Team Profile Summary
The Acapulco Team
Swan Valley Mexico
Prepared by
With assistance from
David P. Ryan Ph.D.
Cheryl A. Cott Ph.D.
Nicole Donaldson
Jessica McAlpine
Pilar Furio-Hong
Connie Cadeau
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TEAM ID: 2/1/1/15
TABLE OF CONTENTS
page
Overview……………………………………………………………………………………..2
Results of the Dimensions of Teamwork……………………………………………...4
Overview of the Dimensions of Teamwork Survey (DTEAM)…..……..……….5
Results and Analysis………………………………………………………………..8
Results of Social Network Analysis…………………………………………………10
Overview of Social Network Analysis……………………………………………11
Social Network Map: Refer Clients To………..…………………………………12
Social Network Map: Exchange Information With……………………………...13
Key To Sociograms………………………………………………………………..14
Summary of Social Network Analysis……………………………………………15
Reflection Questions………………………………………………………………………16
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OVERVIEW
Your team has participated in the Geriatrics, Interprofessional Practice &
Interorganizational (GiiC) funded by HealthForceOntario to enhance practice in
these areas in Family Health Teams and Community Health Centers across the
Province. Through the initiative one your colleagues was designated as a GiiC
facilitator for your team and participated in a 16-hour training program to help them
serve as a resource to your team on the GiiC knowledge base for primary care. As
well, your team’s facilitator has been supported by a GiiC consultant affiliated with
either your area’s Regional Geriatric Program, the Center for Research in Ageing
and Health in Thunder Bay or the North East Specialized Geriatric Services Group in
Sudbury.
An important element of the GiiC initiative evaluation was an edumetric teamwork
exercise in which each team member was encouraged to complete a Dimensions of
Teamwork (DTEAM) Survey and a Network Analysis. This edumetric exercise is
designed to provide a source of information that could be of use in enhancing
interprofessional collaboration on your team. This document is a report on the
structure and function of teamwork on your team.
The DTEAM survey is a measure of team members’ perceptions of teamwork in
seven areas: customer and inter-team issues, team-member strengths and skills,
communication and conflict management, roles and interdependence, clarity of team
goals, decision-making and leadership, and organizational support. The survey is one
of few such tools to be standardized specifically for health care settings.
The social network analysis provides a “snapshot” of the pattern of relationships
amongst team members with respect to referral patterns and exchange of information.
This sociometric method has developed in the field of sociology over the last 50 years
but has seldom been used to inform teamwork in health care. Social network analysis
involves the mapping and measuring of relationships (ties) between individuals,
organizations or teams (nodes). For this study we examined two types of ties [1)
referring clients to and 2) exchanging information with] between individuals within a
Family Health Team or CHC.
In what follows you will find a graph representing your teams mean scores in each
subscale of the DTEAM survey together with a comparator group representing the
responses of all the health care teams who have used the survey in the past. The GiiC
project director has also prepared a brief written summary of the survey results, along
with the highest and lowest rated item on each scale. As well, you will find two social
network analytic diagrams with comments on four important social network constructs:
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1) network density; 2) network centralization; 3) strength of ties and 4) reciprocity of
ties.
Together we hope that these will provide the basis for reflection and discussion during
a team meeting that might help you to enhance the quality of interprofessional
collaboration on your team. As you plan the reflective discussion please keep in mind
that your GiiC consultant and the GiiC project director can be of help to you.
We would like to thank everyone on your team for participating in this exercise and we
hope that we can continue to help you develop your team’s good works in the areas of
Geriatrics, Interprofessional Practice and Interorganizational Collaboration
Dr. David Patrick Ryan
GiiC Project Director
Director of Education & Knowledge Processes
Regional Geriatric Program of Toronto
Assistant Professor, Faculty of Medicine, University of Toronto
Email david.ryan@sunnybrook.ca
Phone 416.480.6100 ext 3369
Dr. Cheryl Cott,
Deputy Director of the Arthritis
Community Research & Evaluation Unit,
University Health Network
cheryl.cott@utoronto.ca
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RESULTS of DIMENSIONS of TEAMWORK SURVEY
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OVERVIEW OF THE DIMENSIONS OF TEAMWORK SURVEY (DTEAM)
THE DTEAM COMPRISES 56 ITEMS ALONG SEVEN DIMENSIONS OF TEAMWORK
1. Customer and inter-team issues - Items sample the extent to which teammembers incorporate customer and inter-team issues into their work.
i. We regularly examine our client’s satisfaction with our work.
ii. We can develop our services without any advice from people outside
of the team.
iii. Our team always works hard to maintain constructive relationships
with other teams involved with our clients.
iv. We seldom allow our clients or their families to decide what
assessments and interventions are needed.
v. The family members of our clients are often just like team members.
vi. Too often, we seem to have to compete rather than co-operate with
other health care teams and organizations.
vii. We always try to remember that our customers include both our
clients and the people who assist them in the community.
viii. We seldom get to know the people working on other teams even
those within our own community.
