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A team is a group of individuals who work together to produce products or deliver services for which they are mutually accountable. Team members share goals and are mutually held accountable for meeting them, they are interdependent in their accomplishment, and they affect the results through their interactions with one another. Because the team is held collectively accountable, the work of integrating with one another is included among the responsibilities of each member. "ZWhy team-based working?(  TTeamwork in healthcare  Research evidence++(*            Implications  *A significant improvement in appraisal is associated with a reduction of 12.3% of the number of deaths after hip fracture 25% more staff working in teams is associated with 275 fewer deaths per 100,000 following emergency surgery or 7.1% of the total number of deaths following emergency surgery +Z+ +   Benefits due to:(  0Input-Process-Output Model of Team Effectiveness11 0   Leadership and Teams$ Leader attention, measurement, rewards and control Leader reaction to critical incidents Leader role modelling, coaching Criteria for recruitment, promotion and retirement Formal and informal socialising Recurring systems and procedures Organisation design and structure Design of physical space Stories and myths about key people and events Formal statements, charters Edgar ScheinVr P-P -Ps y  "Reflexivity and Team Effectiveness##("   Failures of team-based working(        Teams and Structural Awareness(   *Teams  Human Factors    PTeams  Human Factors and Systems Design))$(   PTeams  Human Factors and Systems Design))((   What gets in the way?(   /8-  ` ̙33` ` ff3333f` 333MMM` f` f` 3>?" dd@,?dd@ f  @ ` n?" dd@   @@``PR    @ ` ` p>> [S(    <D4 ?P 4 V Click to edit Master title style! !   6$4 ? 4 RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S   64 ?`` 4 a*    64 ?`  4 c*    6$4 ?`  4 c*  B  s *f޽h ? ̙33 Default Design8 0 0xH(  x x 0d P   4 _*    x 0    4 a*   d x c $ ?  4 x 0  @ 4 RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  x 6 `P  4 _*    x 6 `  4 a*   H x 0޽h ? ̙3380___PPT10.}` ~v X(  X X  0d4?E 4 S"  X  `? 11ȜȜ? &Y iHoward Arthur Director Team Resource Management and Patient Safety NHS Clinical Governance Support Team&j " ji "6?@`NNN?Nm X  `$? 11ȜȜ?vT  'Reducing Error and Learning from Errors&( " (' "6?@`NNN?NH X 0޽h ? 3380___PPT10.0@  ( @ (    Hd ?P  ' `2  s *6-"`  0$@t hTeams and team workingf `2  s *7"`  02uy r Evidence to support team working!!f  `2   s * 66 "`   0S t  `Team processesf `2   s * 6_ "`   0j t  jBarriers to team workingf H  0޽h ? ̙3380___PPT10.-$NQ  PLy(  L L  xaxa1 ?  ' c"$` 6 L  xaxa1 11ȜȜ?Y  ' c"$`  L C xxaxa? 111ȜȜ?u[ YMohrman, Cohen & Mohrman (1995). Designing Team-Based Organisations. London: Jossey Bass,Z8 " ZZH    "6?@`NNN?NH L 0޽h ? ? @]=i=$   f^`D(  Dx D c $DP  ' B D H'Gy` ,$D  0 X Patient care      B D H'Gy  ,$D 0 `Employee involvement    B D H|'Gy ,$D 0 aChange and innovation    B D H'Gy ` ,$D  0 ]Staff well-being   H D 0޽h ? ̙33NF___PPT10&+D*' = @B D' = @BA?%,( < +O%,( < +D' =%(%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*D%(D' =+4 8?dCB1+#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*DD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*DD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*D%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*DD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*DD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*D%(D' =+4 8?dCB1+#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*DD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*DD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*D%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*DD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D++0+D ++0+D ++0+D ++0+D +     pt (  t t Ht' ?z  ' `2 t s *d@"` t 0T}'],} q!Reduced hospitalisation and costs""f! `2 t s *d}"` t 0ԁ', jImproved service provisionf `2  t s *Pd"`  t 0~', bReduced error ratef `2  t s *dC "`  t 0t~'`,f  {+Lower patient mortality and improved health,,f+ `2  t s * dT "` t 04'q ,  mEnhanced patient satisfactionf `2 t s *7 d "` t 0' ,  oStaff motivation and well-being f `2 t s * d)"` t 0}'F ,f kInnovations in patient caref H t 0޽h ? ̙3380___PPT10.p/S   l d  x (  x`2 x s *7"`3 x 0Ԅ',v mCollaboration between surgeons, anesthesiologists and nurses related to risk-adjusted morbidity and mortalitynnf(   <  x 0't 2Young et al. (1997). Health Care Management Review332 `2  x s *7""`  x 0'?v+ SBetter coordination among clinical staff is associated with lower mortality in ICUsTTfS   x 04'2,  0Knaus et al. (1986). Annals on Internal Medicine11 + `2  x s *  5 "`  x 0T'R I>  ZCollaboration between physicians and nurses was related to better patient outcomes in ICUs[[fZ  x 0T$ ,  #Baggs et al. (1992). Heart and Lung$$  `2 x s *s   "` x 0 I NPrevention of patient injury and medical malpractice claims in Perinatal UnitsOOf(?     x 04'Y 3Knox et al. (1999). J of Healthcare Risk Management443 H x 0޽h ? ̙3380___PPT10.q  $>(  $ $ 0A ??:8 $D  0 $ 6  `Mean mortality index(2   $ 0` ` c%staff working in teams(2   $ <Z aWEST et al 2002 H $ 0޽h ? ̙33___PPT10+DV' = @B D' = @BA?%,( < +O%,( < +DH' =%(%(D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$D' =%( DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*$%(D' =-s6Bwipe(down)*<3<*$+0+(+$ 0+Fa  ph,(  , , C Wdf?implicationsImpactx , c $tP  ' x , c $@` ' H , 0޽h ? ̙33y___PPT10Y+D=' = @B +   tl4(  4 40 TA ?1 ?I h $  00  4 Txaxa1?a   G% 2   4 <) Team working and stress (2,200)D (2 H 4 0޽h ? 3eX{IZ(aI  8R(  8~ 8 s *P   6 8 # l3fd?p V ,$D  0 fBuffered from organisation   * 8 # lV @?pC; ,$D  0 ZSocial support$  $ 8  fD33?pc,$D  0 Z Role clarity $  B 8 s *f޽h ? ̙33___PPT10.+ JD%' = @B D' = @BA?%,( < +O%,( < +D' =%(DU' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*8%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*8D#' =+4 8?nCB!#ppt_y+#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*8D' =+4 8?\CB#ppt_wBCB#ppt_wB*Y3>B ppt_w<*8D' =+4 8?RCBBCB#ppt_hB*Y3>B ppt_h<*8D' =%(DU' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*8%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*8D#' =+4 8?nCB!#ppt_y+#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*8D' =+4 8?\CB#ppt_wBCB#ppt_wB*Y3>B ppt_w<*8D' =+4 8?RCBBCB#ppt_hB*Y3>B ppt_h<*8D' =%(DU' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*8%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*8D#' =+4 8?nCB!#ppt_y+#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*8D' =+4 8?\CB#ppt_wBCB#ppt_wB*Y3>B ppt_w<*8D' =+4 8?RCBBCB#ppt_hB*Y3>B ppt_h<*8++0+8 ++0+8 ++0+8 +9     |9 (  | | H ?    | <d$'D UInput  | <$4  _Group Processes  | <$t'D WOutputs  | 0 <  (  | 6D̙  PTeam task and composition Team task Clear roles Team Diversity Size Group tenure.Qf7fP "`  | < C  8Organisations Culture and structure Support for teamwork.9f+f8 "`r  | s *f3C"?r  | s *f3C"?#  | <M   WObjectives Participation Quality emphasis Support for innovation Leadership ReflexivityXXfW "` | s *d̙6 /Effectiveness, Innovation and Member well-being00f/ "`LB | c $DfogoLB | c $Dfo$LB | c $Dfogg$H | 0޽h ? ̙3380___PPT10.rV  =5P(  Px P c $$   x P c $ )   P < ?Y@ Teams need leaders. They also need appropriate leadership. The factors that most influence changes in team and organisational behaviour in order of impact are:f "0 NNN?NH P 0޽h ? ̙3380___PPT10.X0X5  (    Hd4 ?z   `2  s *MH"`S  04  Teams are more effective and innovative to the extent that they reflect upon their objectives, strategies, processes and environments and make changes accordingly.f   0$4 7  O(Relationship between team based working, reflexivity and external evaluations)PPO H  0޽h ? ̙3380___PPT10.s~    H(  H6R H  fD433` ` 0,$D  0 lCooperation across teams -R H Z433` ` ,$D  0 oAutonomy and responsibility &R H Z433` @ 0,$D  0 hThe tasks for teams -R H Z433` @ 0,$D 0 oBuilding team organizations x H c $4,   H H 0޽h ? ̙33NF___PPT10&+kvD*' = @B D' = @BA?