HCA 301 Leadership and Management in Healthcare Setting PDF

HCA 301 Leadership and management in healthcare setting CHAPTER 5 LEADING AND MANAGING IN TEAMS Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023- 20...

HCA 301 Leadership and management in healthcare setting CHAPTER 5 LEADING AND MANAGING IN TEAMS Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 1 Learning Outcomes 1. Define groups and stages of group development 2. Define teams and best practices influencing team performance 3. Explain the norms and roles in groups and teams. 4. Discuss factors that influence team management. 5. Describe the major components that determine group performance and satisfaction 6. Discuss how to lead groups, task forces, and patient care conferences HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 2 Introduction Group - An aggregate of individuals who interact and mutually influence each other May be formal or informal Formal groups; Work groups defined by the organization’s structure that have designated work assignments and tasks ▪ Members may include the following: – Individuals from a single work group – Individuals from different job levels – Individuals from different work groups and different job levels ▪ May be permanent or temporary Informal groups; Groups that are independently formed to meet the social needs of their members ◦ Evolve naturally from social interactions ◦ Not defined by an organizational structure HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 3 Groups and Teams Real (command) groups ◦ ◦ ◦ ◦ Accomplish tasks in organizations Recognized as legitimate organizational entity regularly assigned staff who work together under the direction of a single manager/leader. members are interdependent, share a set of norms, generally differentiate roles and duties among themselves, are organized to achieve ongoing organizational goals, and are collectively held responsible for measurable outcomes. ◦ The group's manager has line authority in relation to group members individually and collectively. ◦ Assignments are usually routine and designed to fulfill the specific mission of the agency or organization. ◦ Examples of real (command) groups are staff assigned to a particular department or ward. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 4 Groups and Teams Task groups ◦ ◦ ◦ ◦ Composed of several persons who work together May or may not have a designated leader Charged with accomplishing specific time-limited assignments A task group consisting of nurses, doctors, dieticians and social services may be formed to develop a care pathway for nutrition management for the elderly Committees or task forces ◦ Formed to deal with specific issues involving several service areas ◦ Standing committees, such as the health and safety committee, the pharmacy and therapeutics committee or the clinical governance committee, which meet regularly and do important continuing work within the organisation. ◦ Committees can also be formed to address a specific need, such as selection of a new information technology system. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 5 Groups and Teams Teams Morhman, Cohen and Morhman define a team as a group of individuals who work together to produce products or deliver services for which they are mutually accountable. ◦ Real groups in which individuals must work cooperatively with each other in order to achieve some primary goal ◦ They demonstrate healthy interdependence ◦ Have command or line authority to perform tasks ◦ Membership is based on the skills needed to accomplish tasks. ◦ May have a short life span or exist indefinitely continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 6 Groups and Teams Not all real groups are teams. Groups of individuals who perform their tasks independently of each other are not teams. For example, a general practice group may have six general practitioners (GPs) who work alongside each other but do not need to work as a team to take care of the patients in that practice. Their office staff may need to work as a team. Competing groups; members compete with each other for resources to perform their tasks or compete for recognition, are also not teams. Eg sales, telephone marketing This type of group is rare in health care continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 7 Groups and Teams A work group becomes a team when the individuals must apply their individual skills within the group to achieve specific results. To perform effectively they must; exchange ideas coordinate work activities develop an understanding of other team members' roles. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 8 Groups and Teams Many groups formed in the healthcare organizations fall into the category of Ordinary interacting groups ◦ Usually have a designated leader ◦ May be leaderless ◦ Include most work teams, task groups, and committees ◦ Normally, the final decision is made by consensus. ◦ Enhance cohesiveness of group members ◦ Participants are able to build strong social ties and will be committed to the solution decided on by the group. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 9 Group Essentials George C. Homan’s social system conceptual scheme provides a framework for understanding group inputs, processes, and outcomes. The schematic depicts the effects of organisational and individual background factors on group leadership including ◦ Dynamics (tasks, activities, interactions, attitudes) ◦ Processes (forming, storming, norming, performing, adjourning) Elements of the required group system and processes influence each other and the emergent group system and social structure. