Vad är kvalitet inom vården? - Karolinska Institutet

Sammanhllning och hgpresterande grupper ett team perspektiv Hilmar Thr Hilmarsson, MMC 2008-08-25 Kvalitetsvinster krnan i virtuella ntverk. Hipp hipp hurra, PS Kryer 1888 En krage utan huvud i lvverket. Det tog 117 r fr vrlden att upptcka det. Vi ser en sjukvrd som r: -Patientorienterad. -Kompetent, lrande och standardiserad. -Kvalitetslednings- och processdefinierad. -Dokumenterad och ltt att

upprtthlla. -Tydligt, skert och snabbt kommunicerad. Syfte: Att med hgsta skerhet bota, lindra, trsta och informera; Rtt patient, med rtt vrd och vid rtt tidpunkt med hjrna, hjrta, hnder understdd av modern teknik. Cohension - Sammanhllning och utveckling i hgpresterande grupper Genom att flyga i V-formation kar flocken effekten med 71 % jmfrt med om varje fgel flg ensam. Nr ledargsen blir trtt flyttar den bakt i formationen

och en annan gs intar ttplatsen. Gssen i formationen skriker bakifrn fr att heja p de frmsta att hlla farten. Nr en gs blir sjuk och mste landa lmnar tv andra Gss flocken fr att hjlpa och skydda den. De stannar tills gsen ter kan flyga. Ge ett exempel p en vlfungerande grupp som du tillhrt? Inlrningsml Definera Group cohension och frst sambandet mellan cohension och hgpresterande grupper. Definiera de fyra faktorer som skapar sammanhllning anvnda dem fr att utveckla en hgpresterande grupp. Vad r de negativa och positiva konsekvenserna av gruppsammanhllning. Veta vad man gr att fr att hantera dessa. Knna till forskning om teameffektivitet. Veta nr team ska anvndas. Definiera team building och tillmpa det p en arbetsgrupp.

Knna till en effektiv metod fr att f ett sjukvrdsteam att fungera bttre SBAR frst strukturen bakom detta. Vad r Group Cohension Gruppsamstmighet eller Gruppsammanhllning Vad r grupp samstmmighet? Cohension Gruppsamstmmighet Cohesion r en social kraft som brs upp av: attraktion, enhet och en Det finns en knsla av enhet och sammanhllning i den hr gruppen stark samman(Moos, Insel & Humprey, 1974) hllning fr att n ett ml (teamwork) och r en konsekvens av en grupputveckling

dr grupper gr igenom olika Jag knner att jag en knsla av tillhrighet utvecklingsperioder. till min grupp (Bollen & Hoyle, 1990) Resultat av Cohension Fortsatt medlemskap lg personomsttning Hgre deltagande mindre frnvaro, kad kommunikation kad tillfredstllelse tycker om gruppen kad produktivitet om ml och normer betonar det (Forsyth, 2005) Cohension = Attraktion Attraktion mellan medlemmar

Attraktion till gruppen som helhet. Attraktion Samman hllning Det r uppenbart att en viktig del i sammanhllning r attraktion jag tycker om min grupp, mina gruppmedlemmar. Tycker du om din grupp? Tycker du om ngon i din grupp? Cohension= Enhet vi - gruppmoral

Det sker genom solidaritet: Tydliga roller - uppgifter, Tydliga normer, tydlig gruppstruktur. Ett beteende. Det sker genom tillhrighet: Man fster sig vid varandra: En knslomssig process. Solidaritet Enhet gruppmoral Tillhrighet Sammanhllning Cohension = Uppgiftsfokus eller starkt teamarbete och Effektivitet Sammanhllning = Teamarbete: Medlemmer I sammahllna grupper kordinerar sina anstrgningar fr att n gruppens ml. Kollektiv effektivitet: en hg grad av sjlvfrtroende kring de ml gruppen accepterat Vi knsla: positiv grupp effekt

Uppgift Kollektiv Effektivitet Teamarbete Motiv_ ation Sammanhllning Gruppmoral Vi knsla Ge ett exempel p ett beteende i grupp dr det Finns en tydlig vi-knsla?

