Team Working in
Health and Social Care
13th June 2006
Lynn Markiewicz
Aston Organisation Development
Aston Business School
©Aston Organisation Development Ltd 2005
Workshop Aims
Explore the links between team working
and service user outcomes
Identify the key dimensions of effective
team working
Make plans to create and maintain
effective team working
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Team Based Working and Healthcare Organisation
Effectiveness - the research evidence
Reduced hospitalisation and costs
Increased effectiveness and innovation
Increased well-being of team members
Multi-disciplinary teams deliver higher quality
patient care and implement more innovations
Lower patient mortality
Reduced error rates
Reduced turnover and sickness absence
Higher levels of patient satisfaction
Reduced levels of violence and aggression
from patients / clients
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Health care team effectiveness
3.5
3
2.5
External
ratings of
innovation
2
1.5
1
<3.2
3.2 - 3.4
3.4 - 3.6
3.6 - 3.8
Ratings of team effectiveness
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>3.8
Health care team innovation
5.5
4.5
Innovation in
quality of
care
3.5
2.5
1.5
0.5
5
7
8
9
10
Professional diversity
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11
12
A Comparison of GHQ-12 Findings from the BHPS1
and the NHS Sample
Source Status
BHPS
NHS
Employed
Employed
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Sample Size Percent
Case
5,001
11,291
17.8%
26.8%
Team working and mental health
35
30
25
20
15%
10
5
0
Not in a team
Pseudo team
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Work in a team
Mean mortality index
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%staff working in teams
Team functioning and patient satisfaction
3.3
Patient experiences
3.2
3.1
Clarity of objectives
3
Reflexivity
Support for innovation
2.9
2.8
2.7
Low
Moderate
Team functioning
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High
Organisational level findings
Working in a well-structured teams
predicted lower levels of injuries and
illness among staff, and lower levels of
errors and near misses witnessed by
staff in the previous month
NHS National Staff Survey 2003 & 2004 & 2005
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The key dimensions for team
and organisational success
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Aston Team Performance Inventory
Inputs
•Team task design
•Effort and skills
•Organisational support
•Resources
Processes
Team Processes
•Objectives
•Reflexivity
•Participation
•Task focus
•Team conflict
•Creativity and innovation
Leadership
•Leading
•Managing
•Coaching
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Outputs
•Individual satisfaction
•Attachment
•Team effectiveness
•Inter-team relationships
•Team innovation
Developing effective team working
Establish clear identity
Develop clear shared vision and objectives
Ensure role clarity
Foster high levels of participation
Promote reflexivity – reflection and adaptation
Nurture effective inter-team relationships
Establish clear leadership
Maintain a supportive organisational culture
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Team Identity
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What is a Team?
Typically no more than 12 members who:
– Have shared objectives in common
– Need to work together to achieve these
objectives
– Have different and defined roles in the team
– Have a team identity
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Home teams and team communities
Home team
The team who’s objectives direct your actions in
all the other teams in which you work
Team community
A collection of teams which need to work
together to achieve an outcome or provide a
service – their outcomes are interdependent
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Trust Board
Ward
Management
Team
Portering
Radiology
Social
Workers
a
w
th
a
P
y
ag
n
Ma
en
m
e
am
e
tT
Bereavement
Counselling
Physio
PCT
Theatres
G.P.’s
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Types of teams
Uni-disciplinary teams
Multi-disciplinary teams
Inter-professional teams
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Types of teams
Uni-disciplinary – single professional
background - planning, co-ordinating and
delivering service
Inter-professional – more than one
professional background - planning, coordinating and delivering service
Multi-disciplinary – many professional
backgrounds working interdependently
on a daily basis to deliver service
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Problems
Requirement for
group member
interdependence
Complex
puzzles
Simple
puzzles
Environmental complexity and fluidity
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Development
2005
Adapted
from David
CaseyLtd
1984
Skills for inter-professional team working
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“interdisciplinary care, whilst not denying the
importance of specific skills, seeks to blur the
professional boundaries and requires trust,
tolerance and a willingness to share
responsibility”
M Nolan (1995) Towards an ethos of interdisciplinary practice. BMJ
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Circle of
Trust
Contact
Values
Risk
Communication
Respect
Altruism
Shared
fate
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Positive
conflict