free essays
Free essays

Research Paper



Module3: Team Building and Performance


Table ofContents

Abstract 3

Introduction 4

1.0. Reasons why healthcare industry depends so much on teamwork 4

2.0.Challenges Facing Administrators in Healthcare in Creation of Team Culture .……………6

3.0.Team Building Model 8

3.2.Drexler model. 8

3.1.1. Orientation 8

3.1.2. Trust Building 9

3.1.3. Clarification of goals 9

3.1.4. Commitment 10

3.1.5. Implementation 10

3.1.6. High Performance 10

3.1.7. Renewal 11

4.0.Four elements of effectiveness of a team 11

4.1.Team Effectiveness 11

4.2.Team Process 12

4.3.Team Characteristics 13

4.4.Environmental Context 14

Conclusion 14

References 16


Theissues affecting healthcare workplaces include the serious concernsthat can affect the physical safety of the workers to those with thepotential of increasing efficiency and productivity. Healthcaremanagement and workers may consider teamwork as an effective asset,but this may be prerequisite for patients. For the recipients of thehealthcare services, teamwork is more than desirable. This paperaddresses issues of effective teamwork as a critical element in thehealth workplace. The reasons for reliance on teamwork andperformances have been highlighted, with the major challenges facingthe healthcare administrators in their promotion of team cultureexamined. The paper has described the most likely team building modelto be followed and the four elements of team effectiveness outlined.

TeamBuilding and PerformanceIntroduction

Inhealthcare, teamwork refers to the ongoing interaction processesbetween the team members as they provide the healthcare to patients.The move towards effective teamwork requires making of explicitdecision by the team members to sacrifice their autonomy and allowtheir activities to be coordinated within the confines of the team,either through the shared decision making or decisions by teamleader. Responsibility of the professionals working within a teamencompasses close monitoring of the activities from their fellow teammembers rather than their professional skills alone(Burns,Bradley, &amp Weiner, 2012).

  1. Reasons why healthcare industry depends so much on teamwork

Themembers from effective teams believe in their ability to resolveproblems, trust each other and are always positive on the activitiesperformed by the team. Such teams are self-evident and producehigh-quality results. Outside healthcare, studies, indicate thatteams in high-intensity high-risky environments make lesser mistakesthan individual workers. Similarly, in healthcare, studies show that,when enhanced by the inter-professional collaboration, teamwork canrealize numerous benefits. Some of the benefits include reduction inmedical errors, addressing the workload issues, building cohesion,improving patient care quality and reduce burnout among thehealthcare professionals(Morey,2002).

Thehealth care industry depends on teamwork, especially, because of thetasks that are performed by healthcare professionals. Various taskswithin the healthcare industry demand relationships andinterdependence between the healthcare professionals. Some activitiesrequire a high level of the role performer interdependence. This alsodepends on serial interdependence between the role performers. Pooledinterdependence is required between the role performers.

Thedelivery of healthcare is unique as it depends mostly oncollaboration between the healthcare professionals and pooledinterdependence between various healthcare professionals to producesuccessful health care services to patients. These characteristicsrender healthcare teamwork as a mandatory requirement. Though not allhealthcare situations require collaboration between the healthcareprofessionals, most of them do. Teamwork promotes responsiveness,satisfaction, efficiency and effectiveness(Nolte&amp Tremblay, 2005).

Thehealth care teamwork enhances responsiveness to changes. Forinstance, any drastic changes to patients` condition calls for theprofessionals to work together to resolve the condition. This way,trust, develops between the team members, and this increasesconfidence on the group members. When doctors, nurses and theirassistants work together, the probability of succeeding is very high(Hoff&amp Jameson, 2004).

Onthe other hand, studies indicate that patients are more satisfiedwhen they see the health professionals offering services as a team.The highly efficient teams tend to utilize the resources in a betterway. Strong leadership of the team enhances realization of efficiencyas the healthcare professionals become empowered to design the workplans based on resources available and their skills(Lemieux-Charles&amp McGuire, 2006).