Samband mellan normer, samstmmighet och produktivitet Grupper med normer av att vara produktiva Ge exempel p en grupp med lg prestationsnorm. Produktivitet Grupper med normer av att inte vara produktiva Ge exempel p en grupp med en hg prestationsnorm.

4 viktiga faktorer i Cohension max. prestation .51 Attraktion Enighet .03 (Grupp stolthet) .18 Uppgifts fokus (teamarbete) Normer .23

Cohension .25 Prestation Metaanalys (Mullen & Copper, 1994) Prestation pverkar sammanhllning mer n vad sammanhllning pverkar prestation. Cohesion and performance in groups: A meta-analytic clarification of construct relations (BEAL, COHEN, BURKE, MCLENDON, 2003) Hur sker utveckling av sammahllning? Enligt Lenner Axelsson & Thylefors (2005) s gr gruppen igenom en process fr att komma till rtta med ngra centrala bitar ssom kontroll och makt, intimitet, samhrighet, autonomi samt problemlsning, prestation och meningsfullt arbete.

Tuckman (1965) fem stegs model av grupp utveckling. Grupper utvecklas i stadier i ett bestmt mnster. Wheelan (1994) Vissa stadier rimliga fre andra, men en grupp kan vxla stadier. Shultz. En grupp gr igenom tre stadier fr att n maximal effektivitet. Grupperna gr igenom stadierna ett i taget, men kan vxla mellan stadier. En medlem kan frstra utecklingen konfliktnivn blir fr hg. En grupp r sllan strre n 8-10 personer olika utveckling i strre grupper som bildar subgrupper. Bion (1959) Antar att en viss ordning i utveckling av grundantaganden. Varfr konflikter i alla modellerna? Ge ett exempel p ngon konflikt frn din arbetsgrupp tnk p att de flesta konflikter r dolda eller rituella: ex vad man fr prata om p fikarasten, ja-sgare eller vem som yttrar sig p mten. Vad innebr det fr ledare om de ska utveckla en grupp?

FIRO-teorin Utvecklad av Will Schutz FIRO Fundamental Interpersonal Relationship Orientation Varfr fungerar vissa grupper bttre n andra trots att enskilda personers skicklighet och utbildning r samma? En grupp genomgr tre huvudfaser under sin utveckling mot enighet och effektivitet Utvecklingen sker genom att medvetandegra inbrdes relationer och genom att medvetandetgra, oh utveckla det kommunikationsmnster som utvecklas. Hipp, hipp, hurra

PS Kryer, 1888 117 r att upptcka kragen i lvverktet Varfr? Forskningens svar p varfr det blir konflikter Individen har enligt Will Schutz bde behov och rdslor som kan kopplas till FIRO. Moxnes: Motsttning mellan behov av trygghet utveckling. I tillhrandefasen vill vi knna oss betydelsefulla och vr rdsla r att knna oss ignorerade. I kontrollfasen vill vi knna oss kompetenta och vr rdsla r att knna oss frdmjukade. I ppenhetsfasen vill vi knna oss omtyckta och vr rdsla r att bli avvisade. Hur vi beter oss i de olika faserna beror p vr sjlvbild (medvetenheten om min egen unika personlighet) samt hur vi tror oss uppfattas av vr omgivning.

Hantera utveckling Slutsatsatser: Motsats trygghet frndring (Mathiasson, 1994) Ju tryggare grupp desto strre frndringsbenghet Ju oskrare grupp desto mindre frndringsbengenhet 1. Vi behver trna oss i att se oss sjlva . 2. .. 3. Kritik mot teorier om utvecklingssteg i grupper Ginnett (1990) Ignorerar det sammanhang som gruppen verkar i: Flygplansbesttningar kan efter 10 minuter bli en hgpresterade grupp fastn de tidigare inte knner varandra. Ett stark, tydliorganisationssammanhang: Ml, roller, ledarskap tydligt snabbar p processen.

