Team Structure
NEXT:
The ratio of We’s to I’s is the best
indicator of the development of a
team.
–Lewis B. Ergen
Team
Structure
Objectives
• Understand what defines a team
• Identify the characteristics of high-performing teams
• Discuss benefits of teamwork and team structure
• Describe components and composition of a
multi-team system (e.g., Core Team, Coordinating
Team, Contingency Team, Ancillary Services, and
Administration)
• Define the roles and effectiveness of team
members
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Team
Structure
Team Structure
Common purpose
Performance Goals
Mutual Accountability
Clear Roles/Responsibilities
Complementary Skills
Interdependent Tasks
Patient
&
Family
Team Skills are the result
of effective team structure
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Team
Structure
What Defines a Team?
• Two or more people
• Interact dynamically,
interdependently, and
adaptively
• Toward a common and
valued goal (14% of
team function)
• Have specific roles or
functions (12% of team
function)
• Have a time-limited
membership
Salas et al. Does team training
work? Principles for health care.
Acad Emerg Med. 2008. 15:1-8.
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Team
Structure
Partnering with the Patient
Embrace patients as valuable and
contributing partners in patient care
−
Listen to patients
−
Learn patients’ preference regarding
involvement
−
Ask patients about their concerns
−
Speak to them in lay terms
−
Ask for their feedback
−
Give them access to relevant
information
−
Encourage patients and families to
proactively participate in patient care
(teach back)
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1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to
do this?
http://www.npsf.org/for-healthcareprofessionals/programs/ask-me-3/
Teach – Back / Show-Me Method
http://pilot.train.hrsa.gov/uhc/pdf/module
_02_job_aid_teach_back_method.pdf
5
Groups vs. Teams
Team
Structure
Team
Working Group
•
Clearly focused leader
•
Share leadership roles
•
Individual accountability
•
Mutual accountability
•
Individual work products •
•
Efficient meetings
•
Problem-solving meetings
•
Indirect measures of
performance
•
Direct measures of
performance
•
Discusses, decides,
delegates
•
Discusses, decides, works
together
Collective work products
Essence of a team is common commitment
Katzenbach & Smith (2005)
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Team
Structure
Barriers to Team Performance
•
Inconsistency in team
membership
•
Conflict
•
Lack of coordination
and follow-up
•
Lack of time
•
Lack of information sharing
•
Distractions
•
Hierarchy
•
Fatigue
•
Defensiveness
•
Workload
•
Conventional thinking
•
•
Varying communication
styles
Misinterpretation of
cues
•
Lack of role clarity
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Team
Structure
Team Failure Video
Videos must be saved in the same file as your power point for the
link to work. If the link does not work, reinsert the video:
• Click on insert tab in power point
• Click on Video
• Click on Video from file
• Click on Sue SheridanLg001
•Mod 2Click
on8 Insert Vig 4aLg001.mpgTEAMSTEPPS 05.2
06.1 Page
8
Team
Structure
Multi-Team System (MTS) for Patient Care
This structure…
establishes clarity of roles and
responsibilities that makes mutual
accountability possible
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Team
Structure
A Core Team is…
Made up of care providers
who work interdependently
to manage a set of
assigned patients
Dynamic Leadership
Core Team
members have
the closest
contact with
the patient!
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Team
Structure
A Coordinating Team is…
Responsible for managing
the operational environment
and resources that supports
the Core Team
Designated Leadership
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Team
Structure
A Contingency Team is…
A time-limited team formed for
emergent or specific events
and composed of members
from various teams
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Team
Structure
Ancillary & Support Services
provide…
Ancillary Services provide
direct, task-specific, timelimited care to patients.
Support Services provide
indirect service-focused
tasks which help to
facilitate the optimal
healthcare experience for
patients and their
families.
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Team
Structure
The Role of Administration is to…
• Establish and communicate
vision
• Develop policies and set
expectations for staff
related to teamwork
• Support and encourage
staff during implementation
and culture change
• Hold teams accountable
for team performance
• Define the culture of
the organization
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Team
Structure
Fall Risk Reduction
Multi Team System
Board of Directors
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MTS Supports Chain of Accountability
Coordinating teams hold core
Core teams accountable for the
reliability of processes.
Patient/
Family
Core Team
The board needs to
learn about quality
and safety from
coordinating teams
that have direct
knowledge of
front line structure,
process, and
outcome.
Coordinating Team
Administration
Board of Directors
16
Team
Structure
Exercise: Your Multi-Team System
?
?
Team members change but the behaviors remain the same
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Team
Structure
Paradigm Shift to Team System
Approach
Single focus (clinical skills)
Dual focus (clinical and team skills)
Individual performance
Team performance
Under-informed decision-making
Informed decision-making
Loose concept of teamwork
Clear understanding of teamwork
Unbalanced workload
Managed workload
Having information
Sharing information
Self-advocacy
Mutual support
Self-improvement
Team improvement
Individual efficiency
Team efficiency
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Team
Structure
Effective Team Members
 Are better able to predict the needs of other team
members
 Provide quality information and feedback
 Engage in higher level decision-making
 Manage conflict skillfully (NOT avoid conflict)
 Understand their roles and responsibilities
 Reduce stress on the team as a whole through
better performance
“Achieve a mutual goal through
interdependent and adaptive actions”
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Team
Structure
Teamwork Actions
• Assemble a team
• Establish a leader
• Identify the team’s goals and vision
• Assign roles and responsibilities
• Hold team members accountable
• Actively share information among team members
• Provide feedback
“Individual commitment to a group effort—that is what
makes a team work, a company work, a society work,
a civilization work.”
–Vince Lombardi
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