Team Leadership and Effectiveness

The study of teams is of particular interest to me working in a health care role.  The majority of patient care is delivered by teams – whether it be an emergency team, a surgical team, or any number of other interdisciplinary teams.  Effective teams provide exceptional care, and this is what leaders in health organizations aim for.

The two critical functions of team effectiveness are performance and development (Northouse, 2016).  Performance is demonstrated by the achievement of goals and objectives that are recognized for quality.  Development is demonstrated by team cohesiveness and by individual members meeting their own needs while still meeting the objectives of the team (Northouse, 2016).

Larson and LaFasto (1989) listed eight characteristics of effective teams (as cited in Northouse, 2016).  Effective teams must have the following:

1. A clear, elevating goal that is worthwhile, important, and can be realized.
2. A results driven structure that defines the task design, team composition and norms of conduct.
3. Competent team members that exhibit technical and interpersonal competencies.
4. A unified commitment so that individuals develop a sense of unity and identification.
5. A collaborative climate that enables team members to focus, take risks, trust and compensate for each other.
6. Standards of excellence that create positive pressure for all to perform at the highest standard.
7. External support and recognition that include the provision of resources, rewards, education and information.
8. Principled leadership that allows team autonomy but is observant enough and discerning to act when necessary to restore team performance or development.

Hackman (2012) proposed that there are six enabling conditions for team effectiveness, and these are  posed as yes/no questions (as cited in Northouse, 2016). Many of these conditions overlap with Larson and LaFasto’s eight characteristics.  The questions that need to be answered by the team, or by team leadership are as follows:

1. Is it a real team?
2. Does it have a compelling purpose?
3. Does it have the right people?
4. Are the norms of conduct clear?
5. Is there support from the organizational context?
6. Is there team focused coaching?

I had the opportunity in 2013 to receive training and visit the Virginia Mason Medical Center in Seattle, WA.  I was able to observe effective and exceptional team functioning, and this opportunity was truly a turning point in my career.  In 2002 Dr. Gary Kaplan, the CEO had applied lean principles learned from Toyota, and together with his senior leaders developed the Virginia Mason Production System^TM – a system that demands excellence in patient care.  The center was able to define their compelling purpose and the clear, elevating goal via their strategic plan which had been visualized as a pyramid with the patient at the top (Kenney, 2011, p. 4).  The right people, competent team members and a unified commitment were identified through the Virginia Mason Medical Center Physician Compact (Kenney, 2011, p. 9) in which five organizational and five physician responsibilities are outlined.  Organizational support and principled leadership were demonstrated when the CEO and the senior leader team committed to learning lean principles, becoming certified, and then committed to training for every existing and new employee.  Norms of conduct and standards of excellence were made clear when leaders were required to be present and available to front line staff and provide team focused coaching and employee recognition in real time.  For more information, visit here.

Principled leadership is committed to the team and intervenes only when the team requires the input of the leader.   Zacarro, Rittman, & Marks (2001) identified four processes by which principled leaders influence their teams (as cited in Northouse, 2016).  The cognitive process assists the team members to understand the problems, the motivational process sets the standards and helps the team achieve them by building confidence and capacity, the affective process sets clear goals, achievable assignments and strategies to eliminate stress, and the process of coordination allows the integration of activities by matching skills to roles, strategic prioritization, monitoring feedback, adapting to environmental changes.

I was able to experience the positive influence of the motivational process when in the role as the music leader in my former church.  The music team consisted of volunteer instrumentalists and vocalists, and the performance and engagement of the team had stagnated.  The senior pastor set new standards for the music, inspired us to rise to those standards, equipped us by sending us to conferences and workshops, worked alongside us as an instrumentalist, and encouraged and recognized us when each new level in technical performance was reached.  The team was able to play and sing technically difficult pieces with excellence as a result, and there was a renewed sense of ownership and passion that developed in the entire team.

Teams that function well can accomplish much; teams that are dysfunctional can be destructive.  Having studied the work cited in this chapter, I can now identify what characteristics or conditions were missing in the teams that were not effective.  Have others also experienced dysfunctional teams?  Can you identify why?  Have you experienced exceptional teams, and can you identify why?  I look forward to the discussion.

References

Kenney, C.  (2011).  Transforming health care:  Virginia Mason Medical Center’s pursuit of the perfect patient experience.  New York, NY:  Productivity Press.

Northouse, P.G. (2016).  Leadership: Theory and Practice.  (7^th ed.). Thousand Oaks, CA:  Sage Publications, Inc.