Stage Model George and Jessup; (1997) Stadierna r inte s klara, grupperna regredierar, inte ltt att mta stadierna. Positiva och negativa effekter av gruppsammanhllning Vad r de negativa och positiva effekterna av sammanhllning? Sammanhllning kan leda till positivt: Gruppmedlemmar knner sig njda Minskad personalosttning och stress Sammanhllna kan leda till negativt: Intesifiera emotionella processer Vara mer emotionellt krvande Uttva mer grupptryck Lida av grupptnkande Svara med mer fientlighet

Att ka Cohesiveness Samstmmighet 1.1. Gr Grgruppen gruppenmindre mindremax max99personer personer 2.2. Uppmuntra medlemmar att acceptera gruppens Uppmuntra medlemmar att acceptera

gruppens ml sjukvrd: prata om varfr vi r hr ml sjukvrd: prata om varfr vi r hr 3.3. Se Setill tillatt attgruppens gruppensmedlemmar medlemmarhar hartid

tidatt atttrffas trffas 4.4. ka kagruppstatus gruppstatus 5.5. Ge Gebelningar belningartill tillgruppen, gruppen,inte intetill tillindivider individer 6.6. Tvla Tvlamot motandra andragrupper

grupper 7.7. Se till att gruppen sitter nra har mjlighet att Se till att gruppen sitter nra har mjlighet

att trffas. trffas. Essentials of Organizational Behavior (Robbins 2007) Ngra exempel p formulr Group Environment Scale (Moss & Humpfrey, 19749 Group Attitude Scale (Evans & Jarvis, 1974) Group Environment Questionaire (Widmeyer, Brawley & Carron, 1992). Perceived Cohension Scale (Bollen & Hoyle, 1990) Group Identification Scale (Henry et. al 1999) Sports Cohesivenes Questionaire (Martens, Lander & Loy, 1972) Exempel p enkt frn ledare fr att mta sammanhllning Instmmer Helt Delvis Knappt Inte alls

Hur tycker du att gruppen fungerar? Vi bryr oss om varandra i vr grupp Vi har en god sammanhllning Vi har en stark vi knsla i vr grupp Vi r fokuserade p att lsa vr uppgift Vi lser problem i vr grupp Vi talar ppet med varandra Vi r delaktiga i beslut En god stmning r vanligt i gruppen Alla bidrar fr att vi ska lyckas Tillmpning Cohesiveness Du ska genomfra en insats fr att utveckla din grupp inom sjukvrden. Ett rehab team smrta. 25 personer. Problem samarbete, prestationer, folk slutar, stort missnje frn patienter, sjukhusledning. Du ska genomfra insatser fr att ka

a) Attraktion b) Enighet solidaritet, gruppknsla c) Uppgiftsfokus d) Normer. Vad ska du brja med? Vad gr du? Du mter innan med frgeformulret Du genomfr ett motivationsarbete: Vilket problem har vi? Vilka frdelar skulle det innebra att bli bttre? Vilket beslut tar vi i gruppen. (Hilmarsson, 2005) Insats 1 under en mnad. Utvrdering: Bra Bttre med gruppen. Insats 2. under en mnad. Utvrdering: Bra Bttre med gruppen. Insats 3. under en mnad. Utvrdering: Bra-Bttre med gruppen Utvrdering: Frgeformulr: . Mte med din grupp: Vad har vi lrt oss? Intervjuer med fyra slumpande individer med en oberoende konsult. Ska organisationer lita p team fr att frbttra sin produktivitet? Vad r ett team?

En specialiserad, tydligt organiserad, och tydligt ml inriktad grupp dr alla samarbetar. De har en hg grad av struktur och koordination, sammanhllning och mluppfyllese (Forsyth, 2005) Egenskaper samma som fr en grupp: Interaktion Beroende Struktur normer, roller Ml S. Adams, Build a Better Life by Stealing Office Supplies (Kansas City MO: Andrews & McMeal, 1991), p. 31. Dilbert reprinted with permission of United Features Syndicate, Inc. E X H I B I T 87 E X H I B I T 87 Skillnad team och grupp

Grupper En mngd individer som r samlade Har ett ml oklar process Sker lsningar frn ledning Fokuserar p den enskildes insats Fokus p att ledningen kontrollerar Team Mnniskor som arbetar tillsammans fr att n ett gemensamt ml. Ml-tydlig process Lser problem inom teamet

