Thursday 7 August 2014

‘A CHAMPION TEAM WILL ALWAYS BEAT A TEAM OF CHAMPIONS’

“Teamwork: Easier Said than Done” 
 
Nauman Faridi

A team is not necessarily a group.

And a group is not necessarily a team.

GROUP:- any collection or assemblage of persons or things.

TEAM:- a number of individuals undertaking different tasks with a view to achieving a pre-determined goal.


TEAM

 Groups have to exist in the same time and usually in the same place. The key characteristic of a group is that of being a collection of individuals who are designated as a ‘group’, that’s it.

The individuals who make up teams on the other hand can exist in the same place or different places; in the same time or in different times.
A group can have no purpose, one purpose or many purposes. A no purpose group: a number of individuals who share a geographical proximity ie they just happen to be standing together for the moment. A one purpose group: the protest march. The many purpose group: the crowd at a U2 concert.

A team can have only one purpose.

If an organisation has one purpose (goal) it has one team and if it doesn’t it will be dysfunctional. It will also be one group. If an organisation has a number of purposes (goals) it will have a corresponding number of teams; BUT it will be, at the same time, one group.

Group members’ individual roles/tasks are not specifically defined and many individual members may have the same role/task.

Team members’ individual roles are clearly specifically defined and duplication of roles is avoided. Take the Australian Rugby team, the Wallabies; 15 team members each with a clearly defined and differentiated task BUT each with a common goal, to win by scoring points. This is not a group.

GROUP or TEAM ?

I have been told that it has been ‘agreed’ by these groups of birds in chevron flight that the two birds immediately behind the leader rest in anticipation of their turn as leader. If that is so, this group is starting to look like a team. To confuse things even further one definition of ‘flock’ is: a large group of things



GROUP


Then why is it that in researching for this BLOG I found the terms used interchangeably so often?

Having got that off my chest……….; what I want to just touch on in the space and time I have available is the evolution and current state of play of teamwork in healthcare.

To Err Is Human: Building a Safer Health System (1) had a lot to do with generating interest in the creation of teams for the delivery of healthcare by highlighting that preventable medical errors, of which it turned out there were many, were often the result of dysfunctional or non-existent teamwork.

Yet,  ‘… training programs designed to improve team skills are still a new concept for medicine, particularly for physicians who are trained largely to be self-sufficient and individually responsible for their actions. On the other hand, outside of healthcare, research has shown that teams working together in high-risk and high-intensity work environments make fewer mistakes than individuals’ (2).

So if we agree that effective teamwork is integral to enhanced clinical outcomes in the provision of healthcare, all we need to do is to introduce teamwork (dare I say in lieu of groupwork). Easy. Not so easy (Teamwork: Easier Said than Done”  Nauman Faridi )

Even today there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. Often it depends on to whom you talk. Healthcare managers might select leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome. It does not take much experience, or imagination for that matter, to recognise that clinicians would identify a largely (although, admittedly, not entirely) different skill set. One skill that I would expect to see on the lists of both is communication.

Background

Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers.

Methods

Members of a state branch of the professional association of Australian health service managers participated in a teamwork survey.

Results

The 37% response rate enabled identification of a management teamwork competency set comprising leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome.

Conclusion

Although not part of the research question the data suggested that the competencies for effective teamwork are perceived to be different for management and clinical teams, and there are differences in the perceptions of effective teamwork competencies between male and female health service managers. This study adds to the growing evidence that the focus on individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork.
Inadvertent patient harm is all too often the result of absent or poor communication. Medical care is complex and complete and accurate expression through language is limited. Creating a healthcare environment, clinical or non-clinical, where all those working together feel empowered to speak, is the first step; and the second is to adopt a standardised, common language where what you mean when you express yourself is what I understand when I hear what you say. Mistakes are inevitable if we do not do this.
But back to the teaching of healthcare, right back, to the undergraduate years.
The existing focus is still largely on   ‘.. individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork.’(6.)
Things are improving, which is something, but ever so slowly………
As they say in rugby……..
‘A CHAMPION TEAM WILL ALWAYS BEAT A TEAM OF CHAMPIONS’

Peter Carter
Chief Executive Officer
August 07 2014

1.         November 1999
        I N S T I T U T E O F M E D I C I N E
       Shaping the Future for Health
       TO ERR IS HUMAN: BUILDING A SAFER HEALTH SYSTEM

2.         Mt Sinai J Med. 2009 Aug;76(4):318-29. doi: 10.1002/msj.20129.
        Teaching teamwork in medical education.
        Lerner S1, Magrane D, Friedman E.

3.        Qual Saf Health Care 2004;13:i85-i90 doi:10.1136/qshc.2004.010033
       The human factor: the critical importance of effective teamwork and communication in providing            safe care
       M Leonard1, S Graham2, D Bonacum

        4.    Teamwork and patient safety in dynamic domains of healthcare: a review of the literature
       T. MANSER
       Article first published online: 22 OCT 2008
       Acta Anaesthesiologica Scandinavica
       Volume 53, Issue 2, pages 143–151, February 2009

5.         Computational & Mathematical Organization Theory
        December 2000, Volume 6, Issue 4, pp 339-360
        Virtual Teams: What are their Characteristics, and Impact on Team Performance?
          Sze-Sze Wong,  Richard M. Burton

6.          BMC Health Serv Res. 2007; 7: 17.
         Published online Feb 7, 2007. doi:  10.1186/1472-6963-7-17
         Effective healthcare teams require effective team members: defining teamwork competencies
         Sandra G Leggat