Building team-based working:a practical guide to organizational transformation

Building Team-based Working is designed for use by managers and consultants who are introducing team-based working into organizations. The book synthesizes knowledge about how to build team-based organizations, focusing particularly on the psychological and social processes that can facilitate or obstruct successful teamwork. Rather than advise managers on how to build effective teams, as most books in this area tend to do, this book instead focuses on how to build organizations structured around teams. The text is divided into six sections describing the six main stages of developing team-based working in an organization. The chapters follow a common structure. Each one opens with a summary of the aims and activities relevant to that stage and concludes with a selection of appropriate support materials and tools. These materials can also be downloaded from the CD accompanying the text. The advice given is based on evidence gathered by the authors over 20 years of practical management experience, research work in organizations, and consultancy across the public, manufacturing and service sectors.

Innovation in teams : a qualitative and quantitative study of team behaviours

This thesis explores the processes of team innovation. It utilises two studies, an organisationally based pilot and an experimental study, to examine and identify aspects of teams' behaviours that are important for successful innovative outcome. The pilot study, based in two automotive manufacturers, involved the collection of team members' experiences through semi-structured interviews, and identified a number of factors that affected teams' innovative performance. These included: the application of ideative & dissemination processes; the importance of good team relationships, especially those of a more informal nature, in facilitating information and ideative processes; the role of external linkages in enhancing quality and radicality of innovations; and the potential attenuation of innovative ideas by time deadlines. This study revealed a number key team behaviours that may be important in successful innovation outcomes. These included; goal setting, idea generation and development, external contact, task and personal information exchange, leadership, positive feedback and resource deployment. These behaviours formed the basis of a coding system used in the second part of the research. Building on the results from the field based research, an experimental study was undertaken to examine the behavioural differences between three groups of sixteen teams undertaking innovative an task to produce an anti-drugs poster. They were randomly assigned to one of three innovation category conditions suggested by King and Anderson (1990), emergent, imported and imposed. These conditions determined the teams level of access to additional information on previously successful campaigns and the degree of freedom they had with regarding to the design of the poster. In addition, a further experimental condition was imposed on half of the teams per category which involved a formal time deadline for task completion. The teams were video taped for the duration of their innovation and their behaviours analysed and coded in five main aspects including; ideation, external focus, goal setting, interpersonal, directive and resource related activities. A panel of experts, utilising five scales developed from West and Anderson's (1996) innovation outcome measures, assessed the teams' outputs. ANOVAs and repeated measure ANOVAs were deployed to identify whether there were significant differences between the different conditions. The results indicated that there were some behavioural differences between the categories and that over the duration of the task behavioural changes were identified. The results, however, revealed a complex picture and suggested limited support for three distinctive innovation categories. There were many differences in behaviours, but rarely between more than two of the categories. A main finding was the impact that different levels of constraint had in changing teams' focus of attention. For example, emergent teams were found to use both their own team and external resources, whilst those who could import information about other successful campaigns were likely to concentrate outside the team and pay limited attention to the internal resources available within the team. In contrast, those operating under task constraints with aspects of the task imposed onto them were more likely to attend to internal team resources and pay limited attention to the external world. As indicated by the earlier field study, time deadlines did significantly change teams' behaviour, reducing ideative and information exchange behaviours. The model shows an important behavioural progression related to innovate teams. This progression involved the teams' openness initially to external sources, and then to the intra-team environment. Premature closure on the final idea before their mid-point was found to have a detrimental impact on team's innovation. Ideative behaviour per se was not significant for innovation outcome, instead the development of intra-team support and trust emerged as crucial. Analysis of variance revealed some limited differentiation between the behaviours of teams operating under the aforementioned three innovation categories. There were also distinct detrimental differences in the behaviour of those operating under a time deadline. Overall, the study identified the complex interrelationships of team behaviours and outcomes, and between teams and their context.

Do stressful times call for team-based working? A study of psychiatric nurses in UK mental healthcase

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

From words to action:visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital

Purpose: The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. Design/methodology/approach: A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Findings: Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. Research limitations/implications: The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. Practical implications: The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Social implications: Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. Originality/value: The authors draw on solid theoretical frameworks - the complexity theory, team effectiveness model and the social identity theory - to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level. © Emerald Group Publishing Limited.

A pre-post test evaluation of the impact of the PELICAN MDT-TME development programme on the working lives of colorectal cancer team members

Background - The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. Methods - The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Results - Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Conclusions - Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.