Fokus p den kollektiva anstrgningen Fokus p sjlvstyrning Hur ofta anvnds team? Frndring det senaste tjugo ren r att organisationer allt mera frlitar sig p team fr att strka sin konkurrenskraft: Svenska siffror mycket hga nrmare 100% (Forsyth, 2005) Sjukvrd och offentlig sektor 81% Enklare arbete 50% Tjnstemn 34% (Koslowski & Bell, 2003) Typ av team Funktion

Exempel Management Executive Planera och ge direktiv Ledningsgrupp Frhandling vertala Labor-management, international treaty Kommit

Vlja, underska Planeringskommite Resultat Skapa, utveckla Forsknings och utvecklingsteam Rdgivande Diagnos, frslag Kvalitet cirkel, Steering committee Service

Tillhandahlla, reparera Snabbmat, bilverkstad Produktion Bygga, stta ihop Byggnadsfirmor, biltillverkning Medicinska Behandla, lka Kirurgi, Rehab, Hab, Rddningstjnst

Rdda, skydda Brandstation, ambulansFire station, paramedics Militr Skydda, neutralisera Infantry squad, tank crew Transporter Frakta, lasta Flygplans besttningar, tgpersonal Sport

Tvla, vinna Projekt Aktion Source: Adapted from Devine, 2002. Hockey, fotboll Ska organisationer frlita sig p team? Ja. Nr team anvnds p rtt stt kar det effektivitet och trivsel (Forsyth, 2005) Metaanlys: Gully, Incalcaterra, Joshi & Beaubien (2002) viktiga taktorer i effektiva team r teamefficacy, teampotency: teamets tro p sin frmga. Vanliga effekter: frnvaro-, personalomsttning -, klagoml frn

anstlla minskar (Sundstrom et al, 1990, 2000) Fall studier: team r effektiva (Applebaum & Blatt, 1994) . Hur ser det ut inom sjukvrden? I USA s r felbehandlingar den 8:e vanligaste ddsorsaken. Det har uppskattats att 44.000 till 98.000 mnniskor dr varje r pga felbehandlingar. 2000-4000 mnniskor dr varje r i Sverige till fljd av felbehandlingar eller misstag i vrden. Det r fyra gnger mer riskabelt att g in p ett sjukhus n att vistas i trafiken och farligare n att flyga. I Sverige har antalet anmlda skador frdubblats sedan 1990. Skadorna sker frmst inom ortopedi (20%), kirurgi (15%), primrvrd (10%) och obstretik & gynekologi (8%) Hkan Eriksson, Medicinsk Vetenskap Nr 2, 2007

Bygga team Stta ml och regler Designa teamet: Hur mnga? Hur samarbeta? Var? Sjlvbestmmande? Organisation: Roller? Normer? Hur lng tid? Vem? Skapa cohension - sammstmmighet, attraktion vnskap, enhet och att underltta fr att gruppen ska n sitt prestationsml. Praktisera fr prestanda: Orientering prioritering. Frdela arbetsuppgifter. Tidsgrnser. Samarbeta, Motivation standard, belning. vervaka kvalitet. vervaka arbetsmetoder (Fleishman & Zaccaro, 1992). The influence of team-building exercises on group attraction Journal of Organizational Culture, Communications and Conflict, Jan, 2007 by Michelle Kirtley Johnston Vad frknippar du med order team-building? Har du ngon positiv erfarenhet? Har du ngon negativ erfarenhet? Bygga team ledaren har stor betydelse

F teamet att tro p sin frmga (Guzzo, Yost, Campbell, Shea, 1993; Little & Madigan, 1997; Silver & Bufanio, 1996, 1997). Gruppen arbetar hrdare, lr sig mera och nr bttre resultat Ledare som har en positiv frvntan, som tror att gruppen r kompetent och effektivt skapar team som r mer effektiva (Pescosolido, 2001, 2003). Ledare som r stdjande de som r rollmodeller genom att vara optimistiska och som hjlper medlemmar att utveckla deras frmgor skapar en effektivare grupp jmfrt med en enbart en uppgiftsorienterad ledare (Jung & Sosik, 2002). Bygga team - ledare Vad r ert bsta exempel p ett beteende hos en ledare som har ftt ett team mindre grupp att fungera? Kritik mot teambuilding Wheelan (1994): Mnga frsker f gruppen att g frn fas ett till tre utan att passera konflikter. Gruppen behver inte bara trning i uppgifter utan ven trning i

