Organizing for teamwork in healthcare: an alternative to team training?

Abstract

Purpose The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input - process - output model of teamwork provides structure to the investigation. Findings Six teamwork enablers from the healthcare team literature - cohesion, collaboration, communication, conflict resolution, coordination, and leadership - are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.

Clarifying workforce flexibility from a division of labor perspective: a mixed methods study of an emergency department team

“…Evaluations of workforce reforms are primarily concerned with quantifying the safety and quality outcomes for a specific role [48] or the extent of task redistribution [15] without understanding the impact of reforms on the whole, multi-professional team in its workplace context [49,50]. Likewise, teamwork research has focused on the social relationships needed for good teamwork in isolation from teams' tasks and the context in which they work [22,23]. Salas et al [51] argue that this narrow understanding of teamwork behavior has contributed to a lack of sustained improvement from teamwork interventions.…”

“…No previous studies have directly examined the functional flexibility within a team of doctors and nurses. Indeed, despite much theorizing on the doctor-nurse division of labor, surprisingly, little is known about precisely who does what in healthcare teams [22,23]. As Larkin [24] observed 35 years ago, healthcare workforce reforms tend to be based on "… a call for 'flexibility' and 'teamwork' … rather than any systematic analysis of the tensions of the resulting division and redivision of labor."…”

What do doctors mean when they talk about teamwork? Possible implications for interprofessional care

“…We do this in order to capture more of all those situations in which the term "teamwork" actually is used to describe the organization of work. In this research, a team is defined as "a group of people who are set to work together on a task" (Rydenfält et al, 2017;p. 349), and teamwork is defined as what this group does in relation to the task.…”

“…On the organizational level, Mickan and Rodger (2000) point out that a clear purpose, an appropriate culture, a specified task, and clear and distinct roles as well as leadership are important teamwork characteristics. Rydenfält et al (2017) show that an organization characterized by team stability, occasions for communication in the team, and a participative and adaptive approach to leadership can achieve many of the traits associated with an effective teamwork process. Weller, Boyd, and Cumin (2014) report on the need for shared mental models, trust, mutual respect and closed loop communication.…”

“…Leadership is identified as an important factor for teamwork (Ezziane et al, 2012;Lakhani, Benzies, & Hayden, 2012;Manser, 2009;Rydenfält, Odenrick, & Larsson, 2017). Leadership can be seen as a type of management of meaning (Smircich & Morgan, 1982), and as a "process of influencing others to understand and agree about what needs to be done and how to do it.…”