Therefore,teamwork in healthcare is necessary since it enables the team membersbecome effective in their delivery of healthcare services. Theprovision of healthcare remains inherently interdisciplinary,demanding collaboration between nurses, physicians and the alliedhealthcare professionals from various specialties. Studies indicatethat team performance is critical in the provision of safehealthcare. However, poor coordination among the healthcare providersfrom different organizational levels affects safety and quality ofhealthcare(Marriott&amp Mable, 2002).

  1. Challenges Facing Administrators in Healthcare in Creation of Team Culture in the Organization

Theorganizational factors have been identified to strongly influence theestablishment of collaborative practices with the healthcareindustry. Studies indicate that the organizational structures andculture influence the outcomes of the team both directly andindirectly. When the organization tends to manage individuals insteadof groups, the efforts towards teamwork are compromised. Therefore,any intervention within the organizational context affects the movetowards the establishment of effective teams. Also, theadministrators experience challenges when establishing teamwork sincethe approach towards teamwork requires making of major changes withinthe organization in order to create an environment that embracesteam-based culture.

Varioushealthcare settings have been experiencing considerable degrees ofcomplexity in management, infrastructural and governance support.This has created varying degrees of resources such as finance andtechnology to support the teams.

Thegreatest obstacle towards any effective change is the hierarchicalculture in healthcare. The entrenched attitudes on scope of practiceand the historical power structure sabotage the essence of teamwork.Formidablebarriers arising from the hierarchical culture include professionalself-regulation, funding and remuneration models, liability laws andcurrent malpractice. For instance, the current malpracticelegislation associates responsibility completely on individualsinstead of the team. On the other hand, the regulations supportingteamwork refocus this from the culture of blame to a culture of thesafety of the patient and management of risk(Lingard, 2004).

Thiscompels the administrators to invest in clarification ofaccountability for the non-physician team members to enhance theirperformance of the shared tasks. Also,the supply issues persistently continue to preoccupy administrators,and confound the dedicated efforts towards implementation ofeffective teamwork. Current shortage of professionals within thehealthcare institutions creates pressure where people can experimentwith new healthcare delivery models(Volpe &amp Cannon-Bowers, 2006).

Themajor factors affecting effective establishment of teamwork includeinadequate time to gather people together to enable them reflectabout the changes. The insufficient inter-professional education andthe persistence of professional silos may also hinder the movetowards teamwork. Sometimes, the established payment systems fail intheir recognition of teamwork. The links between individual goals andcollaborative practices are normally very few. As a result, successand capturing of evidence for successful teams is limited(Dault, Lomas, &amp Barer).

Accordingto research by CHSRF, most administrators feel that the poordesignation of responsibilities in enhancing collaborationcontributes to the failure of teams. Traditions and history act asbarriers when people try to perpetuate the status quo so as to staywithin the comfort zones and protect the vested interests.Furthermore, ineffective communication is a potential barrier to teamculture(Gully, Devine, &amp Whitney, 2005).

Thepolicies established prevent any effective planning for changesacross various jurisdictions and stakeholders. Some of the barriersto change include the territoriality of the professionals and thecross-sectoral profession issues like education and liability. Thedivision between education and health care programs acts as anobstacle to team culture as government has a high likelihood of notaddressing that. Some issues that have been dominating the agendainclude patient`s safety and waiting lists. While the reframing ofthe issues can be done as a result of poor collaboration, such a taskmight be very difficult(Gully &amp Incalcaterra, 2002).

  1. Team Building Model

Thispaper proposes Drexler/Sibbet Model for team development. The figure1 illustrates the 3.2.Drexlermodel.

Figure1:Dexler/Sibbet Team Building Model

Themodel comprises of seven stages. These are orientation, trustbuilding, goal clarification, commitment, implementation, highperformance and renewal(Pronovost, Dorman, &amp Lipsett, 2003).

      1. Orientation

Theorientation stage involves the team members finding out the reasonfor teaming up. This requires clear identification of the purpose andtheir responsibility in the team. Each team member must understandtheir contribution towards enhancing the effectiveness of the team.The team as a whole must develop a sense of identity by definingclearly its purpose and responsibility. Some of the key areas oforientation are purpose, team identity and membership(Baker, Gustafson, Beaubien, Salas, &amp Barach, 2005b).

