The Effectiveness of Health Care Teams in the National Health Service

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Acknowledgements ________________________________________________________ Liaison Officers: Liz Meerabeau Sue Longsdate John Wilkinson Advisory Group Members: Debbie Mellors NHS Executive Research Team: Sarah Connors NHS Executive Jim Ford NHS Executive Bonnie Sibbald NHS Executive Eileen Robertson NHS Executive Sheila Roberts Department of Health Terry Breugha University of Leicester Anne Netton University of Kent Thelma Sackman NHS Executive Dr Carol Borrill January 1997 - December 1999 Aston Business School Aston University Birmingham Sam Bedlingham June 1997 - December 1999 City University London Jean Carletta January 1997 - December 1999 Human Communication Research Centre Edinburgh
Christine Carmichael June 1997 - February 1998 Institute of Work Psychology Sheffield University Sheffield Angela Carter January 1998 - December 1999 Institute of Work Psychology Sheffield University Sheffield Jeremy Dawson July 1999 - December 1999 Aston Business School Aston University Birmingham Simon Garrod January 1997 - December 1999 Human Communications Research Centre Glasgow University Glasgow Heidi Frazer-Krauss January 1997 - June 1997 Medical School Glasgow University Glasgow Anne Rees January 1997 - June 1997 Psychological Therapies Research Centre Leeds University Leeds Anne Richards January 1997 - December 1999 Psychological Therapies Research Centre Leeds University Leeds Carein Todd April 1997 - May 1998 Institute of Work Psychology Sheffield University Sheffield David Shapiro April 1997 - May 1998 Psychological Therapies Research Centre Leeds University Leeds Michael West January 1997 - December 1999 Aston Business School Aston University Birmingham David Woods January 1998 - June 1999 Institute of Work Psychology Sheffield University
Page 1 and 2: The Effectiveness of Health Care Te
Page 3: Appendix II Knowing the way: Effect
Page 7 and 8: The objectives of the research were
Page 9 and 10: Index, Dr Foster; deaths within 30
Page 11 and 12: Chapter 1 Teamwork, Communication a
Page 13 and 14: • Flat organisations can be monit
Page 15 and 16: audit of the case managers' records
Page 17 and 18: Specifically, West and Wallace (199
Page 19 and 20: There is some evidence that team me
Page 21 and 22: circumstances efficient teamwork re
Page 23 and 24: selected the best option. Following
Page 25 and 26: Team and organisational rewards It
Page 27 and 28: Thus the health care team may focus
Page 29 and 30: integrates interventions (Tannenbau
Page 31 and 32: to provide shared direction and ena
Page 33 and 34: Inputs Teams work within a domain s
Page 35 and 36: Chapter 2 Primary Health Care Team
Page 37 and 38: midwives); 33.5% administrative sta
Page 39 and 40: External ratings - team effectivene
Page 42 and 43: Location Four location categories w
Page 44 and 45: functioning, issues of team process
Page 46 and 47: Organisational Context Figure 2.11
Page 48 and 49: Figure 2.12: Consultation and Quali
Page 50 and 51: Figure 2.13: An example of the layo
Page 52 and 53: stakeholders was sufficiently compr
Page 54 and 55:
enefit to all aspects of primary he
Page 56 and 57:
Introduction The data analysis expl
Page 58 and 59:
those which might ultimately predic
Page 60 and 61:
Figure 3.4: Relationship between te
Page 62 and 63:
It seems that professional diversit
Page 64 and 65:
Bearing in mind that a larger score
Page 66 and 67:
Figure 3.15: Clarity of Leadership
Page 68 and 69:
Summary of Findings Chapter 4 Quali
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of the workshops and consultations
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Chronic disease management • effe
Page 74 and 75:
Accountability • meeting NHS care
Page 76 and 77:
Checklist of activities which contr
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Objective 1 - Promote, maintain and
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Objective 5 - High team member comm
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Measure 2 - Young People’s Sexual
Page 84 and 85:
Percentage of team members who repo
Page 86 and 87:
determined the percentage of patien
Page 88 and 89:
test their generalisability for pri
Page 90 and 91:
Introduction Chapter 5 Community Me
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As the Health Team Effectiveness re
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CMHTs managed. The main reasons for
Page 96 and 97:
Section 4: Biographical information
Page 98 and 99:
Number of members % of women 35 30
Page 100 and 101:
Figure 5.4: CMHT occupational group
Page 102 and 103:
CMHT response to emergency referral
Page 104 and 105:
number of teams 50 40 30 20 10 0 Tu
Page 106 and 107:
Team average tenure Average job ten
Page 108 and 109:
� Team processes: team processes
Page 110 and 111:
made about the running of the team.
