Oral Presentation Palliative Care Nurses Australia Conference 2022

Background
Effective teamwork can enhance the quality and safety of end-of-life care for patients in hospitals. End-of-Life Essentials (EOLE) is a Commonwealth funded project that delivers peer-reviewed, evidence-based, online education and practice change resources for doctors, nurses, and allied health professionals working in hospitals. ‘Teams and Continuity for the Patient’ features in the suite of EOLE modules and includes education around effective teamwork in end-of-life care.

Aim
To explore the views of module learners (health care professionals) on managing differences of opinion amongst staff regarding patient care.

Methods
Participants were health care professionals who engaged with the EOLE Teams module. Responses to a question posed at the end of the module ‘How do you manage differences of opinion amongst staff regarding patient care management?’ were extracted for a 12-month period. Qualitative data from 293 health care professionals were thematically analysed in NVivo 12, using an open, inductive approach to privilege participants’ voices.

Results
Analysis revealed three overarching themes:

1. Team collaboration (e.g., inclusive discussions, respecting individual opinions, negotiation).
2. Communication skills and emotional awareness (e.g., openness and honesty, active listening, anticipation of emotive potential)
3. Prioritising the patient (e.g., aligning with patient needs, identifying goals of care, advocating for the patient)

Implications for Practice
Fostering active listening as a skill for healthcare professionals is important for communicating with patients and as part of team discussion and negotiation. When goals of care are oscillating from curative to supportive intent, it is crucial to have a shared understanding of prognosis, treatment plans and end-of-life needs of the patient and family.   

Our results also highlighted the importance of building a psychologically safe workplace within acute healthcare settings. Well managed, respectful responses to conflict has the potential to strengthen team respect and decision-making. A high-functioning team creates an atmosphere of psychological safety, through fostering openness and sharing, and framing mistakes or uncertainties as learning points.

Conclusion
In complex, fast-paced, hospital environments, quality care relies on team members who work in unison and respond to conflict in respectful and appropriate ways. Well-functioning teams are equipped with strategies to identify and work through differences of opinion.