Factors for Building an Effective Team

Understand how to develop and maintain effective working relationships

• Explain the benefits of effective working relationships in developing and maintaining the team

Effective relationships are important to develop and maintain a strong team.  If the individual team members are happy and confident in their roles they will be able to pull together to achieve the goals of the team effectively.  An effective team needs members with a good knowledge of their roles and what they should be doing.  This could be achieved by appropriate training and having protocols and policies in place to which all team members can adhere.  Communication is highly important in a good team.  Teams need to listen to each other.  Having the correct methods of communication in place and communicating to the right people ensures everyone gets and understands information.   Having an honest and blame free culture is also crucial, so that any mistakes made can be accounted for, discussed and learned from.  Positive changes can come from errors made.  Everyone needs to take responsibility for their roles and duties and commit to these.  Helping and supporting other team members also helps build an effective team.  If people in the team feel supported and have the right knowledge to fulfil tasks it will lead to less stress, sickness and a low turnover of staff.  The team will trust one another when there is a blame free open culture and this helps increase patient safety.  Learning from errors leads to improvement in procedures within practice.  If people feel supported by colleagues morale and motivation will be higher and this leads to achieving goals and targets.  Staff development helps build an affective team as members of staff are offered training and opportunities to increase skills, strengthening the team further.  My current practice team have all been involved in discussions regarding new ways of looking after our chronic disease patients and everyone has been given tasks to complete and areas to look after.  This creates a sense of ownership and staff work hard to complete their tasks.  They have been involved in choosing areas they are interested in and have had appropriate training and been given protocols to carry out these tasks.  These protocols have been communicated verbally and written for their future reference.  They all know their own roles but can refer to protocols if they did need to support other team members or to cover sickness.  They help and support one another and are encouraged to discuss any areas they don’t understand. They also discuss mistakes so that we can increase productivity in a safe way and they feel happy and confident in their roles.

• Describe behaviours which could develop and maintain trust at work

Trust is very important in a strong effective team.  Trust can be built in many ways.  In my current role we have a very open culture.  We have regular team meetings.  Meetings allow new projects or changes to be discussed, which helps the whole team to feel part of the business and everyone feel included, which in turn builds trust.  We also discuss significant events and lessons learned.  There is no blame in these events but an open discussion of why things may have happened and ways to prevent them happening again.  We also report on positives such as targets that have been achieved and share the reward.  Team meetings also allow everyone to input ideas and give feedback.  Having annual appraisals and discussing staff development is also a good way of building trust and confidence in the team.  Good communication through meetings, emails, messages all contribute to trust within the team members.  Staff and managers being honest and open and managers having an open door policy builds team trust, it shows a willingness to support the team.

In my current team one staff member was making a lot of errors, this was noticed by me and other staff members.  As we have a very open blame free culture these were discussed with the staff member involved but in a supportive way.  She was offered training and help if the mistakes were through lack of knowledge.  Training was provided in areas where she lacked confidence.  She was also offered support and asked was there any ways we could help her.  It was found that she made errors when trying to multi task answering phone and also working on something else.  To help she was given protected time to work on her set tasks away from the telephone and she was very thankful for this.  Some of the errors made were also shared with the team and chance was given for a few improvement suggestions and this had positive outcomes.  This showed that people felt able to honestly and openly discuss and reflect on issues and positively overcome these as a team.  This sort of working gives a high level of trust throughout the team.

If there was secrecy within a workplace, team members may feel they didn’t know everything that was happening.  This could be through lack of good communication and lack of meetings and this would cause less trust.  If team members were blamed for mistakes and these were not learned from in a positive way then staff may feel less likely to own up to these or bring them to the manager’s attention.  Also not sharing rewards and positive outcomes leads to a less trusting team as staff may feel their work is not appreciated or acknowledged.

