Think of the teams of which you are a member (if not currently a team member think of a team from your past). Select one of these teams to analyze. Would you classify it as a high-performing teams? If yes, why so? If not, why is it not? Also, if you do not currently classify your team as high performing, what could you do to change this?
Chapter 5:
Teams and Team Effectiveness
in Health Services Organizations
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2020 Cengage.
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or posted
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or duplicated,
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posted
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accessible website, in whole or in part.
Purpose
•
Teams represent bedrock of healthcare
organizations:
– Effectiveness of teams can have a direct
impact on effectiveness of organization
– Teams cannot function to full potential
without appropriate leadership
– Managers need to draw on full potential
of teams and overcome common
obstacles to optimal team performance
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Introduction
•
Use of teams in healthcare no longer an
option: teams and teamwork are a
necessity
– Work is too complex to be dependent on
single individual
– Teams are multidisciplinary, relying on
people with multiple skill sets
– Effective patient care and management
are dependent upon teams
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Teams versus Groups
• Teams are groups, but not all groups are teams:
– Teams have:
1. defined purpose,
2. membership or composition,
3. structure,
4. specific processes, and
5. Leadership
– Groups (that are not teams) may possess some characteristics of teams but lack one
or more key elements
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Informal versus Formal Groups
INFORMAL GROUPS
Not formally established or sanctioned by
organization:
◦
◦
◦
Form naturally by individuals in
organization to fill personal or social
interest or need
May be viewed positively by organization
Can also have negative impact on
organization
FORMAL GROUPS
Teams formally recognized, organizational-based,
social systems:
◦
◦
Organizationally based teams are
task-oriented with specific purpose
Operate within an organizational context and
interact with larger organization or
organizational subunits
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare
• Grouping of teams based on certain dimensions generally leads to a better consensus
of team characteristics
• Typology used in to group teams in healthcare (in this chapter):
1. Function or Purpose
2. Decisional Authority
3. Temporal Nature
4. Time and Space
5. Diversity and Inclusion
6. Accountabilities
7. Membership Fluidity and Boundary Permeability
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Function or Purpose
• Function or purpose: why a team?
•
Examples:
–
If complex task is to be accomplished,
teamwork is most appropriate
–
Work teams: produce goods or provide
services
–
Teams have potential to create synergy
and are source of empowerment
–
Support teams: provide support for
primary functions of organization
–
Teams bring together diverse expertise
and perspectives from multiple
disciplines
–
Parallel teams: individuals serving on
work teams and have role in support
teams
–
Drawbacks of teams may be diffusing
talent, requirement of infrastructure,
added costs and stress
–
Project teams: produce one-time
outputs
–
Management teams: provide direction
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Decisional Authority
•
Continuum of roles teams play in decision making:
– At one end, teams may have authority to make decisions
– At other extreme, some teams have no decisional authority
– Role of team should be absolutely clear, particularly role in decision-making
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Temporal Nature
•
Permanence of team
– Teams can be relatively permanent
and ongoing, or time-limited and
focused on particular project or task
– Use of time-limited teams common
because of rapidity of change and
need to respond quickly
– Team processes must accommodate
speed required of temporary teams
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Time and Space
•
Because of communication technology rules
of time and space often do not hold:
– Teams can communicate and work efficiently
over any distance
– Virtual teams: communication among team
members takes place through email, fax, and
video teleconferencing
◦ Virtual teams require additional rules and
guidance
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Diversity and Inclusion
•
Provides both opportunities and challenges for teamwork:
– Advantage of diversity: opportunity to obtain multiple perspectives and expertise
– Challenge of diversity: managing multiple viewpoints and worldviews
– Examples of diversity;
◦
◦
◦
◦
◦
Age and/or generation,
gender,
hierarchical level,
consumer and professional diversity,
demographic and cultural diversity.
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Accountabilities
•
Teams vary in types of accountability required of them
– Internal accountability
– External accountability
– In well functioning teams, team members perceive they are accountable to each
other
– Effective team leader should strive for team that is self-managing, or has selfmanaging characteristics
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Typology of Teams in Healthcare:
Membership Fluidity and Boundary Permeability
•
Liabilities to membership fluidity include
lack of cohesiveness
– On the other hand, fluid membership
may bring a continuous influx of new
ideas that benefit team performance
•
Boundary permeability: depending on
required task teams may require longstanding membership or frequent
turnover
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Understanding Team Performance
•
Teams are entities that make productivity possible
•
Measurement of performance in healthcare starting to be constant feature of
healthcare environment, with teams playing major role
•
Systematic ongoing review of team processes and performance is not common in
healthcare organizations
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
A Model of Team Effectiveness
•
Certain factors are outside control of
organization or manager
•
Managers and team leaders must
understand and anticipate how
uncontrollable factors may affect team
•
Sometimes uncontrollable factors may
have positive impact on team processes
and outcomes
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Team Characteristics
•
•
Team size, composition, and diversity:
–
Too few or too many members may reduce performance
–
Diversity affects way individuals perceive each other and how well they work together
Status differences:
–
•
Psychological safety
–
•
Perceptions about consequences of interpersonal risks in work environment
Team norms
–
•
May motivate others or act as source of conflict and tension
Standard shared by team members regulating member behavior
Team cohesiveness
–
Extent members are committed to group task
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Nature of the Work
•
Principle of Contingency: organizational
structures and processes must be
aligned with number of factors
•
Team goals:
– Categorized according to goal clarity,
complexity, and diversity
•
Task interdependence:
– Interconnections between tasks;
degree to which team members rely on
one another
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Environmental Context
•
Intergroup relationships and
conflict
– Effective team performance
dependent upon team’s ability to
form positive intergroup
relationships with other teams
•
Organizational culture
– For teams to function to maximum
potential, important for there to be
a culture valuing teamwork and
participation
•
External environment:
– For some groups, external
environment may exert influence
equal to or greater than internal
organizational environment
– Social capital: web of cooperative
relationships between providers in
service system involving interpersonal
trust, norms of reciprocity, and
mutual aid
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Team Processes (1/2)
•
Leadership:
– Formal leadership vs. informal leadership
•
Communication network and interaction patterns:
– Team cannot function effectively unless members can exchange information
•
Decision making:
– May be based on input, consensus,
or without input in emergency
situation
– Beware of groupthink
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
Team Processes (2/2)
•
Team learning
– Involves teams obtaining and processing data, allowing
team to adapt and improve
•
Stages of team development
– Forming, storming, norming, performing, and adjourning
•
Team processes as intermediary
– Intermediary is between team structures and outcome of
team effectiveness
© 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly
accessible website, in whole or in part.
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