ZAGAZIG UNIVERSITY

FACULTY OF NURSING

MASTER DEGREE

SECOND TERM

TEAM BUILDING

UNDER SUPERVISION

Dr/ Maha Abdeen

Dr/ Azza Abd-El Diem
Dr/ Aisha El-Sayed El-Araby
PREPARED BY

Heba Abd El Aziz Shehata

2020
 Outlines
1- Introduction
2- Definitions
3- comparison between Team and Group
4- purposes for Team Building
5- Advantages of Team Building
6- Disadvantages of working in teams
7- Types of teams
8- Characteristics of an Effective Team
9- Stages of team building
10- Responsibilities of team leader
11- The Nurse Manager as Team Leader
12- Evaluating Team Performance
13- Barriers to Effective Teams
14- References
15-
 Team Building

1- Introduction
Teams and teamwork are important components of the delivery of health care.
Patient care always involves input from members of different professions who work
together to coordinate care across multiple settings and during various stages of
health and illness.
The ability to communicate and work together is essential for continuity and safe
patient care, especially if medical errors are to be eliminated.
Effective administrative managers in health care organizations understand and are
able to evaluate the skills and overall strength of different team members, matching
them with jobs that are consistent with their strengths and abilities. When team
members are composed of such individuals, it is likely that the overall team will be
cohesive in unity and thus capable of collaborating effectively in the delivery of health
care.

2- Definitions

 A team

A team is a group of people who are mutually dependent on one another to achieve a
common group goal. Teams form in the workplace through administrative assignment
or appointment, and some change from day to day depending on the staffing level
and other administrative concerns, such as the level of patient acuity.
A Group
A group is not necessarily a team. A group can have individuals with varied interests,
attitude as well as thought processes. It is not necessary that the group members
would have a common objective or a common goal to achieve.
  Team building
is a management technique used for improving the efficiency and performance of the
workgroups through various activities. It involves a lot of skills, analysis and
observation for forming a strong and capable team. The whole sole motive here is to
achieve the organization vision and objectives.
Team building focuses on both task and relationship aspects of a group’s functioning
and is intended to increase efficiency and productivity
3- comparison between Team and Group

Basis for
Group Team
Comparison
A team is a group of people who
A group is a collection of individuals
share a common team purpose
Meaning who coordinate their individual
and a number of challenging
efforts.
goals.
A team can have more than one
No. of Leaders A group has only one leader.
leader.
In group the members are In Team the members are
Members
independent. interdependent.
A group focuses on accomplishing A team focuses on
Focuses on
individual goals. accomplishing team goals.
The group members do not share Team members share the
Responsibility
responsibilities. responsibilities.
The process of a group is to discuss
Team discusses the problem,
the problem, then decide and finally
Process then decide the way of solving it
delegate the tasks to individual
and finally do it collectively.
members.
Members of group are bothered by Members of a team see conflict
Conflict
the conflict. as part of problem solving.
Conflict In group there is no process for In team there is provision for
Resolution conflict resolution. conflict resolution.
In groups members are very
Freedom cautious about what they say and Open Communication
are afraid to ask questions.
4- purpose for Team Build
 The purpose of team building is to help nurse leaders understand more
about other members of the team as well as their own personal
attributes
 To build better relationships and more effective teams within the health
care workplace.
 Making the workplace more enjoyable.
 Motivating a team.
 Teaching the team self-regulation strategies
 Helping participants to learn more about themselves (strengths &
weaknesses).
 Identifying and utilizing the strengths of team members.
 Improving team productivity.
 Practicing effective collaboration with team members.
 Better performance.

5- Advantages of Team Building

 More input leads to better ideas and decisions
 Higher quality output
 Involvement of everyone in the process
 Higher likelihood of implementation of new ideas
 Widens the circle of communication
 Increased learning with shared information
 Increased opportunity to draw on individual strengths
 Ability to compensate for individual weaknesses
 Provides a sense of security
 Develops personal relationships
 6- Disadvantages of working in teams
 Requires more time.
 Can lead to many meetings.
 Often difficult to schedule mutual time.
 May take longer to make a decision.
 May be used as an excuse for a lack of individual effort.
 Personality conflicts are magnified.
 Disagreements can cause strained relationships

7- Types of teams

Three types of teams found in health care are:

1- Primary work teams

2- Leadership teams

3- Ad hoc teams

A- Primary work teams

Include all forms of operational teams, including patient care teams such as a
medical intensive care team and teams organized by a focused area , such as the
rapid response team or a quality improvement team .

B- Leadership teams

The senior executive team is an example of an executive or management –

leadership team . At the hospital department level there may be a leadership team
that is composed of the nurse manager , charge nurses and perhaps an educator.
 C- Ad hoc teams

Project teams and problem solving teams are examples of ad hoc teams found across
settings and sites. Specific problem solving teams in departments are other examples
of ad hoc teams, frequently referred to as task forces

8- Characteristics of an Effective Team

1- Clear Purpose
The vision, mission, goal, or task of the team has been defined and is now accepted
by everyone. There is an action plan.