• Explain the role of communication in developing effective team working

Communication is highly important in developing an effective team.  This is both when giving information to others and when listening.  If goals and targets are well defined and communicated, all members of the team will understand them and they can effectively try to attain these.  You can tell your staff the team aims, but if this is not understood then the information is pointless.  Written and verbal communication is vital within the team.  Having goals established and written methods and protocols in place to achieve these goals gives people something to refer to and look back on.  These need to be communicated so that there is an opportunity to ask questions and a chance to check understanding.  This may be best placed in a verbal team meeting to establish understanding and also get feedback or input on better ways of working or team ideas.  Explaining staff roles will allow everyone to know what they should be doing but also what others do.  This helps to maintain morale within the team as things are clear and transparent and it ensures that work is not duplicated and that it is covered should a team member be absent.  Having clear goals that are understood enables the team to achieve or attempt to achieve them.  Feedback both positive and negative needs to be communicated to enable change or to reward good work ethic and productivity.  Sharing of rewards and lessons learned and communicating these to all team members is vital.  Sharing and communicating achievement and rewards can help to boost morale and increase team positivity.

If communication is poor staff may not understand the team goals, their individual and others roles and nobody would hear about lessons learned or get positive feedback.  Without roles staff may not know what they should be doing and if they don’t know others roles they may not give the correct information to the right person.  Staff may not understand other roles and this could reduce morale if they think others are not working as hard as they are, or may cause work to be duplicated or even not done if you think someone else is doing a task but nobody is doing it.  Poor communication doesn’t allow lessons to be learned from mistakes and shared with the team.  Therefore mistakes could continue and lead to targets not being met or could create a safety risk for patients.

Understand how to build the team

• Explain the differences between a group and a team

A group is simply more than one person located, gathered or classed together.  They may have the same interests but do not have a shared goal.  The group members can be independent of one another.  Examples include a group of friends, they may have common interests but may have completely different goals that they are working towards.  Another example would be a group of practice managers attending a monthly meeting.  They have a commonality in their role but each manager has their own practice objectives they are working towards they will not be dependent on one another and may have very different ideas and perspectives.

A team is completely different to a group.  A team is a group of people that have a shared common goal.  The members of a team work together and depend on one another to achieve their goal.  Individual team members may have different roles but they share responsibility and work together with leadership.  Teams are interdependent, they need to work together.  They support and help each other and need to develop good relationships to work together effectively.  Within a team, members show commitment and help each other solve problems, share ideas and create solutions.  An example of a team is a Practice team.  Everyone has common goals in helping the patient population and providing a good service to them.  They work together in different roles whether that be; Doctors, Nurses, Receptionists or the practice manager and they have a plan and aims they share together.  The team work with one another to achieve targets, there is leadership, clear roles, good communication and they work as a unit all contributing and all being recognised for their achievements.  Team members have shared responsibility and accountability.  A team will work more effectively than a group as they will have the same goals, they will have a structure and leadership.  Teams have good communication and have mutual responsibility which may not be the case with a group and this is why teams work and members benefit and support each other.

• Describe the stages of an established model of group formation

One established model of group formation, and probably the most famous is the Tuckman model.  This was first developed in 1965 and it is great basis for effective team building.  This theory has 4 phases and they are depicted nicely in the following diagram.

This theory looks at how building relationships within a team correlates with focusing on team aims and how these can be achieved by working on developing these relationships.  The better the relationships in a team, the more effective the team become at reaching their goals.

The stages are as follows:

Forming – This is a group coming together – the first stage of a team.  The group need to decide on their aims and terms of reference.  The members at this point do not yet know each other and may feel anxiety about the unknown.  Members are still quite independent at this stage and may be polite as they establish ground rules and get to know each other.    At this point they will not know each other’s strengths weaknesses and skills but can create a vision for the group and set some rules and objectives together.

Storming – Storming is the second stage of this team development model.  This is the stage where the members get to know each other and people feel more able to share their views and opinions.  At this point differences of opinion may be expressed and people may challenge others.  This can lead to some hostility within the team but gives an opportunity for discussions around conflict or opinions and these can lead to making decisions that will ultimately help the team.   This is a very important stage as it allows the team structure and roles of its members to be developed.  People need to be able to have that trust to say how they feel and express their ideas.  There may be loss of focus on aims and goals at this stage of development due to conflict and differences.  Different ideas and some element of competing with one another may be seen at this stage as decisions are made.  It is the stage where personality clashes and disagreements can reduce motivation but is also a time when conflicts can be resolved and learned from positively to develop the team.

