Table 5.

Essential elements of prison hospice: Teamwork

Teamwork
Concepts in Context	Definition and Dimensions	Exemplary Quote
Interdisciplinary team (IDT) model	Application of an IDT model to end-of-life care in a correctional setting that involves the coordination of medical, volunteer and security roles working toward a common goal. IDT members include physicians, nurses, social workers, and chaplains working together in to deliver effective wrap-around services. COs may not be formal members of the IDT, but must be consulted and involved throughout the process.	“A lot of volunteers have kept the program going... And then nurses that have been here a while to kind of work with the new people and to give guidance as to what we used to do and what needs to be done and everything, but it's a team. Everybody's got their own part in it.” (Nurse)
Stakeholder interdependence	Recognizing the necessity of not just acting as a team, but of acknowledging the interdependent nature of providing hospice care. Teamwork in this sense also means working well together and a relationship of respect for other roles; knowing that one can rely and count on team members to be there, do their job, and cover for each other if needed. Instances identified as a lack of teamwork were infrequent and often due to a lack of understanding about program goals.	“The nurses...they show [volunteers] some of the things they can do to help them out like clean. Like the nurse is supposed to clean... sometimes we're so short of staff the hospice volunteers do that for them. And that stands out for them and the nurses praise them for helping them do their job too.” (CO)
Formal volunteer team	Volunteers exhibit a high degree of cooperation and coordination that is essential to the functioning of the program; they are formally organized and identify as a team. Volunteers hold regular team meetings with the hospice program coordinator to address program-related concerns (i.e. fundraising, items or resources for hospice rooms and patients) and to discuss their concerns about patient care. Communication amongst volunteers off the unit ensures that patient care duties and vigil shifts are covered.	“We [volunteers] communicate 24/7. We see each other in the dorms, in the education buildings...So every time we see each other, there's something needed, one will let somebody know. Somebody's not going to be able to make a vigil or visit: “Could you stand in?” “Yes, I'll stand in.” If I can't stand in, I'll find somebody that can stand in. And that's how we communicate.” (Volunteer)