2. Team-member strengths and skills - Items sample team member’s perceptions
that the team has the basic skills and knowledge necessary for its work.
i. People know how to get things done on this team.
ii. We lack some important skills and knowledge on this team.
iii. Everyone on this team knows what’s needed to make the team work
well.
iv. On this team, few people know how to run a meeting effectively.
v. People on this team have lots of experience in our type of work.
vi. Most team members have been trained only in their technical
discipline.
vii. Everyone on this team is highly skilled, and confident in their abilities.
viii. People just don’t seem able to adjust to change on this team.
3. Communication and conflict management skills - Items sample member’s
perceptions of the team’s ability to communicate and resolve conflict effectively.
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
People really listen to one another on this team.
On this team, speaking your mind creates problems more often than not.
When problems arise we are always able to talk things through.
People don’t really know each other very well on this team.
When conflicts arise team members negotiate solutions easily.
Conflict on this team is never just left to “smoulder” and get worse.
People on this team are always frank and open with each other.
There are always cliques and political maneuverings on this team.
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4. Team roles and interdependence - Items sample member’s perceptions that roles
are understood and that the team is capable of interdisciplinary functioning.
i. People on this team share their knowledge and skills easily.
ii. On this team, people develop their own care-plans independent of
everyone else.
iii. On this team we understand each other’s roles and are able to be flexible
and creative with them.
iv. On this team, roles are “carved in stone” and you had better not try to
change them.
v. Members of this team co-ordinate their efforts well.
vi. Although no one says it, sometimes it’s hard to get help with things
because people feel that “it’s not my job”.
vii. People collaborate rather than compete with each other on this team.
viii. We have no way of knowing whether we have achieved our goals or not.
5. Clarity of team goals - Items sample members perceptions that team goals are
clear, stable, and understood by all.
This team’s overall goals and objectives are clear.
This team does little planning and has no “game plan” for the future.
Everyone knows the goals we have for each client.
We are always changing our priorities on this team.
The goal of continuous quality improvement is understood by everyone.
We seldom examine what this team does, how it works, and how to
improve it.
vii. When we have team meetings we always have a clear agenda.
viii. We have no way of knowing whether we have achieved our goals or not.
i.
ii.
iii.
iv.
v.
vi.
6. Decision-making and leadership - Items sample member's perceptions of the
team's decision-making skills and facility for developing leadership skills.
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
This team can make good decisions in difficult situations.
I often don’t understand how the team makes the decisions it does.
I’ve always felt that I am able to influence the way this team makes
decisions.
I have too little authority to carry out the responsibilities that are assigned
to me.
Ability not politics determines whether someone is leader on this team.
It’s often unclear who has authority on this team.
All team members are accountable for the care our patients receive.
On this team, we rely on the physician’s authority; after all, they are the
ones who are accountable in the end.
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7. Organizational support - Items sample members’ perceptions of support for their
team from the organization as a whole.
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
I can always get the resources I need to carry out my job.
My workload is so heavy that it’s impossible to complete during an
ordinary work day.
The community seems to really understand the kind of work we have to
do on this team.
I’m concerned because too often, the amount of work I have to do
interferes with the quality of care I can provide.
The organization shows its appreciation for work well done.
It’s often unclear who has authority on this team.
I think this team has a lot of influence in the community.
If the team were disbanded, the community would not feel the loss.
Psychometric Properties of the DTeam Survey
Dimension of
Teamwork
Customer and
Inter-team
Team member
strengths and
skills
Communication
and Conflict
Roles and
Interdependence
Clarity of Team
Goals
Decision-making
and Leadership
Organizational
Support
Internal
Consistency
(n=116)
0.39
Inter-rater
Reliability
(n=28)
0.58*
Test/Retest
Reliability
(n=16)
0.84*
Convergent
Validity
(n=104)
0.46*
0.81
0.69*
0.93*
0.72*
0.77
0.45*
0.96*
0.84*
0.77
0.58*
0.96*
0.74*
0.81
0.60*
0.95*
0.71*
0.69
0.46*
0.96*
0.79*
0.67
0.28
0.97*
0.63*
* p<.05
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RESULTS AND ANALYSIS FOR YOUR TEAM
45
Mean Average Score
40
35
30
28.5
25
27.4
26.7
23.4
20
27.5
24.7
27.0
15
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Dimensions of Team Work Subscales
Note: Number of Respondents 10,
Number in columns represent mean scores for your team on each dimension
The solid line represents a overall average score for the standardization group of LTC,
Acute Care, Rehabilitation and Outreach teams in Ontario
Summary/Interpretation:
The results of the DTEAM survey suggest that this might be a new team or a team
that has recently expanded its membership and is reforming. There is great variance
in the perceptions of team members and many opportunities for team development.
