The Effectiveness of Health Care Teams in the National Health Service

Conclusions and Research Mode
A review of the literature reveals that progress has been made in understanding the
factors that influence the ability of people to work effectively together in teams.
However, in the health care domain progress is still patchy and only a few studies are
constructed on firm theoretical bases. Progress is further inhibited by the added
difficulty of operationalising the concept of effectiveness. In the research described
in this report we attempted to build our research on a well-accepted theoretical base
and to engage a large number of health care teams in the research endeavour.
Moreover, we were charged with grasping the nettle of effectiveness in health care
and developing robust and sufficiently broad measures of this difficult concept.
Finally, the research team, drawn from a wide range of epistemological backgrounds
and theoretical orientations, determined to employ diverse, powerful and innovative
research methods to answer the question of what factors influence the effectiveness
of health care teams. The starting point for the research was a model of the factors
influencing team effectiveness and which distinguishes between at least three major
domains of effectiveness. Theoretical approaches to understanding teams at work
have been dominated by the input-process-output structure, mainly because of its
categorical simplicity and utility (see Figure 1 below) (West, Borrill, & Unsworth,
1998). This is the model used to guide the research described in this report.
Figure 1: Input, process, output model of team effectiveness
INPUTS GROUP PROCESSES OUTPUTS
Domain
Health Care
Environment
Organisational
context
Team task
Team composition
Leadership
Clarity of objectives
Participation
Task orientation
Support for innovation
Reflexivity
Decision making
Communication/
integration
Effectiveness - self and
externally rated
Clinical
outcomes/quality of
health care
Innovation - self and
externally rated
Cost effectiveness
Team member mental
health
Team member turnover