Introduction to team effectiveness

1. Introduction to team effectiveness Steve Onyett.

2. Our Health Our Care Our Say • “By 2008 we expect all PCTs and local authorities to have established joint health and social care managed networks and/or teams to support those people with long-term conditions who have the most complex needs”. Steve Onyett.

3. The Challenge of Commissioning- Promoting • using practice based commissioning creatively, so that practice teams can work with patients, families and carers to design care packages better suited to their needs. • How radical is this new approach to teamworking? • Models for this can already be seen in mental health and intermediate care teams. • BUT HAVE WE LEARNED THE LESSONS?. Steve Onyett.

4. What is a Team? A group of people who depend on each other to get a specific job done well. Steve Onyett.

5. Benefits of Effective Team Working • Performance • Staff well-being Steve Onyett.

6. The 2006 NHS National Staff Survey • 89% responded positively when asked: “Do you work in a team?” • However this shrunk to 41% when the survey explored whether the team in question fulfilled criteria for a well structured team • Findings consistent since 2003! Steve Onyett.

7. Real teams • Shared objectives • Members who work closely together to achieve the objectives of the team • Members who have different and defined roles within the team • Less than 7-8 members • Opportunities to review the performance of the team and how it could be improved • A team identity, in that others can recognise it as a team Steve Onyett.

8. Effective teams have….. • Clear and shared objectives – but when combining hierarchies also need to be clear about where NOT collaborating • The means to deliver in terms of resources, authority and autonomy • The minimum number of team members required to get the job done. • Clear, differentiated, and diverse roles Steve Onyett.

9. Effective teams have….. • A need among members to work together to achieve team objectives • Participation in decision making • Norms for excellence • Rhetorical and practical and support for innovation • Defended time out to review what it is trying to achieve, how it is going about it and what needs to change Steve Onyett.

10. The evidence on CMHT effectiveness • Borrill et al, (2000) examined 113 CMHTs • External ratings of innovation and effectiveness associated with • team clarity of and commitment to objectives, • higher levels of participation, • a stronger commitment to quality, and • practical support for innovation. Steve Onyett.

11. Vision that is • based on explicit and shared values • clear, • negotiated, • shared, • motivating and • attainable Steve Onyett.

12. Participative safety • A climate in which team members feel free to participate and share ideas, even if those ideas are a little “half-baked”. • Associated with • Less resistance to change and a greater likelihood of innovation • Constructive controversy in pursuit of excellence. • A collaborative, and participative leadership style. • Appropriate exchange of information for collective decision-making and as a way of achieving good decisions and role clarity. Steve Onyett.

13. Climate for excellence • Team commitment to achieving excellent performance through modifying practices and implementing improved methods of working. • Look for commitment to giving users real power in shaping practices, openness to critical evaluation, and time and resources devoted to planning and implementing evaluation. Steve Onyett.

14. Support for innovation • The teams expectation, approval and support of attempts to introduce new and improved way of doing things. • May be verbal approval or offers of co‑operation, time and resources. • Support needs to be demonstrated in practice. Steve Onyett.

15. A typical effective CMHT had • few part-time workers, • relatively low stress levels. • clear leadership Steve Onyett.

16. Poor functioning • Unclear team objectives were the biggest contributor to poor functioning. • This was associated with the absence of a clear team leader or co-ordinator or where there was conflict about leadership. Steve Onyett.

17. The mental health of team members Those working in teams have much better mental health than those working in looser groups or working individually. Steve Onyett.

18. Mental Health The benefits appear to be due to: • greater role clarity • better peer support • Those working in teams are also buffered from the negative effects of organisational climate and conflict. Steve Onyett.

19. The better the functioning of teams the better the mental health of team members across all domains of health care. Steve Onyett.

20. Communication and regular meetings • are associated with higher levels of effectiveness and innovation in Primary Health Care and CMHTs • yet the quality of meetings is often poor Steve Onyett.

21. Barriers to effective teamworking • Teams without tasks • Teams without freedom and responsibility • Unwieldy teams with the wrong members • Organisations deeply structured around individual work • Team processes are neglected rather than developed • Strong teams in conflict Steve Onyett.

22. Obstacles to Effective Teamwork • Professional divisions, exacerbated by gender issues • Team members belong to different organisations • The lack of professional mutual role understanding and respect Steve Onyett.

23. Obstacles to Effective Teamwork • Lack of understanding of organisational context • Lack of pre-qualification team working training • Lack of clear team objectives and feedback on performance • Poor or non-existent team meetings, and team reviews of strategies, processes and objectives • The unmet need to base practice and teamwork on the assessed needs of local populations Steve Onyett.

24. Organisational Supports for Teams • Clear goals • Resources • Communication and information systems • Education and training systems • Feedback systems • Liaison and integration with other parts of the system Steve Onyett.

25. Organisational Supports for Teams • Support with the process of teamworking • Reward systems • Appraisal processes • Recruitment and selection policies Steve Onyett.