%,( < +O%,( < +D' =%(%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*H%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*HD' =+4 8?dCB1+#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*HD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*H%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*HD' =+4 8?dCB0-#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*HD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*H%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*HD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*HD#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*H%(D' =+4 8?dCB1+#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*HD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*H++0+H ++0+H ++0+H ++0+H +  UM0`(  ` ` <4S  [ L = P + Q `f   ` <4 S r Reg Revans *   H ` 0޽h ? ̙3380___PPT10.gh  og@h(  h h H4 ?M  4 `2 h s *X"` h 0D4j [ Ambiguity f  `2 h s *X"` h 04j lFixation or pre-occupationf `2  h s *X"`  h 04j lConfusion or empty feelingf `2  h s *Xn"`  h 04j 8No one  flying the aircraft f `2  h s *XP"` h 0D4j DNo one  looking out of the window ##f" `2 h s *X3 "` h 0D4pjj  pUse of undocumented proceduresf `2 h s * XD "` h 0D4q jk  z(Violating statutory or minimum standards))f( `2 h s * X& "` h 0E4T jN  jUnresolved discrepanciesf `2 h s * X "` h 0dF4F j@  iFailure to meet targetsf `2 h s *s X "` h 0F4( j  2Departure from standards, protocols and guidelines33f2 `2 h s *.X"` h 0G4 j kIncomplete communicationsf `2 h s *>X"` h 0DH4j lTask overloaded/saturationf H h 0޽h ? ̙3380___PPT10.hP%  "P (    HI4 ?,  4 `2  s *MH"`  0I4 p Operating in an imperfect system!!f  `2  s *#H"`  0J4 kManaging threats and Errorsf `2   s * G "`   0DK4  ^Team Processesf `2   s * G "`   0L4   eSituational Awarenessf H  0޽h ? ̙3380___PPT10. *e   `de(  d d HL4 ?M  4 `2 d s *kd"` d 0$M4, lAvoid reliance on memory  at individual or team level77f6 `2 d s *d["` d 0M4x, XSimplify f `2  d s *d "`  d 0N41,Q  Z Standalone f  `2  d s *4 d "`  d 0dO4 ,  u%Use constraints and forcing functions&&f% `2  d s * d "` d 0$P4 ,  mUse protocols and check listsf `2 d s * d9"` d 0V ,v aTrain and developf H d 0޽h ? ̙3380___PPT10.gE)  pl)(  l l Ht ?z   `2 l s *>d"` l 0ԫ, KBriefing helps get everyone on the same page and sets the tone for the teamLLfK `2 l s *d"`G l 04,w  It is much easier to monitor a plan, change and adapt it, if you know what the plan is, what the desired outcome is and that your input be well coveredf `2  l s * d) "`  l 0F ,f  cHelps and surprisesf H l 0޽h ? ̙3380___PPT10.k@'f   pf(  p p H ?z   `2 p s *"` p 0t/XO aHierarchy / powerf `2 p s *}"` p 0Ԯ"X( 7Lack of common mental models / language / understanding88f7 `2  p s *}  "`  p 0" XB  nLack of education and trainingf `2  p s *z "`  p 0 X% jNot wanting to look foolish  asking stupid questions66f5 `2  p s *]  "` p 0 X"  r"Lack of process support / coaching##f" H p 0޽h ? ̙3380___PPT10.o! 0 (q(  (d ( c $x   ' ( s *4x @  ' [5Staff management practices and mortality in hospitals 6 H ( 0޽h ? ̙33 0 0(  0d 0 c $x   y 0 s *x @   Leadership in the 21st Century is about focusing much more on people issues - we are all good at strategy or we can pay someone to be. We need leaders who are people focused. What are the human needs leaders need to focus on?  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