enhance the quality of a cooperative approach to patients' care planning. Training in team conflict resolution is needed as a key ingredient to ensure all team members can enhance the effectiveness and quality of interprofessional client-centered collaborative practice. This benefits not only the health providers in the team, but also their clients/patients who are recipients of their shared teamwork.

Long-term care residents with cancer and their health care providers reflect on hope.

This study examined hope in long-term care residents with cancer from the perspectives of both residents and health care providers (HCPs). Clinical data established that the prevalence of a cancer diagnosis in the study facility (15%) was similar to other estimates in the literature. Eight experienced HCPs were interviewed. Ten residents with a cancer diagnosis were interviewed, and they completed the Herth Hope Index (HHI). Dimensions of hope and contextual factors that shape hope emerged as themes for both HCPs and residents, but reflected their different perspectives. HCPs identified hope as integral to care. HHI scores were high, indicating residents were generally hopeful. The study findings suggest that for the small but complex subgroup of long-term care (LTC) residents who have a diagnosis of cancer, hope is not lost, but rather it is relevant, nuanced, and possible to attain.

Staff opinions about the components of a good death in long-term care.

AIM: The aim of this study was to identify differences of opinion about the relative importance of different components of a good death among care providers in a long-term care home serving Canadian war veterans. METHODS: The Concept of a Good Death scale (Swartz et al, 2003), with slight adaptations to fit the long-term care context, was made available to all staff. Responses were accepted for a one-month period. FINDINGS: Survey return rate was 30.4%. There was a majority (greater than 50%) opinion that 12 of the 20 items were essential or important to a good death, and that three items were not necessary: 'that death is sudden and unexpected' (64.5%), 'that there be control of bodily functions to the end' (61.8%) and 'that there be mental alertness to the end' (55.3%). There was not a majority opinion on the five remaining items: 'that the dying period be short', 'that death occurs naturally without technical equipment', 'that the person lived until a key event', 'that the ability to communicate be present until death', and 'that death occurs during sleep'. CONCLUSIONS: Detailed analysis of survey results identified differences of opinion that could have implications for consistency and quality of care. The findings suggest ways in which the unique characteristics of the long-term care environment and population influence opinions about the components of a good death.

Canada: an external quality review process--the Wellspring model.

Wellspring is a group of cancer support centers in Ontario, Canada. The centers provide information, support, and coping-skills programs for people with cancer and their families. To ascertain that all centers provide the same high quality of programs, the board at Wellspring established a panel of external oncology experts and asked them to establish a process to review program quality in each center. This article outlines the process undertaken to provide quality improvement in a nonprofit charitable organization.