Esteem HealthCHW Certification Training
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Module 4: CHW in PracticeLesson 4.1 · 6 sections · ~35 min

Care Team Dynamics

Learning Objectives
  • Name the five characteristics of effective health care teams.
  • Explain the challenges specific to CHWs within care teams and strategies to address them.
  • List tips for promoting successful teamwork.
  • Describe the role of CHWs within the healthcare team when the patient's safety is at risk.

Why team dynamics matter

Advocates for the increased use of community health workers believe that CHWs are most effective when they work closely with different healthcare professionals in a multidisciplinary care team. They call for CHWs to have access to their patients' health records, be part of meetings to discuss cases, and have a voice in making care plans.

Care teams should be more than just a collection of individuals with diverse skills. It's the collaborative effort and synergy among team members that enhances — or hinders — patient care.

What are team dynamics?

Team dynamics are the invisible behavioral forces operating between members of a team — personalities, roles and responsibilities, conscious and unconscious behaviors.

A team might have the skills to do the job — but it takes cooperation to coordinate the variety of tasks involved.

The CHW's role in the healthcare team

CHWs serve on the front lines, working directly with individuals in their communities. CHW services include:

  • Outreach to new individuals
  • Screenings and assessments
  • Home visits
  • Health education
  • Action planning
  • Consistent communication with patients
Note
Many of your patients are already supported by care coordinators, care/case managers, or community resource specialists — so fostering positive team dynamics and clear communication across all support providers is essential.

Five characteristics of effective teams

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Shared Goals

All members (including the patient) establish shared goals. These reflect patient and family priorities, and are clearly communicated, understood, and accepted by all.

Four common ways healthcare teams communicate

Great for sharing and accessing patient information. Less interactive than other methods.

Tip
When all else fails or when there's an immediate need — pick up the phone, or walk over and talk to someone face-to-face.
Knowledge Check

Which of the following is one of the five characteristics of positive team dynamics?

AStrict hierarchy where the physician always decides
BShared goals established by all members, including the patient
CKeeping each member's tasks private from the rest of the team
DLimiting communication to avoid interrupting clinical staff
Knowledge Check — Matching

Match each team communication method to its description.

Terms
Electronic Health Record (EHR)
Team Huddles
Case Conferencing
Direct Messages
Definitions
Short daily meetings concentrated on patient safety.
Notes via EHR or email that can be missed when volume is high.
Scheduled gatherings to discuss a patient's situation and coordinate care.
Great for sharing and accessing patient information, but less interactive.

Meet Janice

Janice is a new CHW joining a care team at a local health clinic. The team includes doctors, nurses, and social workers. She quickly notices challenges.

Janice's initial challenges

How Janice overcame the challenges

Tip
By employing these strategies, Janice established herself as a valuable member of the care team — contributing effectively to both patient care and team dynamics.

Successful teamwork checklist

  • Become familiar with other roles and disciplines — every team member has an important role.
  • Know your "scope of practice" — understand your responsibilities and areas of expertise. Ask if something is unclear.
  • Participate actively in team meetings and case conferences — own your role.
  • Be adaptable — different teams have different expectations and ways of doing things.
  • Bring your "best self" to work — stay positive; provide culturally respectful, patient-centered care.
  • Keep up to date with your documentation — consistently update and maintain accurate records.
  • Focus on solutions more than problems — acknowledge challenges, but resolve them.
  • Take responsibility for mistakes — accept errors professionally.
  • Learn to receive and provide critical feedback — active listening when receiving; specific behaviors and improvements when giving.
  • Maintain close communication with your supervisor — seek support and guidance proactively.
  • Don't avoid big or persistent problems — communicate concerns respectfully (a meeting with your supervisor, a team gathering, or a case conference).

When patient safety is at risk

In the daily work of a CHW, issues related to physical, mental, and social well-being can arise. Address these within your scope of practice — and collaborate with the care team for proper follow-up.

Examples of safety issues

Difficulty breathing or shortness of breath (hard to speak, gasping)
New facial drooping, slurred speech, or loss of feeling on one side of the body
Blue-tinted lips or face (signs of poor oxygen)
Inability to wake someone or keep them awake
Relentless chest pain or pressure
Recent fall or head injury
Warning
When these issues arise, CHWs may feel pressured to go beyond their defined role to 'rescue' individuals. Rely on the entire care team's expertise. Don't take on sole responsibility for solving all problems — it isn't safe, for the patient or for you.

What CHWs should do

Care team roles in safety situations

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Inform Team Members
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Share the situation with team members so they can provide suitable follow-up.
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Stay within scope
It is NOT within the CHW's scope of practice to assess and provide clinical guidance in cases involving safety or risk concerns. Seek assistance and consult with clinicians without hesitation.
Knowledge Check

A CHW becomes aware during a home visit that a patient is having thoughts of suicide. What is the most appropriate action?

AProvide clinical counseling and a treatment plan on the spot
BInform the team and consult a clinician/supervisor, following crisis protocols
CKeep it confidential and handle it alone to protect trust
DWait until the next scheduled case conference to mention it
Reflection Prompts

Think of a time you joined a new team. Which of Janice's four challenges felt most familiar, and what helped you find your footing?

Which item on the successful teamwork checklist is your strongest? Which one will you work on first?

Lesson Takeaways

🌟 Lesson takeaways

Successful care teams share five characteristics: shared goals, clear roles, mutual trust, effective communication, and measurable processes and outcomes. CHWs on the front line face specific challenges — limited understanding of their role, underappreciation of community-based work, respect and perception issues, and perceived misalignment with the agency. Janice's strategies (educate, demonstrate value, build collaboration, balance advocacy and protocols, communicate openly) show how to overcome them. When patient safety is at risk, collaboration with the whole team — not heroic solo action — is what protects everyone.

🎉Great work!
📅
Coming up

Great work! At the end of this module, you'll join a live discussion with your cohort and an instructor. We'll see you there.