“I am a member of a team, and I rely on the team, I defer to it and sacrifice for it, because the team, not the individual, is the ultimate champion.”
The importance of forming a carefully constructed team early in the evidence-based practice (EBP) process cannot be overstated. We all recognize that healthcare is provided by teams. Failing to include key players at the beginning of the EBP process can slow progress. These team-structure factors have an impact on success (Xyrichis & Lowton, 2008):
Location: People who work near each other may find it easier to attend meetings and stay up to date with communications.
Size of the team: Smaller teams are more efficient than teams that are too large. This is a balancing act between having every stakeholder involved and keeping the team size manageable.
Composition: Interprofessional diversity and skill mix are important.
Communication: All members need to feel safe in expressing their views, regardless of their position in the organization.
Stability: EBP projects can take a long time to organize, roll out, and sustain. It is important to have team members who will stay the course and commit to the project in the long run.
Leadership: Appoint a leader or project director who will keep projects on track and keep members accountable.
When developing the team, think about disciplines to involve (for example, physical therapy, social services); representation across roles (nursing assistants, radiology technicians); services impacted by a practice change (pharmacy, housekeeping); and relevant committee members within the governance structure (quality improvement, information technology). Keep the team balanced with skills and the ability to influence. Look for members having a positive effect on colleagues who can influence their peers. Clinicians who are opinion leaders (see Strategy 2-6) can bring important energy to promote adoption of EBP. Your choice of participants will affect how the team functions as a whole (Porter-O’Grady, Alexander, Baylock, Minkara, & Surel, 2006). A team communication wheel may be useful for planning membership and coordinating efforts within the infrastructure (see Example 4.1).
Identify strategies for building collaboration with and support from key stakeholders (Issel, 2014) who are invested in the practice and may contribute resources for the EBP (Harvard Business Review, 2004). Stakeholders will have varying involvement with project work, yet all will want progress reports so they can stay up to date. The amount of influence and support from stakeholders will vary. Strategies to build a team including different stakeholders may be developed based on their level of influence and support (AHRQ, n.d.-b; Registered Nurses’ Association of Ontario, 2012).
EBP team members can divide the workload associated with the EBP process. They will need to have an understanding of the evidence supporting the practice change and their roles and responsibilities ...