sociala frdighter (Cannon-Bowers, Tannenbaum, Salas & Volpe, 1995) Trningen ska ske av hela gruppen och inte av enskilda medlemmar (Salas & Canno-Bowers, 2001). Gruppstorlekens betydelse Hur stor ska en grupp vara? Ur ett problemlsarperpektiv? Ur ett kunskapsperspektiv? Vad hnder om gruppen r fr liten, fr stor? (Svedberg, 2003, s 117-118) Group Size and Workshop Effectiveness Lucille B. Garmon University of West Georgia Presented at the

19th Biennial Conference on Chemical Education Purdue University August 3, 2006 Correlation of Group Size and Exam Average 0.0 Change inExamAvg -2.0 -5.0 0.0 2.0

4.0 -10.0 -15.0 -20.0 R 2 = 0.8082 -25.0 Increase in Group Size 6.0 8.0 Workshop ledarnas kommentarer: 11 r fr mycket. Deltagarna knner sig inte lika bekvma med varandra. En person tar ver. tta r en bra gruppstorlek.

Med strre grupper 11, 12, 13 s blir det fler problem fr det r alltid ngon som inte hnger med. Min strsta var 11 och min minsta var 5. 8 r perfekt. Ibland s hade jag fr f. 2 eller 3 r inte tillrckligt fr att det ska ske ett samarbete i gruppen och skapa inlrning. Det r svrt att f alla fokuserade nr du har 10 eller 12. Sammantrdessjukan Latmasken sammantrder Han pratar vind och vder Han hyvlar inga brder Han garvar intet lder Han smnar inga klder Han hedrar inga fder Han sammantrder Alf Henriksson Hilmar TH. Hilmarsson

Kompetensutveckling 43 Gruppens storlek Lite samspel = 2 - 3 Lsa problem = 4 7 Strst aktivitet = 4 5 Bst prestation = 5 - 7 Undergrupper = 8 mer Starka starkare Svaga svagare (Malten, 1992) Hilmar TH. Hilmarsson Kompetensutveckling 44

Placering Ttare placering bttre kontakt Undvik tomma stolar Hilmar TH. Hilmarsson Kompetensutveckling 45 Om tider och Pauser 45 min = max. konc. Benstrckare. Vdra! Hll inte p mer n

tv timmar! Hilmar TH. Hilmarsson Kompetensutveckling 46 Regler fr gruppen Hlla oss till mnet Inte avbryta Inga personangrepp Ge positiva frslag Respektera mtestid Utvrdera bra - bttre Hilmar TH. Hilmarsson

Kompetensutveckling 47 Effektiva mten - roller En som hller mnet - avbryter och sammanfattar frslag En som hller tiden En som ser till att alla pratar En som skriver ner Hilmar TH. Hilmarsson Kompetensutveckling 48 Omedvetenhet: Risker fr grupper. Risker fr ledarskap.

Hilmar TH. Hilmarsson Kompetensutveckling 49 vningsuppgift: Bygga team Ni har bestmt dig fr att ditt sjukvrdsteam 45 personer ska indelas i mindre grupper. Nmn tre sakar som du tnker p vid genomfrandet: 1. 2. 3. Ett perspektiv p hur teamwork fungerar i sjukvrden Ineffektiv muntlig eller skriftlig kommunikation mellan vrdpersonal r en bidragande orsak faktor till

majoriteten av alla missden och skador som drabbar patienter i hlso- och sjukvrden (Lkartidningen, 2008-06-24). 1. Leonard M, Graham S, Bonacum D. The human factor: The critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13 (Suppl 1):i85 i90. 2. Solet DJ, Norvell JM, Rutan GH, Frankel RM. Lost in translation: Challenges and opportunities in physician-to-physician communication during patient handoffs. Academic Medicine. 2005;80(12): 1094-9. 3. Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004;13:330-4. 4. Sutcliffe K, Lewton E, Rosenthal M. Communication failures: an insidious contributor to medical mishaps. Academic Medicine. 2004;79: 186-94. 5. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, et al. A prospective study of patient safety in the operating room. Surgery. 2006;139:159-73. 6. Davenport DL, Henderson WG, Mosca CL, Khuri SF, Mentzer RM, Jr. Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. J Am Coll Surg. 2007;205:778-84. 7. Greenberg CC, Regenbogen SE, MD, Studdert DM, Lipsitz SR, Rogers SO, Zinner MJ, et al. Patterns of communication breakdowns resulting in injury to surgical patients. J Am Coll Surg. 2007;204:533-40. SBAR modell fr bttre kommunikation mellan vrdpersonal

