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Management in Nursing ch 11 Building and Managing Teams


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Value of Team Building or team development is a popular organizational development technique that can be used to address some work group dysfunctions such as agression, competition, hostility, aloofness, shaming or blaming.
Differentiating Groups from Teams
Group planning and organizing skills, knowledge in conflict management and interpersonal relationships are important to facilitate work group performance
Differentiating Groups from Teams
Characteristics that facilitate group performance
POSITIVE CLIMATE is one in which there is a mutual high regard and in which group members safely may discuss work-related concerns, critique and offer suggestions about clinical practice and comfortably experiment with new behavior.
Differentiating Groups from Teams Positive Climate
Group – is an aggregate of individuals who interact and mutually influence each other
Differentiating Groups from Teams Group
Formal groups - clusters of individuals designated temporarily or permanently by an organization to perform specified organizational tasks; may be structured laterally, vertically and diagonally
Differentiating Groups from Teams
Formal Group
Informal groups–evolve naturally from social interactions and are not defined by an organizational structure. EXAMPLE : individuals who regularly eat lunch together or who convene spontaneously to discuss a clinical dilemma
Differentiating Groups from Teams Informal Group
Real (command groups) – accomplish tasks in organizations and are recognized as a legitimate organizational entity
•its members are interdependent,
•share a set of norms,
•organized to achieve ongoing organizational goals;
Differentiating Groups from Teams
Real or Command Group
Task Group–composed of several persons who work together, with or without a designated leader and are charged with accomplishing specific-time limited assignments. Example: a group of nurses selected by their colleagues to plan an orientation program f
Differentiating Groups from Teams
Task Group
Committees/task forces – groups that deal with specific issues involving several service areas.
Example: A committee responsible for monitoring and improving patient safety or a
Task force assigned to develop better procedures for specimen c
Differentiating Groups from Teams
Committees/Task Forces
Teams- are real groups in which people work cooperatively with each other in order to achieve some goal; have command or line authority to perform tasks and membership is based on the specific skills required to accomplish tasks. Teams maybe lateral, ver
Differentiating Groups from Teams
Activities –observable behavior of group members
Attitudes – are the perceptions, feelings and values held by individuals group members, which may be both positive or negative
Forming – initial stage of group development, in which individuals assemble into a well-defined cluster. Group members are cautious At this stage, the members often depend on a leader to define purpose, tasks and roles
#1 Forming
Storming- a stage in which there is much conflict, dissatisfaction, competition and attempts at the establishments of individual stage; informal leadership emerges and in here also the leader helps the group to acknowledge; In the storming stage the memb
#2 Storming
Norming- stage where group begins to establish rules and design its work, group structure, roles and relationships, standards of performance and behavior are explained, group structure defines and facilitates relationships building.
Phases of Group and Team Development
#3 Norming
Performing-members agree on basic purposes and activities and carry out the work; where the work actually gets done; energy group becomes task-oriented; members communicate effectively; leader provides feedback on the quality and quantity of work, praise
Phases of Group and Team Development
#4 Performing
Adjourning (termination or closure) the leader guides members to summarize, express feelings and come to a closure; a celebration at the end is usually a good way to conclude group effort; group dissolves after achieving its objectives. When a group adjo
Phases of Group and Team Development
#5 Adjourning
Reforming- requires the group to refocus its activities and recycle through the four stages If the group is to refocus its activities the leader will explain the new direction and provide guidance in the process of reforming.
Phases of Group and Team Development
#6 Reforming
Team building -focuses on both task and relationship aspects of a group’s functioning and is intended to increase efficiency and productivity.
Team Building
1 outside interventions to build team cohesiveness,
2 use internal consultative services
3 be manager driven,
4 involve training and development of the group members and leaders
Team building activities includes
1 data gathering
2 diagnosis.
3 Addressing priority team problems by holding semistructured retreat session
The most important initial activities in team building are
HIDDEN AGENDAS are members’ individuals unspoken objectives that interfere with commitment or enthusiasm
Hidden Agendas
1 open and effective communication
2 involved members who are committed to the team
3 understand team dynamics and are emotionally invested in the team
4 clearly defined goals that identify member roles and responsibilities
5 trust an
1 MEMBER NOT A TEAM PLAYER -consider why you want person on the team, approach assertively, give opportunity to provide feedback., approach for one-one dialogue, listen actively to both verbal and non-verbal, avoid blaming or shaming
2 MEMBER LACKS SENSE OF PERSONAL ACCOUNTABILITY –explain how failure to take responsibility affects team as a whole, provide feedback from all team members without blaming or shaming
3 TEAM LACKS CLEAR GOALS –brainstorm to clarify short –term goals and develop action plans, consensus regarding mission and goals, define member responsibilities, determine resources needed to accomplish goals, periodic team review on progress and go
4 UNCLEAR ROLES AND BOUNDARIES – clarify boundaries, define roles and responsibilities and periodically review team development
Norms – are the informal rules of behavior shared and enforced by group members. It applies to all group members. EXAMPLE: not calling sick on Fridays, accommodating trading shifts requests, returning from breaks in timely manner.
