3.4.f Steps in Role Clarification

You can use a role clarification process to clarify roles when working with any team. Role clarification can also be useful when working through the steps in shared decision making. Here is how it is done.(7)

1. Each person describes briefly what they would like to do within the team. This includes describing your own preferred duties and responsibilities. Make statements like “I would like to take the baby’s vitals and be responsible for determining and initiating resuscitation if it is needed.”
2. Other team members then make requests for each person’s contribution to the team. This is accomplished by using statements like, “do more of...”, “do less of…”and “keep on…”. An example of this would be “When you are taking the baby’s vitals, can you please say your findings out loud when you do the checks so that we can all hear you?”
3. Feedback, validation, and negotiation are used to establish and define the team’s division of roles. When clarifying your role and your willingness to change based on other member’s role request, there are three options: yes, no, or negotiate. Say yes if you are willing and able to make the requested change. Say no if you can articulate that the change will not help the team meet its overall goals. Negotiate by saying “I will be able to do… if you do….”. Negotiation is done to ask team members for the help you need to make the change they requested.
4. Document what role each person agreed upon.

Clear expectations about performance helps providers to identify, measure, and provide feedback about the team’s outcomes and performance. A shared understanding of each other’s responsibilities and accountabilities, leads to transparency and seamless collaboration. If you have dual or overlapping roles determine who can most effectively and efficiently meet the overall objectives of the group while respecting the preferences of the patient. In health care this is determined in a case by case basis. If one member of the team has a particularly relevant expertise or background, the team may decide to allocate an aspect of care that is not commonly assigned to their professional role. Clearly and openly discussing and documenting roles and responsibilities on an ongoing basis allows teams to define and redefine how they work together in a complex and multi-professional setting.

When new members are introduced into the team, it is helpful to clarify each members typical roles when collaborating. This should also be done when team members responsibilities change, and/or when the team’s overall responsibilities change. Examples of when to clarify roles in health care are: when the primary care provider changes; after shift change or during a break relief; when someone outside the team is consulted as part of decision making; or after an event when the team’s primary focus has changed (ex: ongoing care after the birth of a baby). Another time where role clarification should be done is when the environment itself has changed, and new policies or procedures are in place.