Situation Bakgrund Aktuellt tillstnd Rekommendation Example Scenario: Medication Changes The situation: A nurse notices that her patient is on a number of new medications that she is unfamiliar with. The patient has a number of comorbidities, and she is concerned about drug interactions. She asks the patient about the medications he is receiving; he appears unaware of any changes that have been made. The communication issue: The nurse needs to ensure that the team, including the patient, is aware of new medications and their implications and side effects. She wants to communicate, particularly with the physician and pharmacist on the team, to clarify the medications and information given to the patient.

Phase 2: SBAR Implementation Stroke team: (n=38 or 88% of team) All personal. Implementation strategies included: Three education sessions Team champions who encouraged and reinforced use of SBAR Reminder tools (e.g. posters, telephone prompts, pocket cards) were placed strategically on the unit Learning-in-action format to allow for further adaptations and refinements as required Patient Satisfaction: Stroke Team Pre-Post Intervention Change in Satisfaction for Neuro Stroke Percent Positive Score

100 80 60 Jan - Jun 2006 (n=44) Jan - Apr 2007 (n=24) 40 20 0 Client Participation Client-Centred Education Continuity & Transition

Emotional Support Evaluation of Outcomes (Pre n=44 Post n=24) Family Involvement Overall Quality of Care Physical Comfort

Safety Reporting: Incidents Total Number of Incidents Reported # of Incidents 500 400 300 All Programs 200 Stroke Rehab 100 0

18 23 12 30 34 39 Jan-Mar 06 Apr-Jun 06 Jul-Sep 06 Oct-Dec 06 Jan-Mar 07 Apr-Jun 07 Safety Reporting: Near Misses # of Near M isses

Total Number of Near Misses Reported 40 35 30 25 20 15 10 5 0 All Programs Stroke Rehab 0 JanMar06 0

AprJun06 2 3 4 2 JulSep06 OctDec06 JanMar07 AprJun07

Current SBAR Use Stroke Rehab Team continues to use the adapted SBAR tool Debriefing mechanism (e.g. following a falls incident) To resolve difficult situations (e.g. conflict between team members) Changes in patient status Changes in patient care plan At shift change Staff Perceptions of Patient Safety Culture: Stroke Team Pre-Post Intervention 90%

80% 70% 60% 50% 40% 30% 20% 10% 0% 1 2 3 4 5

6 7 Dimension Pre Post (Pre n=32 Post n=21) 8 9 10

11 12 Legend 1 Overall Perceptions of Patient Safety 2 Frequency of Events Reported 3 Manager Expectations 4 Organizational Learning 5 Teamwork Within Units 6 Communication Openness 7 Feedback About Error 8 Non-punitive Response to Error

9 Staffing 10 Management Support 11 Teamwork Across Units 12 Handoffs Team Leadership Approach Leadership Theory and Practice, 3/e Peter G. Northouse, Ph.D. Overview Team Leadership Approach Perspective A Functional Model of Team Leadership Dimensions of Leadership on Teams Characteristics of Effective Teams Team Leadership Model

Strategic Leadership Decisions How does the Team Leadership Model Work? Historical Perspective of Team Leadership 20-30s Human Relations movement 40s Group dynamics Social Collaborative science

efforts at theory work 50s T group Leaders role in T group 60-70s 80s Org. Quality development teams

90s 2000 + Global Virtual perspective teams Team Benchmarking Flatter org. leader structure effectiveness Continuous improvement Strategies for competitive advantage

Rapidly changing environments Team Leadership Approach Description Perspectiv Effectiveness research e(Parker, 1990) The use of teams has led to: of teams has led to:

Greater productivity More effective use of resources Better decisions & problem solving Better-quality products & services Increased innovation & creativity Issues Difficult to understand the team process because of its complexity Leader ineffectiveness is major obstacle to overall team effectiveness Objectives To understand the following: Functions a leader must perform The complexity involved in performing these functions

How the performance of these complex functions relates to actual team performance McGraths Critical Leadership Functions Two Critical Functions of Leadership Facilitate the group in accomplishing its task (Task Function) Ensure group maintenance and functioning (Maintenance Function) Monitor INTERNAL Diagnosing Group Deficiencies

Taking Remedial Action Forecasting Environmental Changes Preventing Deleterious Changes 1 EXTERNAL Executive Action

3 2 Source: Hackman & Walton (1986) 4 Dimensions of Leadership on Teams LEADER One who processes and acts on information Functions Monitoring (objection mediation) Action taking (action mediation) Helps the group form an organizing framework

Effective team performance starts with a leaders mental model of a situation Dimensions of Leadership on Teams MONITORING Leaders need to monitor both internal and external environments to create an accurate model of team functioning Search - Seek out information to assess current state Structuring - Analyze, organize, interpret information Dimensions of Leadership on Teams

ACTION TAKING Involves selecting from competing courses of action and assisting the team in developing a system of organizing that facilitates quality decision making Skills of action mediation Material resources - Decision making & task accomplishment Personnel resources - Managing interpersonal relations For team success, leaders must: Remain open and objective in understanding and diagnosing team problems; and Skillful in selection of appropriate action/inaction Effective Team Characteristics Conditions of Group Effectiveness

Hackman & Walton (1986) Clear, engaging direction An enabling performance situation Group structure fostering competent task work Organizational context supporting and reinforcing excellence Available, expert coaching and process assistance Adequate material resources Effective Team Characteristics Eight Characteristics of Team Excellence Larson & LaFasto (1989) Clear, Elevating Goal Clear so that one can tell if performance objective has been met Is motivating or involving so that members believe it is worthwhile and important

Results-Driven Structure Need to find the best structure to achieve goals Clear team member roles Good communication system Methods to assess individual performance An emphasis on fact-based judgments Effective Team Characteristics Eight Characteristics of Team Excellence Larson & LaFasto (1989) Competent Team Members

Components Right number and mix of members Members must be provided: Sufficient information Education and training Requisite technical skills iInterpersonal skills Team Factors Openness Supportiveness Action orientation

Positive personal style Core Competencies Ability to do the job well Problem solving ability Effective Team Characteristics Eight Characteristics of Team Excellence Larson & LaFasto (1989) Unified Commitment Teams need a carefully designed and developed sense of unity or identification (team spirit)

Collaborative Climate Trust based on openness, honesty, consistency, and respect Integration of individual actions Leaders facilitate a collaborative climate by: Making communication safe Demanding and rewarding collaborative behavior Guiding the teams problem-solving efforts Managing ones own control needs Effective Team Characteristics Eight Characteristics of Team Excellence Larson & LaFasto (1989)

Standards of Excellence Regulated Performance How Accomplished Facilitates task completion Requiring results (clear and coordinated action expectations) Stimulates a positive pressure Reviewing results (feedback/ for Support membersand to Recognition perform at resolve issues External Teamslevels

Rewarding supported by external resources are: highest results (acknowledge Given the material resources needed to do their jobs superior performance) Recognized for team accomplishments Rewarded by tying those rewards to team member performance, not individual achievement Effective Team Characteristics Eight Characteristics of Team Excellence Larson & LaFasto (1989) Leadership Influences team effectiveness through four sets of processes (Zaccaro et al., 2001)

Cognitive - Facilitates the teams understanding of problems confronting them Motivational - Helps team become cohesive and capable by setting high performance standards and helping team to achieve them Affective - Assists team in handling stressful circumstances by providing clear goals, assignments, and strategies Integrative - Helps coordinate teams activities through matching member roles, clear performance strategies, feedback, and adapting to environmental changes Leader Mediation Decisions Hills Model for Team Leadership Type of intervention (Monitor/Action) Level of intervention (Internal/External) Function of intervention Internal Team Leadership Functions

