Authored by Andrea White, PhD andValerie West, EdD for the C3 Initiative

Teaching Team Skills:Goals for Today

Introduction to Team Competencies/ Content for teaching

Team exercise – as an exampleObservation and FeedbackReview Handbook ContentsQuestions and evaluation

What is a Team?•Two or more individuals with a high degree of interdependence geared toward the achievement of a goal or the completion of a task.

•Teams make decisions, solve problems, provide support, accomplish missions, and plan their work.

How is a Team Different from a Group or Committee?

• Teams embody a collective action arising out of task interdependency

• Members of the team agree on the goal

• Members agree that they must work together to achieve the goal

• Each member is viewed as having one or more important roles to play to successfully achieve the goal

• There is less hierarchy within the unit than in most work groups

Why is Teamwork Important in Healthcare?

While our healthcare delivery system has the potential to be outstanding, our system currently is not as safe, effective, or efficient as it should be.

Promoting teamwork and good communication among health professionals can dramatically improve healthcare delivery, resulting in much better outcomes for our patients. How do we know this?

There are Many Types of TeamsExamples of Teams:

Athletic Team – people working together to win a gameNatural Work Group – people working together every

day in same office with similar processes and equipmentBusiness Team – cross-functional team overseeing a

specific product line or customer segmentImprovement Team – ad hoc team with responsibility

for improving an existing processHealthcare Team – several healthcare professionals

working closely together for the benefit of a patient or group of patients

When to use a team?Quality and Acceptance

Low Quality/Low acceptance

Flip a coin

High Quality/Low acceptance

Ask an Expert

Low Quality/High Acceptance

Group decision

High Quality/High acceptance

Team Consensus

Understanding group behavior

Group Content - what is being said, the words, the discussion

Group Process - how the group works, methods, ways of making decisions, how people participate

Aspects of Group Process: Communication

Who talks to whom? Who interrupts and how is it handled?How are quiet members treated?High and low participators? Shifts in

participation levels?Do people look at each other when they talk?How are new members treated?

Aspects of Group Process: Decision -making

What process does the group use to make decisions?

Is the process agreed upon by everyone?Does the process change as group proceeds?Does anyone make a decision and carry it out

without agreement from the others?Is there evidence of a majority pushing a decisionAre minority opinions heard?

Aspects of Group Process: Problem-solving

Does the group take time to understand the problem?

Is the problem well articulated?Is there time for brainstorming creative

solutions?Can the group move to from problem

identification, identifying possible solutions, to selecting solutions and implementation?

Group Problem Solving

•Listen for common Themes

• Organize ideas

•Evaluate alternatives

• Manage conflict

•Involve people

•Get information

• Develop plan

•Generate ideas

•Assign responsibilities

• Find resources

•Monitor progress

•Motivate

•Details/Finish

•Presentation

•IDENTIFY PROBLEM

Recognizing Dysfunctional BehaviorBlockingAggressionDominatingWithdrawingOut of field behavior

Team Roles: Task

• Initiating• Seeking and Giving Information• Clarifying• Summarizing• Consensus Taking• Accountability

Team Roles: Relationships• Communication Gatekeeping• Encouraging• Resolving Conflict• Acknowledging Feelings• Setting Standards/Norms• Openness

Attitudes for Effective TeamworkAppreciation for value of team decisionsRespect for team membersMutual trustOpenness to feedbackReflection on group process and interest in

improvingShared vision

Team ExerciseInstructions for

ObserversInstructions for Team

membersTeam ExerciseScoring, Team

members and Observer comments

Discussion

What are Characteristics of Effective Teams? Members have a clear goalThe focus is on achieving resultsThere is a plan for achieving the goalMembers have clear rolesMembers are committed to the goalMembers are competentThey achieve decisions through consensusThere is diversity among team membersMembers have effective interpersonal skillsThey know each other well and have good relationships

More Characteristics Each member feels empowered to act, speak up, offer

ideasEach member has a high standard of excellenceAn informal climate and easiness exists among membersThe team has the support of managementThe team is open to new ideasThere is periodic self-assessmentThere is shared leadership of the teamThe team is a relatively small sizeThere is recognition of team member accomplishmentsThere are sufficient resources to support the team work

Effective Team-Building Takes TimeThere must be

frequent and prolonged contact

Team members come together around a specific goal or project

Effective teams go through four stages of team development

What are the Four Stages of Team Development?

FormingStormingNormingPerforming

Every effective team goes through these life cycle stages

FormingTeam members are

introduced and begin getting to know each other

Goals and tasks are established

Generally polite behavior among members

Norms are not understood

StormingMembers are sizing

each other up and may feel more comfortable and voice their views

Members may compete for team roles

May argue about goals or how they should be accomplished

May choose sides against other members

NormingOnce issues are

resolved, agreement occurs around team norms and expectations

Trust and common interests are developing

Roles and objectives are clarified and understood

PerformingMembers make

contributions and are motivated by results

Leadership is shared according to members’ knowledge and skills

Norms and culture are well understood

Tasks get accomplished effectively and efficiently

References Thiagarajan, S. and Parker, G. (1999). Teamwork and Teamplay. San

Francisco: Jossey-Bass/Pfeiffer.

Dean, P., LaVallee, R., & McLaughlin, C. (1999). Teams at the core of continuous learning in McLaughlin, & Kaluzny, A. (eds.) Continuous Quality Improvement in Health Care: Theory, Implementation, and Applications, 147 – 168.