Normally,purpose is established after the team members understand the purposefor forming a group, the acceptable challenges and when they feelthat their purpose in the organization is critical. The team identityinvolves the team members identifying with the team, it norms, valuesand the purposes for which it stands for. In the membership, thepeople must feel part of the team to create a sense of identity andownership with the work of the group. This makes them feel pride ofinvolvement in the enterprise of the team. People within the teamfeel accepted and believe the success of the team fully depends oneach of the team member(Burns, Bradley, &amp Weiner, 2012).

      1. Trust Building

Thisforms the stage two of the model. This stage involves theestablishment of the bonds of trust between the members. This ensuressecurity in each other`s confidence. Trust means counting on othersto remain competent in their work as well as being truthful to theteam. Trust ensures essential information sharing. This involvessharing of the mutual regard, forthrightness and reliability. Sharingof mutual regard means that the team members can consider one anotheras reliable and competent. Trust can be expressed primarily on thewillingness to be free and open when dealing with other members ofthe group. Trust is established when the members consider each otheras reliable and they can count on them(Burns, Bradley, &amp Weiner, 2012).

      1. Clarification of goals

Thisforms the third stage in team development when the work is beginningto take shape. This stage enables the team draw vision of it and setsclear goals that act as milestones as it progresses. The majorfactors influencing clarification of the goals include explicitassumptions, integration of goals and shared vision. A team shouldmake the basic assumptions and philosophy explicit. This makes itrecognize the agreement areas and confirm them. Clear goals andassumptions set the pace for the team to define the priorities.Members should also share understanding and agreement on what theyanticipate doing. A concerted effort by the entire team gives thegreen light on the path to be followed, both for present and future(Marriott &amp Mable, 2002).

      1. Commitment

Thisforms the fourth stage in team development. This is the time when theteam makes preparation to start the work. This involves making thenecessary choices and letting go off the differences between themembers. The members genuinely commit themselves to what the groupanticipates doing. This should be characterized by interdependence tomaster the stages and chose high performance(Burns, Bradley, &amp Weiner, 2012).

      1. Implementation

Thisforms the fifth stage of team development. During this stage, timingand sequencing form the major components. Implementation involvessetting clear processes, alignment and taking a disciplinedexecution. People in the team must be aware of how things are done.This involves setting of standard operating procedures to completethe various tasks. Hallmark of good alignment in the team is depictedby smoothness of the work done. Various members must blend their workwell to achieve the objectives. A team must stay on track to minimizeerrors and misplays(Volpe &amp Cannon-Bowers, 2006).

      1. High Performance

Highperformance is assured after the team members develop implicit trustfor one another and master the technologies of their roles. Increasedinterconnectedness between the team members supports high creativityand synergy levels. Easiness of interactions enhances nimbly responseto the changing conditions. The members interact easily with oneanother and interact easily. High performance is characterized byspontaneous interaction, synergy and surpassing outcomes(Pronovost, Dorman, &amp Lipsett, 2003).

      1. Renewal

Thisforms the final stage of team development model. In this stage, theteam accomplishes the tasks. Signs of an effective team involverenewal and congruence of the vision of the teams. This involvesregular setting of the time for practices and having celebrations andrealignment. In team-based cultures, the journey becomes easier asthe members anticipate the various issues dealing with them from conscious competence. Renewal is normally characterized byrecognition and celebration, change of mastery and staying power(Oandasan, 2006).

Themodel may be appropriate for use in healthcare institutions toenhance team development. This model by Bruce Tuckman outlinesclearly the development sequence for a team, and this can be adoptedin team development in healthcare industry. From the analysis, it isclear that a teamwork in healthcare is compulsory, to some extent,and the healthcare professionals must embrace the team work to remaineffective and offer efficient services to the patients. The sevenstages outlined by Tuckman in Drexler model might be very criticalfor the success of team work in health care industry(Nolte &amp Tremblay, 2005).