Page 112 and 113:
single evaluative or morale factor.
Page 114 and 115:
turn, team characteristics were ent
Page 116 and 117:
• Teams using integrated client c
Page 118 and 119:
Team Inputs Information about the t
Page 120 and 121:
Results The method of analysis was
Page 122 and 123:
Figure 6.4: Impact of team processe
Page 124 and 125:
4.5 4.0 3.5 3.0 2.5 2.0 -.2 0.0 .2
Page 126 and 127:
external rating of team innovation
Page 128 and 129:
meetings), beta = -.20, t = -2.20,
Page 130 and 131:
Two factors, acting independently o
Page 132 and 133:
that the majority of such training
Page 134 and 135:
In relation to recruitment and rete
Page 136 and 137:
Chapter 7 Community Mental Health T
Page 138 and 139:
Figure 7.1: Process and effectivene
Page 140 and 141:
Figure 7.2: Client caseload profile
Page 142 and 143:
Figure 7.3: Summary of selected cli
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83 per cent of selected clients wer
Page 146 and 147:
Figure 7.5: Summary of health econo
Page 148 and 149:
Team I 39 26 33 Team J 45 39 13 TOT
Page 150 and 151:
Figure 7.11: Costs and clinical tar
Page 152 and 153:
Overall costs Overall cost per clie
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Referrals pooled in the team/number
Page 156 and 157:
12 months. Of course, some of these
Page 158 and 159:
We were also forcibly reminded of t
Page 160 and 161:
Section 1: Biographical information
Page 162 and 163:
comprised of six items with five in
Page 164 and 165:
• Does your team have relatively
Page 166 and 167:
The mean caseness of teams was 23.3
Page 168 and 169:
Response Fifty-seven teams particip
Page 170 and 171:
health care areas. For example, a b
Page 172 and 173:
The Coronary Care Unit This team is
Page 174 and 175:
specialities. The clinicians are in
Page 176 and 177:
Summary of Findings Chapter 9 Secon
Page 178 and 179:
Analysis of variance within and bet
Page 180 and 181:
Role Conflict 148.16 1,2147
Page 182 and 183:
etween team membership types in str
Page 184 and 185:
237 team members (752 nurses, 114 d
Page 186 and 187:
Multiple Team Membership Most peopl
Page 188 and 189:
higher level unit (organisation, th
Page 191 and 192:
Team size and type of Trust are ass
Page 193 and 194:
Introduction Chapter 10 Meetings an
Page 195 and 196:
Even in relatively small groups, ac
Page 197 and 198:
did not code finer timing informati
Page 199 and 200:
Figure 10.2: Communication in a pri
Page 201 and 202:
Figure 10.4: Communication in a com
Page 203 and 204:
Summary of Findings Chapter 11 Anal
Page 205 and 206:
team's size (unrelated t-tests, all
Page 207 and 208:
meetings, we will return to why thi
Page 209 and 210:
taken up by "any other business" ra
Page 211 and 212:
attendance to GPs and the practice
Page 213 and 214:
(See Figure 11.8). The graph includ
Page 215 and 216:
members in other ways. From the con
Page 217 and 218:
equal responsibility subset (for eq
Page 219 and 220:
Types of Meetings The number of dif
Page 221 and 222:
Figure 12.2: Four Categories of Pra
Page 223 and 224:
Teams which are commissioned by hea
Page 225 and 226:
Although the meetings fell into the
Page 227 and 228:
Figure 12.5: Duration of meetings i
Page 229 and 230:
chairing meetings, such cases illus
Page 231 and 232:
Attendance at meetings The CMHT mee
Page 233 and 234:
