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Saturday, March 26, 2011

The many faces of team building entities

This week I attended two distinctly different activities which on the surface had little in common, but upon further reflection had much in common. Earlier this week I attended the IHI conference on Ambulatory care in Dallas. I am particularly interested in data collection approaches which can facilitate improvement of care in the ambulatory setting, something which has lagged similar efforts in the inpatient environment.

I go to a variety of professional meetings and there is generally some degree of uniformity of focus and status of attendees. Basically most are physicians or PhD researchers.  This meeting was very different in that attendees represented a huge spectrum encompassing the entire spectrum of professions involved in health care, including Doctors, PhDs in all types of disciplines, RNs, nurse practitioners, social workers, administrators, CEOs, CFOs, and representatives from professional groups.

The message which unified all of these participants was clear; we are all committed to improve patient care and that taking care of patients is a team activity. The keynote addresses took on an evangelical characteristic, While I did not hear any amens or praise the Lord from the audience, if I had it would not have appeared particularly out of place. The audience was filled with true believers. While they might not have shared common training or done similar jobs, the audience shared a common belief set and most worshiped at the altar of safety, quality, and patient centered care. This belief set is a powerful motivator of team based activities in the health care environment and it serves to create operating units over the entire country and the world.

This weekend I attended a bar mitzvah at an orthodox Jewish Synagogue. It was the bar mitzvah of the son of a close friend, whose family had been associated with this congregation for many generations. The sanctuary was filled with worshipers who shared a common vision of their history and beliefs, linked by age old rituals. They came together to celebrate the coming of age of one of their own, much as their parents had done previously, and their parents prior to them.  This congregation is a long standing cohesive entity, a team which creates and maintains structures which serve people in the present, supports those who have served diligently in the past, and prepares those to serve in the future.

Motivating people to behave in ways which creates and supports a better life for more people is all about working together in teams.There is no right answer as to how best to do this but there can be little doubt that as the world gets more complex, the need for tools which facilitate the development and sustaining of teams will become more and not less important. While financial resources allow for certain things to happen, they do not guarantee them. There are only certain things that can be purchased.

Teams function best when tasks they take on require contributions from more than one person to succeed, that those involved have access to the tools they need to succeed, and when those involved have common beliefs regarding what they are trying to accomplish. I found it remarkable that these elements were shared between the IHI attendees and the attendees of the bar mitzvah.

1 comment:

  1. There may be more than one right answer as to how to organize teams for effective execution of their responsibilities, but there is one essential criterion for success and that is leadership. In many of today's organizational structures, and particularly in medicine, there is the notion that because everyone's contribution to teamwork is essential for success that everyone's individual perspectives, decisions, actions must be equally valued. It is good management to solicit and consider the views of all involved parties to an enterprise. It is poor leadership to accommodate everyone's perspective on how mission accomplishment should be achieved. Leadership is about decision making and leaders only emerge when challenged, rewarded and elevated for making effective decisions. Much of what passes for leadership in medicine today is piecing together compromised solutions to problems so as to accommodate all of the parties sitting at the table and meet the demands of a highly regulated environment. While compromise in the face of externalities such as we practice in today is sometimes necessary, it should be noted that a compromise is a decision that no one wanted in the first place. Developing leaders, rather than administrators, is a difficult task and not one done without conscious effort initiated by those already in leadership roles. Developing leaders also means tolerating failures on the way to leadership maturity. Risk averse and zero tolerance environments do not nurture potential leaders. And most certainly leadership will not emerge in an environment like children's sports today, where no score is kept and everyone goes home with a trophy. Egalitarianism may massage the egos of all of the members of a team but it does not work when difficult decisions need to be made. Good leaders are needed to make good decisions that make for effective teamwork. And good team members value good leadership above all, for their individual success is dependent upon it.

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