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 10 Figure 12-1 Conceptual scheme of a basic social system. Source: Adapted from Homans, G. (1950). The human group. New York: Harcourt Brace Jovanovich; and Homans, G. (1961). Social behavior: Its elementary forms. New York: Harcourt Brace. By permission of Transaction Publishers. Copyright © 2018, 2013, 2009 Pearson Education, Inc. All Rights Reserved Group and Team Processes: Homans Framework Homans' framework indicates that background factors, the leader's style and the organisational system influence the normal development of the group Three essential elements of a group system include: ◦ Activities ◦ Observable behaviors of group members ◦ Interactions ◦ Verbal or nonverbal exchanges of words or objects among two or more group members ◦ Attitudes ◦ Perceptions, feelings, and values held by individual group members To understand and guide group functioning, a leader should analyze the activities, interactions and attitudes of work group members. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 12 Phases of Group Development In 1965, Bruce Tuckman presented a paper outlining his model saying that phases were necessary for a team to develop and grow: Forming Storming Norming Performing Later Adjourning Re-forming HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 13 Phases of Group Development ◦Forming ◦ Individuals assemble into a well-defined cluster. ◦ Group members are cautious in approaching one another. ◦ Members often depend on a leader to define purpose, tasks, and roles. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 14 Phases of Group Development ◦Storming ◦ Conflict, dissatisfaction, and conflict arise. ◦ Members often compete for power and status. ◦ Informal leadership emerges. ◦ Leader helps the group acknowledge the conflict and resolve it in a win-win manner continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 15 Phases of Group Development ◦Norming ◦ Group defines goals and rules of behavior. ◦ Group structure, roles, and relationships become clearer. ◦ Cohesiveness develops. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 16 Phases of Group Development ◦ Performing ◦ Members agree on purposes and activities and carry out work. ◦ Cooperation improves, and emotional issues subside. ◦ The leader provides feedback. ◦ Adjourning ◦ The group dissolves after achieving its objectives. ◦ Re-forming ◦ A major change requires the group to refocus its activities and recycle through the four stages. continued on next slide HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 17 Phases of Group Development HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 18 Phases of Group Development HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 19 Characteristics of Groups Norms ◦ Informal rules of behavior are shared and enforced by group members. ◦ Groups develop norms that members believe must be adhered to for fruitful, stable group functioning. ◦ Norms are likely to be enforced if they serve to facilitate group survival. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 20 Characteristics of Groups Norms Groups go through several stages in enforcing norms with deviant members. ◦ First, members use rational argument or present reasons to the deviant individual for adhering to the norms. ◦ Second, if rational argument is not effective, members may use persuasive or manipulative techniques, reminding the deviant of the value of the group. ◦ The third stage is coercion, an attempt to force the deviant to conform. ◦ Attacks may be verbal or even physical and sometimes include sabotaging the deviant’s work. ◦ Final stage is ignoring the deviant. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 21 Characteristics of Groups Roles ◦ Set of expectations about behavior ascribed to a specific position in society or at work. ◦ Are characteristic of persons in a given context ◦ Task roles attempt to keep the group focused on its goals. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 22 Characteristics of Groups Dr Meredith Belbin’s research showed that the most successful teams were made up of a diverse mixture of behaviours. To build high-performing teams we need to represent each of the nine Belbin Team Role behaviours at appropriate times. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 23 Belbin Team Roles Belbin suggested that there are no 'good' or 'bad' roles. People are as they are, and all roles play important parts in Successful teams. An individual in a team can play more than one role, but to be effective, the team needs all roles to be undertaken HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 24 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 25 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 26 Belbin Team Roles Role name Description Coordinator (CO) Able to get others working to a shared aim; confident, mature Shaper (SH) Motivated, energetic, achievement-driven, assertive, competitive Plant (PL) Innovative, inventive, creative, original, imaginative, unorthodox, problem solving Monitor—evaluator (ME) Serious, prudent, critical thinker, analytical Implementer (IMP) Systematic, common sense, loyal, structured, reliable, dependable, practicable, efficient Resource investigator (RI) Quick, good communicator, networker, outgoing, affable, seeks and findsoptions, negotiator Teamworker (TW) Supportive, sociable, flexible, adaptable, perceptive, listener, calming influence, mediator Completer—finisher (CF) Attention to detail, accurate, high standards, quality orientated, delivers to schedule and specification Specialist (SP) Technical expert, highly focused capability and knowledge, driven by professional standards and dedication to personal subject area HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 27 Characteristics of Groups Status ◦ Social ranking of individuals relative to others in a group based on the position they occupy ◦ Higher-status members often exercise more influence than others in group decisions. ◦ comes from factors that the group values (achievement, personal characteristics, the ability to control rewards, or the ability to control information). ◦ Status is usually enjoyed by members who most conform to group norms. Status incongruence ◦ ◦ ◦ ◦ Occurs when factors associated with group status are not congruent For e.g when a younger, less experienced person becomes the group leader. Can have a disruptive impact on a group May occur because the individual does not need the group's approval and makes no effort to obtain it For example, imagine that a department has been having problems with MRSA. Working with infection control, alcohol gel bottles have been installed at the door. The nurses have all agreed to use the gel; however, the consultant refuses. The consultant's actions are based on her perception that she does not need the nurse's approval, and her status puts her outside the group norms HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 28 Characteristics of Groups ▪The most important role in a group is the leadership role. ▪Leaders are appointed for most formal groups, such as command groups, teams or committees. ▪Leaders in informal groups tend to emerge over time and in relation to the task to be performed. ▪Some of the factors contributing to the emergence of leadership in small groups include the ability to accomplish the group's goals, sociability, good communication skills, self-confidence and a desire for recognition. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 29 Communication in Groups ▪Groups provide an important channel of communication in organisations. ▪Members of high-performance work teams generally communicate openly, candidly and clearly with one another about procedures, expectations and plans. ▪Effective leaders can facilitate communication in groups by maintaining an atmosphere in which group members feel free to discuss concerns, make suggestions, critique ideas and show respect and trust. ▪An important leadership function related to communication is gatekeeping; Keeping communication channels open, refocusing attention on critical issues, identifying and processing conflict, fostering self-esteem, checking for understanding, actively seeking the participation of all group members and suggesting procedures for discussing group problems. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 30 How groups affect individuals ▪Group relationships affect individual behaviour in many ways. ▪ Organisational work groups affect the beliefs, knowledge, attitudes, values, emotions and social behaviour of individuals. ▪ Groups profoundly affect the nature and process of communication and interpersonal relationships. ▪A group can bring out the best and the worst in individuals due to the stimulating presence of others. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 31 Group productivity and cohesiveness Productivity ▪Represents how well the work group or team uses the resources available to achieve its goals and produce its services. ▪ If patient care is satisfactorily completed at the end of each day in relation to the levels of staffing, supplies, equipment and support services used, the group has been productive. ▪ Is influenced by work-group dynamics, especially a group's cohesiveness and collaboration Cohesiveness ▪Degree to which the members are attracted to the group and how much they are willing to contribute ▪Strong group cohesiveness leads to a feeling of 'we' as more important than 'l’. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 32 Group productivity and cohesiveness Groups are more likely to become cohesive when members are characterized by the following: Share similar values and beliefs Are motivated by the same goals and tasks Interact to achieve their goals and tasks Work in proximity to each other (e.g., on the same unit and on the same shift) Have specific needs that can be satisfied by involvement in the group HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 33 Group productivity and cohesiveness ▪Group cohesiveness is also influenced by the formal reward system. ▪Groups tend to be more cohesive when group members receive comparable treatment and pay and perform similar tasks that require interaction among the members. ▪Similarities in values, education, social class, gender, age and ethnicity lead to similar attitudes and strengthen group cohesiveness. ▪Cohesiveness can produce intense social pressure. Highly cohesive groups can demand adherence to norms regardless of their practicality or effectiveness HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 34 Group productivity and cohesiveness ▪Group cohesion can also affect absenteeism and turnover. ▪Groups with high levels of cohesiveness exhibit lower turnover and absenteeism than groups with low levels of cohesiveness. ▪For most individuals, the work group provides one of the most important social contacts in life. ▪Group cohesiveness and effectiveness improve as staff members take responsibility for teaching each other and jointly seeking new information or techniques. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 35 Group size and composition ▪Groups with five to ten members tend to be optimal for most complex organisational tasks, which require diversity in knowledge, skills and attitudes, and allow full participation. ▪Groups tend to perform better with competent individuals as members. ▪Homogeneous groups tend to function more harmoniously, whereas heterogeneous groups may experience considerable conflict. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 36 Evaluating team performance Team evaluation is based on patient outcomes and team functioning. Group functioning can be assessed by the level of: Work-group cohesion. Involvement in the job. Willingness to help each other. Stability of members is an additional measure of group functioning. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 37 Leading Committees and Task Forces Committees ◦ Generally permanent ◦ Deal with ongoing work. ◦ Membership on committees is usually determined by organisational position and role Formal committees ◦ Part of the organization ◦ Have authority as well as a specific role Informal committees ◦ Primarily for discussion and have no delegated authority Task forces ◦ Ad hoc committees appointed for a specific purpose and a limited time HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 38 Leading Committees and Task Forces Guidelines for Conducting Meetings ◦ Preparation ◦ Includes clearly defining the purpose of the meeting ◦ The leader should prepare an agenda. ◦ Participation ◦ Meeting should include the fewest number of people who can actively and effectively participate in decision making. ◦ Place and time ◦ Meetings should be held in places where interruptions can be controlled and at a time when there is a natural time limit to the meeting. ◦ Meetings should be limited to 50 to 90 minutes. ◦ Meetings should start and finish on time. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 39 Leading Committees and Task Forces Guidelines for Conducting Meetings ◦ Member behaviors ◦ Group members should: ◦ Be prepared for the meeting. ◦ Ask for clarification as needed. ◦ Offer suggestions and ideas as appropriate. ◦ Encourage others to contribute ideas and opinions. ◦ Offer constructive criticism as appropriate. ◦ Help the discussion stay on track. ◦ Assist with implementation as agreed. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 40 Leading Committees and Task Forces Managing Task Forces ◦ Members of a task force have less time to build relationships. ◦ Preparing for the first meeting ◦ Leader must clarify the objectives of the task force. ◦ Task force members should be selected on the basis of their: ◦ Knowledge. ◦ Skills. ◦ Personal concern for the task. ◦ Time availability. ◦ Organizational credibility. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 41 Leading Committees and Task Forces Managing Task Forces ◦ Conducting the first meeting ◦ Goal is to come to a common understanding of the group's task and to define the group's working procedures and relationships. ◦ A standard of total participation should be well established. ◦ Managing subsequent meetings and subgroups ◦ Keep all members informed of the group's progress. ◦ A work plan should be developed. ◦ The leader must be sensitive to conflicting loyalties. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 42 Leading Committees and Task Forces Managing Task Forces ◦Completing the task force's report ◦ Prepare a written report for the commissioning administrators. ◦ Leader should consider involving a few task force members in the administrative presentation. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 43 Leading Committees and Task Forces Patient Care Conferences ◦Held to address the needs of individual patients or patient populations ◦Meetings are usually interprofessional and used for case management to discuss specific patient care problems. For example, a multidisciplinary team meeting to discuss the care program approach (CPA) for mental health patient prior to discharge. ◦Team leader needs to have excellent leadership skills. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 44 Ponder points ▪A group is an aggregate of individuals who interact and mutually influence each other ▪Groups may be classified as real or task, formal or informal, permanent or temporary. ▪A team is a group of individuals with complementary skills, a common purpose and performance goals, who are mutually accountable for the achievement of the goals. ▪Groups have an impact on cohesiveness and productivity, as well as individual development and growth. ▪A group's norms and roles directly influence the productivity and satisfaction of group members and their ability to develop and growth. ▪Groups come together, build cohesiveness, complete their task and disband or reform. ▪Leading teams requires good communication and conflict resolution skills as well as the ability to plan, organise, facilitate and evaluate group performance. ▪Managing meetings involves preparing thoroughly, facilitating participation and completing the group's work HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 45 Useful links Tuckman Model: understanding the stages of team formation https://www.youtube.com/watch?v=2QbXc6E08H4 What is Group dynamics? | Meaning, Types, Importance, Stages https://www.youtube.com/watch?v=OUJJgktZqTw Belbin’s team roles https://www.youtube.com/watch?v=hMesDq_rNOw https://www.youtube.com/watch?v=oplI3Dg68es HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 46