describe the overall nature of CMHT
Page 235 and 236:
Chapter 13 Conclusions and Recommen
Page 237 and 238:
� Leadership also emerges as crit
Page 239 and 240:
care teams must therefore be traine
Page 241 and 242:
3. Team composition Today’s healt
Page 243 and 244:
always be to move as quickly as pos
Page 245 and 246:
customer satisfaction with retail o
Page 247 and 248:
In traditional organisations, power
Page 249 and 250:
Team processes When TBW is introduc
Page 251 and 252:
Appendix I Measures Used Primary He
Page 253 and 254:
Accessibility of the service to use
Page 255 and 256:
Introduction The World Health Organ
Page 257 and 258:
From this conceptual, background Po
Page 259 and 260:
Com peting Values M odel Internal H
Page 261 and 262:
care and of taking into considerati
Page 263 and 264:
derived from 100 teams, examining t
Page 265 and 266:
Rational Goal Objectives Example In
Page 267 and 268:
Human Relations Objectives Example
Page 269 and 270:
contingencies for each indicator, t
Page 271 and 272:
Centre Steven Campbell Research Ass
Page 273 and 274:
Appendix III Effectiveness Measures
Page 275 and 276:
Objective: Promote, maintain and im
Page 277 and 278:
Effectiveness To what extent......
Page 279 and 280:
Relevance To what extent...... Are
Page 281 and 282:
∗ If the measures suggest that th
Page 283 and 284:
Measure 4 - Patient access to consu
Page 285 and 286:
Next steps • Compare the average
Page 287 and 288:
whether steps could be taken to ens
Page 289 and 290:
Measure 8 - Patients have access to
Page 291 and 292:
Objective: Efficient Use of Resourc
Page 293 and 294:
Date: Day of week: Name: Job title:
Page 295 and 296:
Measure 11 - Patients/clients who d
Page 297 and 298:
Measure 12 - Efficient use of admin
Page 299 and 300:
Objective: Continuous personal and
Page 301 and 302:
Measure 16 - Team members use each
Page 303 and 304:
Objective: Responsiveness to client
Page 305 and 306:
Measure 19 - Patients’ experience
Page 307 and 308:
5. The last two times that you aske
Page 309 and 310:
18. In the last month: How many mor
Page 311 and 312:
___________________________________
Page 313 and 314:
Letters were sent to all the primar
Page 315 and 316:
(ii) The principles of effective te
Page 317 and 318:
• Which aspects of the PHCT servi
Page 319 and 320:
the person’s environment such as
Page 321 and 322:
Handout 3 Practical tips and guidel
Page 323 and 324:
‘The best and most cost-effective
Page 325 and 326:
feedback on performance against tho
Page 327 and 328:
Handout 6 Practical tips and guidel
Page 329 and 330:
Teamworking Mechanisms for reviewin
Page 331 and 332:
Efficient use of resources Of no Ve
Page 333 and 334:
Handout 10 Practical tips and guide
Page 335 and 336:
Page 338 and 339:
Handout 14 Measuring Quality of Car
Page 340 and 341:
Page 342 and 343:
Page 344 and 345:
Page 346 and 347:
Page 348 and 349:
Page 350 and 351:
Berger, J., Fisek, M.H., Norman, R.
Page 352 and 353:
Department of Health (1990). The Ca
Page 354 and 355:
Guzzo, R.A. & Shea, G.P. (1992). Gr
Page 356 and 357:
King, N. (1990). Innovation at work
Page 358 and 359:
Myer, C. (1993). How to Align Purpo
Page 360 and 361:
Schober, M.F., & Clark, H.H. (1989)
Page 362 and 363:
groups. Academy of Management Journ
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