Pawar (2007) has identified blame as the root cause of conflict in health care teams. In the author’s estimation, there are six ways in which blame has a negative effect on an organization: it damages the morale of the team; it causes the team to focus their energies in the wrong way; it reinforces harmful biases; it inhibits creative thinking and ideas; it costs the team valuable time and money; and it can cause loss of life. Blame, and its negative consequences, results in growing tension among the members of health care teams. In order to foster a spirit of cooperation amongst team members, Pawar (2007) has developed a three-tiered system.

Each of the three components requires effective communication and strong leadership. In the first stage, a team learns to focus attention on the reasons why a problem occurred instead of blaming the problem on an individual. The author advises that problems be discussed during meetings where every member of the team can contribute to the dialogue about the reasons underlying a problem. In this stage, an effective leader is necessary to encourage the team members to focus their attention not on blaming other members of the team but rather on weaknesses in the system or organization that allowed the negative outcome to occur.

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In order to identify these weaknesses, Pawar advocates using the “five whys” technique developed by Masaki Imai. With this system, the team begins by identifying a major problem and asking why it occurred. Each time an answer is presented, team members are instructed to ask why it happened. Pawar notes that using this technique, rooted in strong communication skills, keeps the focus on problems, their causes, and their solutions, rather than on the blaming of individuals. In the second stage, Pawar (2007) suggests that teams ensure that they are working towards a common goal.

Here again, communication among the team members is essential. The author recommends that members talk openly about their individual needs, desires, and concerns in order to evaluate how they fit within the goals of the group as a whole. The result of this alignment of individual concerns with the concerns of the group is that individuals become more strongly invested in the group once they become aware of how the success of the group is tied to their own personal success.

In addition, through this dialogue, team members become more sensitive to other members of the team once they see the commitment of each team member. The third stage identified by Pawar (2007) is the one in which effective communication strategies are discussed. Here, the author suggests how comments can be worded in order to facilitate clear discussion of ideas. Her suggestions emphasize the need to understand fully the meaning and perspective of other team members. Before putting forth your own personal ideas, you should ask respectful questions about the suggestions of other team members.

Pawar notes that this strategy is particularly difficult for physicians; therefore, the team leader should model this behavior as an example for the others. In conclusion, though only the third of Pawar’s strategies is explicitly labeled as communication, all three emphasize the necessity of effective communication in avoiding the negative effects of blame. References Pawar, M. (2007, May). Getting Beyond Blame in Your Practice. Family Practice Management, 14 (5), 30-34. Retrieved June 3, 2009.