  1. Four elements of effectiveness of a team
    1. Team Effectiveness
  • Member satisfaction: the members within the teams are satisfied and content with one another. They, therefore, perform their duties collaboratively without complaining. Satisfied members will be willing to give their best and assist one another in the team. Satisfaction enables the team to maintain high performance for longer. The interests of the members do not change as the goals are achieved. The team will maintain the initially set goals to sustain a high performance without scapegoating within their groups (Oandasan, 2006).

  • Quality of work being done: a hallmark of an effective team is quality work and smoothness of executed activities. The members will have their efforts blending easily with little or no duplication and contradiction. The members ensure that all standard operating procedures are followed and will be ready to count on their neighbors for delivery of quality service.

  • Capacity for sustainability: Bottom line test of sustainability in a team is being capable of providing the resources required for the job and delivering services required at the team required with extreme care. The team should, therefore, ensure proper use of the resources and set clear priorities. Proper management of the resources implies that the people can easily strike a balance between what is there and what is required (Lingard, 2004).

    1. Team Process
  • Quality of leadership: Effective team will have leaders who embrace growth and prosperity and will look for ways of keeping the team strong. Such leaders do not make decisions to satisfy themselves but to propel the team towards achieving the goals. Teams comprising of staying power will have leaders with broad purposes and who can maintain their commitment (Kates &amp Ackerman, 2002).

  • Communication, decision making: In an effective team, team members will always feel included by their fellow members. This sense of identity enhances communication between the members and instills pride of involvement within the enterprise of the team. This enhances communication and decision making as they believe that the success of the team is solely dependent on them.

  • Learning and development: The team identifies all the goals and the mode of implementation after which they embark on purposeful development. Sorting of the responsibilities requires definition of roles for each member within the team. The members from the team learn from one another and may even be supported through regular training programs organized by the management (Baker, Gustafson, Beaubien, Salas, &amp Barach, 2005b).

    1. Team Characteristics
  • Size, composition and diversity: the team member must be aware that they have come from diverse fields like nursing, assistants and doctors for a common good of promoting healthcare. Therefore, they should ensure that they complement one another without feeling of insecurity or confusion. The team members should depend on one another to complete the tasks set (Lemieux-Charles &amp McGuire, 2006).

  • Behavioral norms: The team must stay on tract ensuring that the work operations are crisp. This minimizes misplays and errors and instills mastery of having things under control. They embrace the goal of the organization and discipline that comes with it. Through this way, efforts will be concentrated and only little will be wasted.

  • Cohesiveness: a high performing team will collaborate with one another towards achievement of a certain course. Members within the team must embrace the spirit of cohesiveness to enable them collaborate towards a common goal (Baker, Gustafson, Beaubien, Salas, &amp Barach, 2005b).

    1. Environmental Context
  • Intergroup relationships and conflict: When the team members know whatthey should do and when it should deliver, and then they will always be moving towards one direction. This eliminates the instances of team members speaking ill of another team member. All the members will at any one time do what is expected of them (Kates &amp Ackerman, 2002).

  • Organizational culture: the teams should be adaptable to the culture of the organization. The team forms a component of a larger organization and hence, all its activities must be geared towards the promotion of the goals of the company.

  • External environment: despite the effective teams identifying with the team, they should have norms and values and stand for whatever is right. This instills a feeling of part of one whole. External environment factors such as economy and politics may tend to affect the team. Effective teams will withstand such pressures and will never let such differences affect them.

Fromthe analysis of the elements of effective teams, it is clear that thefour elements are intertwined. No one element appears stronger thanthe other. Just like a team, the elements complement one another toform an effective whole(Hoff &amp Jameson, 2004).


Insummary, effective teams must embrace trust, empathy, attitude andmutual respect.

Trustenhances honesty between the team members regarding their strengthsand weaknesses to enable them know their dependence on each otherfor a common goal. This makes them focus on getting the jobaccomplished, and they often feel appreciated by their fellowteammates. Trust acts as the glue holding together the teams. Withouttrust, each individual member will spend a lot of energy and timetrying to defend themselves or even to outdo one another. Mistrustreduces the effectiveness of the team.