Norming – The third stage is known as norming.  During this stage the team will be settling after any conflict of the storming stage.  Roles will be more established and the team will have developed ways of working together that they have discussed and planned.  Members of the team will have established what is accepted in the team and know each other’s ways of working and skills.   As the team work together in a more familiar way processes can be developed and roles can be clarified, everyone knows who is doing what in the team.  The team work more harmoniously in this stage and productivity increases.

Performing – This is the final stage in team development.  At this stage the team are working effectively and performing at a high level producing results.  At this stage any disagreements can be positively resolved, the team work together in an organised supportive way, communication is good and roles work alongside each other.  The aims of the team are the focus and are being achieved at this stage.  This is where a team are working at their best.  The team trust each other at this point and results can be reviewed and performance measured and appraised.

My practice has recently formed a Primary care network with neighbouring practices.  We have come together in the forming stage and established some aims and terms of reference for our group.  This has included some team building sessions to discover each other’s personalities and skills, we have also agreed on when we shall meet and some common objectives for the Network.  We are all still at the anxious stage where we all haven’t yet gave many opposing opinions so need to get to the storming stage so that we can establish differences and develop strategies and roles and from there we can move on to norming and eventually perform effectively as a team rather than a group.

• Explain how a manager could benefit from knowing team members preferred roles as defined in an established team role model

If a manager knows their team members strengths weaknesses and preferred style or role then they can utilise these to their advantage and build a more effective team.  Dr Meredith Belbin researched team behaviours and came up with 9 roles in a team.  These roles consist of:

Team workers – these people are usually good listeners and build relationships, but may avoid confrontation.  In my current team we have team workers on both the reception and nursing teams.  These people tend to be friendly and support others building relationships, but avoid conflict and can be a little indecisive.

Co-ordinators – Co-ordinators also help in bringing a team together, helping to organise roles within the team, they are usually confident and good at delegation.  They could perhaps over delegate and pass off work or been seen as controlling.  I have two co-ordinators in my team one being my reception supervisor, she delegates appropriately and brings the team together assigning tasks and keeping people working together in the right roles.  Another co-ordinator is a receptionist but this is a little more overpowering and is done in a controlling manner and not in a particularly effective way.

Implementers – Implementers are reliable and focused and carry out ideas organising what needs to be done, they can sometimes be slow to respond to change.  In my team I have reception and administrative staff that do like to get on with tasks and are very reliable at doing so.

Completer-Finishers – These are perfection seeking characters that are very conscientious.  They can be reluctant to delegate work.  I find myself to be quite a completer finisher as I do over analyse and seek perfection and I find it hard to delegate and give responsibility to others.

Specialists – These people have skills that are rare and are dedicated to their work they may have a less broad area of knowledge but they may be vital in a team.  My secretary at the practice is a specialist as she is a fountain of knowledge regarding referrals and very dedicated to her work but knows less about other aspects in the surgery.  She is vital however to the functioning of the practice and patient care.

Resource investigator – These people explore opportunities, making contacts, they are quite outgoing, but can be over optimistic.

Shaper – Shapers are driven and can navigate obstacles but can provoke other team members with their ways of working.

Monitor-evaluator – These are the more discerning team members that evaluate and look at all options from all angles.  They can be over critical and lack drive in moving forward.

Plant – The plant is the team member that comes up with innovative new ideas and can really think outside the box.  They may come up with great ideas but these will need implementing and finishing by others.  Our surgery has a GP that does come up with new innovative ideas but has no idea how to actually achieve these. The team work together and use shapers, investigators and implementers to pull the plans together implementing the ideas.  These ideas will be helped by specialists and evaluators and finished by completers to carry forward the plants initial thoughts.  If a manager knows the team areas of strength and style of working they can ensure the team has someone that fits all of these roles.  A team without a plant may never strive to achieve highly but if the team only has plants then nothing will ever move forward.  Even if innovative ideas are there we need organisation and implementation of these ideas.  If you know your team strengths you can use these where they are needed.  Knowing the weaknesses of your team can allow you to train or develop team members or even bring in further team members to fill roles that are unfulfilled within the team.

References:

• Thornfields training manual – Managing People with Confidence
• Oxford English dictionary
• belbin.com
• The-happy-manager.com
• Teambuilding.co.uk