Team Formation
Groups do not become well-functioning teams by deciding to become a team.
All teams develop through a series of phases. Tuckman labels these phases
as:
- Forming: creation stage for the group
- Storming: tasks and roles are worked out through conflict
- Norming: norms and patterns are worked out
- Performing: team working together for the care of the patient.
We will look at the Forming stage of team development. When reading through
the next section think about how you could apply these principles to a dental
practice or working with your fellow residents.
Chartering a team
Before a team can be assembled and begin its work, you will need to establish
what the team is to accomplish and why. Try to establish clear parameters and
goals, and define the team's mission. The final product of this planning will
be a team charter that offers the following information:
- A brief description of the process under study
- Why the process needs improvement
- How the team is to demonstrate that the process has improved
- Who is affected by the process
- A timeline for team meetings
- Resources available to the team
- How the team should communicate
Recruiting team members
To work efficiently, teams need diversity: people with different skills, experience,
knowledge and viewpoints. As you assemble your team, try to keep it small (no
more than six members). Smaller teams are easier to manage than larger teams.
Sometimes you may be able to select members for a team, but most patient centered
healthcare teams require team members who represent various healthcare specialties.
If you do not have all the require specialists within your organization you
can ask for members from affiliated organizations. If are are forming a non-healthcare
team you'll want to recruit enthusiastic members, those who are very invested
or interested in the process under study. Preferably, allow people to volunteer
for the team rather than appointing them.
You will then need to select a facilitator and a team leader.
Teamwork has two components: task (which includes the content of the issues
being addressed, holding team meetings, etc.) and process (such as how the team
members interact with one another while performing their work). The team leader
generally focuses on task, while the facilitator helps with process. The team
leader keeps everyone on track by ensuring that the team is making progress
toward the charter objectives. The facilitator keeps the team healthy by monitoring
participation and group interaction and by intervening as necessary. In a small
team often found in a dental office the dentist may fill both of these roles
- if they have the skills and personality to be effective.
Running effective meetings.
The key to effective team meetings is planning. Good meeting planning and preparation
really do make a difference! We have found that our team meetings are much more
productive if the team leader and team facilitator meet briefly before each
team meeting. They set objectives and the agenda for the team meeting; identify
methods or tools needed to facilitate group idea generation, problem solving
or decision making; assign responsibility for each part of the agenda; and allot
time for each agenda topic.
A good portion of the first team meeting should be devoted to ensuring that
members understand their charge and the standards for working together. The
first meeting's agenda should address the following:
- A written agenda so the team members know what you expect to accomplish.
- Estimate time for completing the agenda.
- Introduce team members, clarify each member's role on the team (why they
are there and what they think they can contribute to the process) and explain
the facilitator's or team leader's roles. If members do not understand why
they are there and what roles they can play on the team, they will be reluctant
to participate. Identify a Recorder to keep track of agreements about the
care plan reached by the team and is responsible for recording changes in
the patient record.
- Establish team guidelines: Behaviors encouraged by the team (e.g., respect
and good listening skills, Team etiquette (e.g., starting and finishing meetings
on time).
Seven-Step Meeting Process
Step 1. Clarify Objectives - Ensure that all understand and
are in agreement with the meeting objectives.
Step 2. Review Roles - Review who will be timekeeper, recorder,
leader, and facilitator. Decide at what intervals feedback on time will be given.
Step 3. Review Agenda - Review details of agenda items listed
under step 4. Ensure that all team members understand and are in agreement with
the agenda items.
Step 4. Work Through Agenda Items
Step 5. Review Meeting Record - Review the flipchart record
on the walls but do not read all charts. Look for changes and additions. Decide
which charts should be kept and which should be discarded.
Step 6. Plan Next Steps and Next Meeting Agenda - Decide who
will do what before the next meeting. Decide what the objectives and agenda
items will be for the next meeting.
Step 7. Evaluate Meeting - What did the team do well that it
should continue doing? What could the team do differently to improve the meeting,
group, and continual improvement processes?
See the GITT
Learning Resources for additional information on forming and running teams.