Task Clarifying Goals Establishing Structure Decision Making Standard Setting External Team Leadership Functions Relational Coaching Collaborating Managing Conflict Building Commitment Satisfying Needs Modeling Principles

Team Effectiveness Performance Development/Maintenance Environmental Networking Advocating Negotiating Support Buffering Assessing Sharing Information Strategic Leadership Decisions The leaders role is to monitor the following: Performance conditions (goals, structure, resources) Performance processes (effort, knowledge, strategies)

Outcome states (satisfaction, performance) Strategic Decisions Determine whether to continue monitoring function or take action based on current information gathering Determine what level of team process needs attention (internal task, relational team dynamics, or environmental dynamics) Decide most appropriate function or skill to be performed in the intervention How Does the Team Leadership Approach Work? Focus of Team Leadership Approach Strengths Criticisms Application

Team Leadership Approach Focus Model provides a cognitive map to identify group needs and offers suggestions on appropriate corrective actions Assists leader in making sense of the complexity of groups and provides suggested actions to improve group effectiveness Strengths Provides answers to what constitutes excellent teams Provides a cognitive guide that assists leaders in designing and maintaining effective teams Recognizes the changing role of leaders and followers in organizations Can be used as a tool in group leader selection

Criticisms Complete model has not been totally supported or tested May not be practical as the model is complex and doesnt provide easy answers for difficult leader decisions Fails to provide much guidance for handling everyday interactions and complications of team management More focus required on how to teach and provide skill development in areas of diagnosis and action taking Application Useful in leader decision making Can be used as a team diagnostic tool

Recently Viewed Presentations

  • TITLE

    TITLE

    Questions? * Who am I? Matthew Gillespie CTI Networks RHCSA Redhat 7 CCNA/CCNP Route Switch UWCA braindeadprojects.com What is GNS3? GNS3 grew out of a Masters thesis by Jeremy Grossman It's a Python suite of tools that glue together a...
  • privecsg-14-0014-00-0000 IEEE 802 Privacy Threat Model Date: [2014-10-22]

    privecsg-14-0014-00-0000 IEEE 802 Privacy Threat Model Date: [2014-10-22]

    Misattribution. Misattribution occurs when data or communications related to one individual are attributed to another. Misattribution in the protocol context comes as a result of using inadequate or insecure forms of identity or authentication, and is sometimes related to spoofing
  • Learning Objective To identify and discuss some of

    Learning Objective To identify and discuss some of

    Richard: Phil! Phil, watch this! Phil, watch me, watch me, Phil! 'wasn't it good when Phil was running the show?' John Tate's found God. Cathy doesn't care. She's too busy running things. Dangerous game. I feel sorry for Lou. PHIL...
  • 36 Zephaniah - crosstraining.us

    36 Zephaniah - crosstraining.us

    a synonym of... tsaphan. to hide, treasure, or store up, hide from discovery; which is associated with the name Zephaniah: ... This seems to make it unlikely that a water bird like the cormorant or pelican is intended, or a...
  • Global Business Today, 5e

    Global Business Today, 5e

    An International Comparison Information Sources Utilizing Export Management Companies Export Strategy Chapter 13: Exporting, Importing, and Countertrade EXPORT AND IMPORT FINANCING Mechanisms for financing exports and imports have evolved over the centuries in response to a problem that can be...
  • Author's Purpose - Ereading Worksheets

    Author's Purpose - Ereading Worksheets

    Author's Purpose Lesson and Review ... 1 A poem about a garbage truck that uses a lot of onomatopoeia 2 A five-paragraph essay in which the author attempts to convince readers to recycle more and to be less wasteful 3...
  • Personal Essay

    Personal Essay

    -the thesis . can be at the . beginning or the end . of the essay, or even simply implied throughout-has a clear voice/tone reflecting you-contains some or much emotion. Step One ... What are the aspects of my identity...
  • Global Winds - Winston-Salem/Forsyth County Schools

    Global Winds - Winston-Salem/Forsyth County Schools

    Tropical Easterlies: From 0-30 degrees latitude (aka Trade Winds). Convergence Zone (ITCZ)", producing a narrow band of clouds and thunderstorms that encircle portions of the globe.