Illusions of team working in health care.

PURPOSE The ubiquity and value of teams in healthcare are well acknowledged. However, in practice, healthcare teams vary dramatically in their structures and effectiveness in ways that can damage team processes and patient outcomes. The aim of this paper is to highlight these characteristics and to extrapolate several important aspects of teamwork that have a powerful impact on team effectiveness across healthcare contexts. DESIGN/METHODOLOGY/APPROACH The paper draws upon the literature from health services management and organisational behaviour to provide an overview of the current science of healthcare teams. FINDINGS Underpinned by the input-process-output framework of team effectiveness, team composition, team task, and organisational support are viewed as critical inputs that influence key team processes including team objectives, leadership and reflexivity, which in turn impact staff and patient outcomes. Team training interventions and care pathways can facilitate more effective interdisciplinary teamwork. ORIGINALITY/VALUE The paper argues that the prevalence of the term "team" in healthcare makes the synthesis and advancement of the scientific understanding of healthcare teams a challenge. Future research therefore needs to better define the fundamental characteristics of teams in studies in order to ensure that findings based on real teams, rather than pseudo-like groups, are accumulated.

[1]  M. West,et al.  Team working in intensive care: current evidence and future endeavors , 2010, Current opinion in critical care.

[2]  J. Dawson,et al.  24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations , 2015 .

[3]  A. Woolley,et al.  Multiple Team Membership: a Theoretical Model of its Effects on Productivity and Learning for Individuals and Teams , 2011 .

[4]  R. AbuAlRub,et al.  The relationships between safety climate, teamwork, and intent to stay at work among Jordanian hospital nurses. , 2012, Nursing forum.

[5]  J. Dawson,et al.  Leadership clarity and team innovation in health care , 2003 .

[6]  M. West,et al.  The determinants of effectiveness in primary health care teams , 1999 .

[7]  D. Tjosvold,et al.  Reflexivity for Team Innovation in China , 2004 .

[8]  Michael A. West,et al.  The link between the management of employees and patient mortality in acute hospitals , 2002 .

[9]  S. Goñi,et al.  An analysis of the effectiveness of Spanish primary health care teams. , 1999, Health policy.

[10]  John R. Hollenbeck,et al.  Beyond Team Types and Taxonomies: A Dimensional Scaling Conceptualization for Team Description , 2012 .

[11]  R. Winkens,et al.  ‘Quod scripsi, scripsi.’ The quality of the report of telephone consultations at Dutch out-of-hours centres , 2010, Quality and Safety in Health Care.

[12]  Jody Hoffer Gittell,et al.  A Relational Model of How High-Performance Work Systems Work , 2010, Organ. Sci..

[13]  T. Manser Teamwork and patient safety in dynamic domains of healthcare: a review of the literature , 2009, Acta anaesthesiologica Scandinavica.

[14]  Michael A. West,et al.  Reflexivity, Effectiveness, and Mental Health in BBC-TV Production Teams , 1998 .

[15]  Michael A. West,et al.  Real Teams or Pseudo Teams? The Changing Landscape Needs a Better Map , 2012, Industrial and Organizational Psychology.

[16]  D. P. Baker,et al.  Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire , 2010, Quality and Safety in Health Care.

[17]  Jane Ball,et al.  Are teamwork and professional autonomy compatible, and do they result in improved hospital care? , 2001, Quality in Health Care.

[18]  K. Holland Proposed changes for nurse education in England (UK) as a result of the Darzi report (DoH, 2008a) Health Quality Care for All--NHS next stage review final report: some initial observations. , 2008, Nurse education in practice.

[19]  M. Euwema,et al.  Care pathways lead to better teamwork: results of a systematic review. , 2012, Social science & medicine.

[20]  K. Marton,et al.  Physician, nurse, and social worker collaboration in primary care for chronically ill seniors. , 2000, Archives of internal medicine.

[21]  A. Bleakley Working in “teams” in an era of “liquid” healthcare: What is the use of theory? , 2013, Journal of interprofessional care.

[22]  S Cretin,et al.  Quality collaboratives: lessons from research , 2002, Quality & safety in health care.

[23]  J. Firth‐Cozens,et al.  Cultures for improving patient safety through learning: the role of teamwork. , 2001 .

[24]  E. Rink,et al.  Integration or pragmatic coalition? An evaluation of nursing teams in primary care , 2000 .

[25]  Michael A. West,et al.  Recent developments in reflexivity research: A review , 2009 .

[26]  S. G. Cohen,et al.  What Makes Teams Work: Group Effectiveness Research from the Shop Floor to the Executive Suite , 1997 .

[27]  L. Lemieux-Charles,et al.  What Do We Know about Health Care Team Effectiveness? A Review of the Literature , 2006, Medical care research and review : MCRR.

[28]  R. Wiles,et al.  Teamwork in primary care: the views and experiences of nurses, midwives and health visitors. , 1994, Journal of advanced nursing.

[29]  Marvin C. Alkin,et al.  What Have We Learned? , 2019, Stumbling Blocks Against Unification.

[30]  K. Vanhaecht,et al.  An overview on the history and concept of care pathways as complex interventions , 2010 .

[31]  Denise M. Rousseau,et al.  The challenges are organizational not just clinical , 2006 .

[32]  J. Dawson,et al.  Well-structured teams and the buffering of hospital employees from stress , 2011, Health services management research.

[33]  M. Leonard,et al.  The human factor: the critical importance of effective teamwork and communication in providing safe care , 2004, Quality and Safety in Health Care.