Building effective teams in a hospital based medical departments

The most challenging aspect we have in medical department lies in the role clarification. Team members have to understand what is expected from them and how their interdependent participation will contribute to succes. To build a commitment to the teams' goal, the team members must be engaged in developing strategies and tactics. Guiding the team focus and the direction are mandatory for the team leaders.

Using the Interaction Style Indicator (INSI), we analysed the human behaviour of the team members in their interaction and communication during staff meetings and during interdepartmental meetings. Based on the quadrant model, we placed team members independently in one of the eight interaction styles. The cognitive style indicator is characterised by four basic styles : fact-finding, planning, creating and co-operating. 

We defined the differents cognitive styles of the team members using the provided COSI questionnaire (statements). The feedback given to the team members of our cognitive style interpretation was approved and reflected by all the individual members.

Several drivers have also an important impact on team member engagement: proudness of the team, empowerment leadership behaviour, culture of the organisation focused on well-being and goal orientation of the team.

Patrick Lencioni (The Table Group) reveals in his book the five dysfunctions of a team. These dysfunctions go to the very heart of why teams often struggle. He descibes a powerfull model with steps that can overcome these hurdles and build a cohesive effective team. True cohesive teams therefore trust each other, engage in unfiltered conflict around ideas, commit to decisions and plans of action, hold one another accountable, focus on the achievement of collective results. Based on a closed team members meeting on this Lencioni model, we perfomed a team assesment and we graded the different functions of our team. 

Given the independent position of the physicians in a hospital and their relation to the overall management and their colleagues, questionnaires about physicians' performances and attitudes are avoided and not encouraged. Although this attitudes are personal, we experience that in general most of the physicians are committed to performance. Others have other standards of performances and like to be left alone in this discussion of performance and quality. On this topic, most of the medical departments struggle to allign their colleagues in the same high standards and performance, because of their horizontal relationship and independency.

Standardisation and acrreditation (governemental or non-governemental) can oblige this peer-to-peer evaluation to identify the underperformers. This will not only help the identification, but more important, will encourage leading and managing physians to tackle the attitudes of their colleagues and to have an insight of the current problems of performance.

To help overcome an avoidance of accountability a few classic management tools are effective and should be implemented in an organisation: publication of goals and standards, single and regular progress reviews and team rewards. 

The role of the leader (medical director, department head) is more than crucial. Leaderships-skills for leading physicians are a necessity. Team leaders must author a vision and identify the metrics of success, communicate clear expectations and hold team-members accountable for their performance. This is enforced by humanity and sensitivity. True and successful leading a team is creating commitment, having followers by inspiration and establishing alignment.

The teams that are blessed with energy, creativity and shared commitment far surpass other teams.

Different aspects of communication affect team performance. 

The first is energy, which we measure by the number and the nature of exchanges among team members. The most valuable form of communication is face-to-face. The least valuable forms of communication are e-mail and texting.

The second important dimension of communication is engagement, which reflects the distribution of energy among team members. If all members of a team have relatively equal and reasonably high energy with all other members, engagement is extremely strong.

The third critical dimension, exploration, involves communication that members engage out- side their own team.

The key to high performance lays not in the content of a team's discussions but in the manner in which it was communicating.

Successful teams share several defining characteristics in the way of communication and interaction:

• Everyone on the team talks and listens in roughly equal measure, keeping contributions short and sweet.
• Members face one another, and their conversations and gestures are energetic.
• Members connect directly with one another- not just with the team leader.
• Members carry on back channel or side conversations within the team.
• Members periodically break, go exploring out- side the team, and bring information back.

M.H.McCormack reveals in his book "What they don't teach you at Harvard Business School", that there are few basic fundamentals in watching and reading people and team-members.

• Listen aggressively: not only listen to what people say but also how it is told.
• Observe aggressively: interpret motions and gestures.
• Talk less: you will learn more, hear more, see more and make fewer blunders.
• Take a second look at first impressions.
• Take time to use what you've learned: what do you know and what reaction you want.
• Be discreet: let people learn of your qualities and achievements from someone else.
• Be detached; act and do not react. If you don't react you will never over-react.
To build a high performing team, the medical leader should raise energy and engagement in its team. The optimal communication skill consists of energised but focused listening with charismatic tools for connecting team members. 

Using the Johari window, it helps the team members better understand their relationship with themselves as well as others (known to self, known to others). 

Engaging all team members to alignment and performance should be the ultimate goal for any efficient team.

In building effective teams, sustainable and honest leadership is mandatory. Leadership, true leadership, is not the bastion of those who sit at the top. It is the responsibility of anyone who belongs to the team, keeping the circle of safety and and optimal care strong in healthcare.

By showing that team members believe in their team, leaders are able not only to make 'us' a psychological reality but also to transform 'us' into an effective operational unit. It is by such means that teams of champions become champion teams

Leaders should have the capacity to enhance confidence and performance by strengthening players' team identification. They have to unlock the huge potential of their people.