Onthe other hand, empathy entails the ability of imagining oneself inanother person`s circumstance. This implies the awareness of, andappreciation of feelings and skills of the other person. Most of theworkers in healthcare have been experts on empathy, and theydemonstrate this whenever they attend to a patient. The extension ofsuch consideration to the coworkers strengthens the relationshipbetween the workers and the whole team.

Attitude,refers to a disposition, feeling or manner with regards to someone orsomething. A team performs better when the team members works for theinterest of the company. This involves avoiding the issues that oneis undergoing to affect his/her delivery of the tasks assigned. Theteam members must also ensure that the small issues affecting themare resolved before they surmount into bigger problems.

Mutualrespect implies the recognition and attempt of upholding the dignityand rights of the other people. This means accepting views by otherpeople and accepting them in the team. A successful team willcelebrate the success of the fellow members and will share in thedisappointments of each other. The member involved will always worktogether towards resolving the problem and come up with the solution.


Baker,D., Gustafson, S., Beaubien, J., Salas, E., &amp Barach, P. (2005b).MedicalTeam Training Programs in Health Care. In Advances, in PatientSafety: From Research to Implementation (Vols. 1-4).Rockville, MD: Agency for Healthcare Research and Quality.

Burns,L., Bradley, E., &amp Weiner, B. (2012). Shortell&amp Kaluzneyâ`s Health care management: Organization design &ampbehavior, 6th ed.Clifton Park, NY: Delmar-Cengage Learning.

Dault,M., Lomas, J., &amp Barer, M. Onbehalf of the Listening for Direction II partners. 2004. Listeningfor Direction II: National Consultation on Health Services and PolicyIssues for 2004-2007.Ottawa: Canadian Health Services Research Foundation.

Gully,S., &amp Incalcaterra, K. (2002). A Meta-Analysis of Team Efficacy,Potency, and Performance: Interdependence and Level of Analysis asModerators of Observed Relationships. Journalof Applied Psychology 87(5),819-32.

Gully,S., Devine, D., &amp Whitney, J. (2005). A Meta-analysis of Cohesionand Performance: Effects of Level of Analysis and TaskInterdependence. SmallGroup Research 25(4),497-520.

Hoff,T., &amp Jameson, E. (2004). A Review of the Literature ExaminingLinkages between Organizational Factors, Medical Errors and PatientSafety. MedicalCare Research and Review 61(1),3-37.

Kates,N., &amp Ackerman, S. (2002). SharedMental Healthcare in Canada. A Compendium of Current Projects.Ottawa: Canadian Psychiatric Association and Mississauga: College ofFamily Physicians of Canada Collaborative Working Group on SharedMental Health.

Lemieux-Charles,L., &amp McGuire, W. (2006). What Do We Know about Healthcare TeamEffectiveness? A Review of the Literature. MedicalCare Research and Review 63,263-300.

Lingard,L. (2004). Communication Failures in the Operating Room: AnObservational Classification of Recurrent Types and Effects. Qualityand Safety in Healthcare 13(5),330-34.

Marriott,A., &amp Mable, J. (2002). Sharingthe Learning: The Health Transition Fund Synthesis Series: PrimaryHealthcare.Ottawa: Health Canada.

Morey,J. (2002). Error Reduction and Performance Improvement in theEmergency Department through Formal Teamwork Training: EvaluationResults of the MedTeams Project. HealthServices Research 37(6),1553-81.

Nolte,J., &amp Tremblay, M. (2005). EnhancingInterdisciplinary Collaboration in Primary Healthcare, in Canada.Ottawa: Enhancing Interdisciplinary Collaboration in PrimaryHealthcare Initiative.

Oandasan,I. (2006). Teamworkin Healthcare: Promoting Effective Teamwork in Healthcare, in Canada.Ottawa: Canadian Health Services Research Foundation.

Pronovost,P. B., Dorman, T., &amp Lipsett, P. (2003). Improving Communicationin the ICU Using Daily Goals. Journalof Critical Care 18(2),71-75.

Volpe,C., &amp Cannon-Bowers, J. A. (2006). The Impact of Cross-trainingon Team Functioning: An Empirical Investigation. HumanFactors 38(1),87-100.