The Effectiveness of Health Care Teams in the National Health Service

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functioning, issues of team processes and, given the anomalous preponderance of male GPs, of leadership issues. Fig 2.7: Distribution of gender by occupational group in primary health care teams GPs Practice Nurses Trust Nurses Admin staff Managers PAMs Other Male 99 5 16 10 24 8 1 Female 75 160 249 378 61 42 4 Fig 2.8: The distribution of mean age across the occupational groups Mean Age Standard Deviation GPs 41.2 7.6 Practice Nurses 42.1 7.6 Trust Nurses 42.2 8.3 Admin/clerical 43.7 10.2 Managers 44.3 8.4 PAMs 41.6 11.0 Others 40.8 8.2 Age The distribution of age across the occupational group is shown in Figure 2.8. Occupational Groups The majority of teams comprised: GPs, practice nurses, administrative staff, district, health visitors and one or more practice managers. Less than 15% of teams did not include trust nurses, and only 6% of teams had no manager. Twenty four percent of teams included ‘other’ types of staff (counsellors, community psychiatric nurses, physiotherapist etc). Proportion of occupational groups The proportion of each of the main occupational groups in the teams is shown in Figure 2.9.
Figure 2.9: Proportion of occupational groups in the sample PAM's Others Managers Admin/cleri cal A different picture of team composition emerges when hours worked is taken into account and team membership calculated using 'whole time equivalent' figures. This shows that largest grouping is GPs, with only 10.7% of the input to the team being provided by trust nurses. GPs Trust Nurses 2.10: Proportion of occupational groups in the sample Managers Admin/ clerical PAM's Others Trust Nurses Practice Nurses GPs Practice Nurses
Page 1 and 2: The Effectiveness of Health Care Te
Page 3 and 4: Appendix II Knowing the way: Effect
Page 5 and 6: Christine Carmichael June 1997 - Fe
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 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
Page 70 and 71: of the workshops and consultations
Page 72 and 73: Chronic disease management • effe
Page 74 and 75: Accountability • meeting NHS care
Page 76 and 77: Checklist of activities which contr
Page 78 and 79: Objective 1 - Promote, maintain and
Page 80 and 81: Objective 5 - High team member comm
Page 82 and 83: 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
Page 92 and 93: As the Health Team Effectiveness re
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CMHTs managed. The main reasons for
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Section 4: Biographical information
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Number of members % of women 35 30
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Figure 5.4: CMHT occupational group
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CMHT response to emergency referral
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number of teams 50 40 30 20 10 0 Tu
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Team average tenure Average job ten
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� Team processes: team processes
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made about the running of the team.
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single evaluative or morale factor.
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turn, team characteristics were ent
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• Teams using integrated client c
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Team Inputs Information about the t
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Results The method of analysis was
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Figure 6.4: Impact of team processe
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4.5 4.0 3.5 3.0 2.5 2.0 -.2 0.0 .2
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external rating of team innovation
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meetings), beta = -.20, t = -2.20,
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Two factors, acting independently o
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that the majority of such training
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In relation to recruitment and rete
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Chapter 7 Community Mental Health T
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Figure 7.1: Process and effectivene
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Figure 7.2: Client caseload profile
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Figure 7.3: Summary of selected cli
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83 per cent of selected clients wer
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Figure 7.5: Summary of health econo
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Team I 39 26 33 Team J 45 39 13 TOT
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Figure 7.11: Costs and clinical tar
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Overall costs Overall cost per clie
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Referrals pooled in the team/number
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12 months. Of course, some of these
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We were also forcibly reminded of t
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Section 1: Biographical information
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comprised of six items with five in
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• Does your team have relatively
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The mean caseness of teams was 23.3
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Response Fifty-seven teams particip
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health care areas. For example, a b
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The Coronary Care Unit This team is
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specialities. The clinicians are in
Page 176 and 177:
Summary of Findings Chapter 9 Secon
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Analysis of variance within and bet
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Role Conflict 148.16 1,2147
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etween team membership types in str
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237 team members (752 nurses, 114 d
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Multiple Team Membership Most peopl
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higher level unit (organisation, th
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Team size and type of Trust are ass
Page 193 and 194:
Introduction Chapter 10 Meetings an
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Even in relatively small groups, ac
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did not code finer timing informati
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Figure 10.2: Communication in a pri
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Figure 10.4: Communication in a com
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Summary of Findings Chapter 11 Anal
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team's size (unrelated t-tests, all
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meetings, we will return to why thi
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taken up by "any other business" ra
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attendance to GPs and the practice
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(See Figure 11.8). The graph includ
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members in other ways. From the con
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equal responsibility subset (for eq
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Types of Meetings The number of dif
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Figure 12.2: Four Categories of Pra
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Teams which are commissioned by hea
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Although the meetings fell into the
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Figure 12.5: Duration of meetings i
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chairing meetings, such cases illus
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Attendance at meetings The CMHT mee
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describe the overall nature of CMHT
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Chapter 13 Conclusions and Recommen
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� Leadership also emerges as crit
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care teams must therefore be traine
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3. Team composition Today’s healt
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always be to move as quickly as pos
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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
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From this conceptual, background Po
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Com peting Values M odel Internal H
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care and of taking into considerati
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derived from 100 teams, examining t
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Rational Goal Objectives Example In
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Human Relations Objectives Example
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contingencies for each indicator, t
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Centre Steven Campbell Research Ass
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Appendix III Effectiveness Measures
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Objective: Promote, maintain and im
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Effectiveness To what extent......
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Relevance To what extent...... Are
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∗ If the measures suggest that th
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Measure 4 - Patient access to consu
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Next steps • Compare the average
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whether steps could be taken to ens
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Measure 8 - Patients have access to
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Objective: Efficient Use of Resourc
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Date: Day of week: Name: Job title:
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Measure 11 - Patients/clients who d
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Measure 12 - Efficient use of admin
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Objective: Continuous personal and
Page 301 and 302:
Measure 16 - Team members use each
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Objective: Responsiveness to client
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Measure 19 - Patients’ experience
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5. The last two times that you aske
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18. In the last month: How many mor
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___________________________________
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Letters were sent to all the primar
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(ii) The principles of effective te
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• Which aspects of the PHCT servi
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the person’s environment such as
Page 321 and 322:
Handout 3 Practical tips and guidel
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‘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
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Teamworking Mechanisms for reviewin
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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
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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.
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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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The Effectiveness of Health Care Teams in the National Health Service

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