Roles – are specific to positions in the group; set of expected behaviors that fit together into a unified whole and are characteristics of persons in a given context.
Task roles- focus on goals; initiator/contributor, information seeker, information giver, opinion seeker, opinion giver, elaborator, coordinator, orienter, evaluator –critic and energizer, procedural technician, recorder
Task Roles
Nurturing roles (socio-emotional roles)- facilitates the growth and maintenance of the group; concerned with group functioning and interpersonal needs: encourager, harmonizer, compromiser, gate-keeper, group observer, follower
Nurturing Roles
Most important role in a group is the leadership role
Leader in a group #1
Leaders are appointed for most formal groups, such as command groups, teams, committees or task forces
Leaders in a group #2
1 Open communication
2 Determining topics of discussion
3 Setting tone
4 Influencing how decisions are made
5 Gatekeeping
Facilitate Group Communication By
Group Productivity and Cohesiveness – represents how well the work group or team uses the resources available to achieve its goals and produce its services
Group Productivity and Cohesiveness
Productivity is influenced by work-group dynamics, especially a group’s cohesiveness and collaboration
1 Share similar values and beliefs
2 Are motivated by the same goals and tasks
3 Must interact and work in proximity to each other
4 Have specific needs met by working in the group
Groups are more likely to become cohesive when members
Disjunctive- the group succeeds if one member succeeds; the greater the number of people the higher the probability that one group member will solve the problem
Divisible – tasks that can break down into sub-tasks with division of labor; more people provide greater opportunity for specialization and interdependence performing a task
Conjunctive- the group succeeds only if all the members succeeds
Group Size and Composition –Groups with 5 or 10 members tend to be optimal for most complex organizational tasks, which requires diversity in knowledge, skills, and attitudes and allow full participation
Group Size and Composition
Evaluating Team Performance: Patient outcomes and team functioning are the criteria by which teams can be evaluated. Clinical pathway data, variances in critical paths, complication rates, falls, and medication errors are examples of outcome data that ca
Evaluating Team Performance
Group functioning can be assessed by the level of work-group cohesion, involvement in the job, and willingness to help each other. Stability of members is an additional measure of group functioning
Group Functioning
Aggression, competition, hostility, aloofness, shaming or blaming are characteristics of poorly functioning groups
Characteristics of poorly functioning groups
MEETINGS are held principally for problem solving, decision-making and enhancing working relationships
Meetings for problem solving
1 Preparation –includes clearly defining the purpose of the meeting; nurse manager prepares an agenda, determine the attendees, make assignments, distribute relevant materials, arrange for recording of minutes, and select appropriate time and place of
Guidelines for Conducting Meetings
2 Participation—include who can actively and effectively participate in decision making, who have skills and knowledge to deal with the agenda and who adequately can represent the interests of those who will be affected by decisions made
Guidelines for Conducting Meetings
3 Place and time- held in places where interruptions can be controlled and at a time when there is a natural time limit to the meeting such as late in the morning or afternoon when lunch or dinner make natural time barriers. Meetings should start and fin
Guidelines for Conducting Meetings
Place and Time
Member behaviors- all attendees should be familiar with behaviors that they may employ to facilitate well managed meetings
Guidelines for Conducting Meetings
Begin and end on time
Arrange for follow-up
Guidelines For Leading Group Members
A key to success in brainstorming-encouraging members to refine and develop the ideas of others
A group norms and roles directly influence the productivity and satisfaction of group members and their ability to develop and grow
Groups Norms and Roles
Formal committees are part of the organization and have authority as well as specific role
Formal Committees
Informal committees are primarily for discussions and have no delegated authority
Informal Committees
Task Forces work on problem or projects that cannot be readily handled by the organization through its normal activities and structures; deals with problems crossing departmental boundaries; generate recommendations and then disband; are temporary
Task Forces
Leading a Team requires good communication and conflict resolution skills as well as the ability to plan, organize, facilitate and evaluate group performance
Leading a team
1. Preparing thoroughly
2. Encouraging all members to participate and communicate openly
3. Seperating idea generations from evaluations
4. Recording problems
5. Summarizing informations and the groups progress
6.Identifying dis
Principles of Effective Management of Meetings Includes
Purpose- held for the ourpose of addressing the needs of individual patients or patients populations; it determines the composition of the group
Patient Care Conferences
Team leader role- is a coach, teacher, and facilitator often may not be a manager with line responsibility to supervise, evaluate or hire employees. the task of a tem leader varies according to the task and the skill level of the team members
Patient Care Conferences

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