In the domain of ‘patient and inter-team issues’ the team might benefit from
reflection on the issue of understanding patients satisfaction with the team’s work
and reviewing the extent and quality of inter-team or inter-organizational
collaboration.
In the domain of “team member strengths and skills” the results of the survey
suggest that while each team members possess high levels of clinical skill and
knowledge, skills along the dimension of team maintenance and process roles could
be developed. Two areas for team development here include making team meetings
more effective and managing adjustment to change team process.
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TEAM ID: 2/1/1/15
In the domain of ‘team member roles and interdependence’ the team might benefit
from reflection on the distinction between multi-professional and inter-professional
teamwork.
In the area of “communication and conflict management” the team appears to be
fraught with differing opinions that have been difficult to resolve. This is an area in
which the team might benefit from the assistance of an external facilitator.
Similarly, in the area’s of the “clarity of team goals”, survey responses suggest that
the team has been struggling with a high level of change and again external
facilitation might be beneficial.
Survey responses to items in the area’s of “decision-making and leadership” and
“organizational support” the team may be overly dependent on the authority of team
physicians, may not always understand how decisions are made, may feel that their
own decision making and leadership skills are not used effectively, and need more
support and encouragement for the work that they do.
In summary, the team’s strengths appear to lie in the skills, knowledge and
experience of its members and their willingness to share information, its ability to
make good decisions in difficult situations, and its willingness to respond to patient
and community needs. Still there are several area’s in which high performance is
compromised and it might be worthwhile for the team to consider engaging an
external facilitator to assist with team development.
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RESULTS of SOCIAL NETWORK ANALYSIS
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OVERVIEW OF SOCIAL NETWORK ANALYSIS
Social network analysis involves the mapping and measuring of relationships (ties)
between individuals, organizations or teams (nodes). For this study we examined
two types of ties (referring clients to: and exchange information with) between
individuals within a Family Health Team or CHC.
The following constructs are considered:
Network Density: how many connections there are between network members
compared to the maximum possible number of connections that could exist. The
higher the proportion, the more dense the network (e.g. the more interconnected the
members of the network). One might expect that a highly functioning interprofessional team would have a high network density with team members highly
interconnected with each other.
Centralization of a Network: extent to which the network is centralized around one
or a few actors. Are there members of the network who are more highly
interconnected or less interconnected than others?
Strength of Ties: ranges from weak (interactions that are infrequent, once per week
or less) to strong (frequent interactions, at least several times per week).
Reciprocity: refers to the extent to which relationships are two-way. Symmetric means that
the ties are reciprocated, e.g. participants refer clients to each other. Asymmetric means that
ties are not reciprocated e.g. the referrals are in one direction only from one person to
another. One might expect that in a well-functioning interprofessional team ties would be
symmetrical (participants refer to each other) whereas asymmetrical ties would suggest
hierarchy (referrals are just in one direction).
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This page would include the social network diagram
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On this page we would list the positions of the folks participating in the network
analysis
Response Rate: 9/14
64%
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SUMMARY OF SOCIAL NETWORK ANALYSIS FOR YOUR TEAM
Network Density: how many connections there are between network members
compared to the maximum possible number of connections that could exist.
Overall the network density is low. This means that not all team members are
linked to each other.
Centralization of a Network: extent to which the network is centralized around
one or a few actors.
Patterns of Referral (Sociogram: Refer clients to): There are three sub-groups who
are more or less interconnected. The Psychiatrist, RN, Receptionists and Clerical
are the most highly interconnected. The Medical Secretary, Geriatric Psych/Mood
Disorder Clinician, the two physicians, the RN Diabetic Program and the Nurse
Practitioner are the next most highly interconnected. The LTCHome Administrator,
Program Manager and Administrator are least interconnected.
Exchange of Information (Sociogram: Exchange information with): Most team
members are interconnected with respect to exchanging information with the
exception of the
Strength of Ties: ranges from weak (interactions that are infrequent, once per
week or less) to strong (frequent interactions, at least several times per week).
There are strong ties between most team members except the Psychiatric
specialist, LTCHome Administrator and the Psychogeriatric Clinician.
Reciprocity: refers to the extent to which relationships are two-way.
The majority of ties within the team are reciprocal.
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This is a loosely connected team with many opportunities for team development.
Scores on the DTeam Survey are considerably lower than average for highperforming teams. The following questions are designed to help the team reflect on
how it might become more high-performing.
REFLECTION QUESTIONS
Is this Team Profile an accurate representation of your team?
Are there some team members who are isolated from the rest of the group? How
might this be changed?
How might team meetings be made more effective?
What strategies could be implemented to ensure involvement of all team members in
communication and decision-making?
Are all team members’ roles and skill sets understood and utilized appropriately by
other team members?
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