2- Informality
The climate tends to be informal, comfortable, and relaxed. There are no obvious
tensions or signs of boredom.

3- Participation
There is much discussion and everyone is encouraged to participate.

4- Listening
The members use effective listening techniques such as questioning, paraphrasing,
and summarizing to get out ideas.

5- Civilized Disagreement
There is disagreement, but the team is comfortable with this and shows no signs of
avoiding, smoothing over, or suppressing conflict.
 6- Consensus Decision
For important decisions, the goal is substantial but not necessarily unanimous
agreement through open discussion of everyone’s ideas and avoidance of formal
voting or easy compromises.

7- Open Communication and Trust

Team members feel free to express their opinions on the tasks as well as on the
group’s operation, coupled with a high level of trust. Communication also takes place
outside of meetings.

8- Clear Roles and Work Assignments

There are clear expectations about the roles played by each team member. When
action is taken, clear assignments are made, accepted, and carried out. Work is fairly
distributed among team members.

9- Shared Leadership
Although the team has a formal leader, leadership functions shift from time to time
depending on the circumstances, the needs of the group, and the skills of the
members. The formal leader models the appropriate behavior and helps establish
positive norms.

10-External Relations
The team spends time developing key outside relationships, mobilizing resources,
and building credibility with important players in other parts of the organization.
 11-Style Diversity
The team has a broad spectrum of team player types, including members who
emphasize attention to task, goal setting, focus on process, and questions about how
the team is functioning.

12-Self-Assessment
Periodically, the team stops to examine how well it is functioning and what may be
interfering with its effectiveness.

9- Stages of team building

A-Forming
In the initial stage, forming, individuals assemble into a well-defined cluster. Group
members are cautious in approaching each other as they come together as a group
and begin to understand requirements of group membership. At this stage, the
members often depend on a leader to define purpose, tasks, and roles.
B-Storming
As the group begins to develop, storming occurs. Members wrestle with roles and
relation-ships. Conflict, dissatisfaction, and competition arise on important issues
related to procedures and behavior. During this stage, members often compete for
power and status, and informal leadership emerges. During the storming stage, the
leader helps the group to acknowledge the conflict and to resolve it in a win–win
manner.
C- Norming
In the third stage, norming, the group defines its goals and rules of behavior. The
group determines what are or are not acceptable behaviors and attitudes. The group
structure, roles, and relationships become clearer. Cohesiveness develops. The
leader explains standards of performance and behavior, defines the group’s structure,
and facilitates relationship building.

A. Performing
In the fourth stage, performing, members agree on basic purposes and activities and
carry out the work. The group’s energy becomes task-oriented. Cooperation
improves, and emotional issues subside. Members communicate effectively and
interact in a relaxed atmosphere of sharing. The leader provides feedback on the
quality and quantity of work, praises achievement, critiques poor work and takes
steps to improve it, and reinforces interpersonal relationships within the group.
B. Adjourning or re-forming
The fifth stage is either adjourning (the group dissolves after achieving its objectives)
or re-forming, when some major change takes place in the environment or in the
composition or goals of the group that requires the group to refocus its activities and
recycle through the four stages. When a group adjourns, the leader must prepare
group members for dissolution and facilitate closure through celebration of success
and leave-taking. If the group is to refocus its activities, the leader will explain the new
direction and provide guidance in the process of reforming.
 10-Responsibilities of team leader

 Assign clear tasks to each member

 Regularly review and monitor progress of work
 Ensure that the team meets deadlines
 Discuss and agree on the timetable for major activities with the team
 Motivate team members
 Resolve conflicts
 Give guidance when needed
 Helps members to overcome barriers
 Regularly assess team performance using a checklist

11-The Nurse Manager as Team Leader

Because staff nurses work in close proximity and frequently depend on each other to
perform their work, the nurse manager’s leadership is vital. A positive climate is one in
which there is mutual high regard and in which group members safely may discuss
work-related concerns, critique and offer suggestions about clinical practice, and
comfortably experiment with new behaviors. Maintaining a positive work group climate
and building a team is a complex and demanding leadership task.
Communication
Communication is a central component of the nurse manager’s leadership. The Joint
Commission, the organization that accredits hospitals, found that poor inter
professional communication was the cause of nearly 70 percent of unexpected events
causing death or serious injury (Joint Commission, 2011).
Effective nurse managers can facilitate communication in groups by maintaining an
atmosphere in which group members feel free to discuss concerns, make
suggestions, critique ideas, and show respect and trust. An important leadership
function related to communication is gatekeeping, that is, keeping communication
channels open, refocusing attention on critical issues, identifying and processing
conflict, fostering self-esteem, checking for understanding, actively seeking the
participation of all group members, and suggesting procedures for discussing group
problems.
12-Evaluating Team Performance
The manager may be accustomed to evaluating individual performance, but
evaluating how well a team performs requires different assessments. Patient
outcomes and team functioning are the criteria by which teams can be evaluated
(Rosen et al., 2008). Outcome data, such as clinical pathway information, variances in
critical paths, complication rates, falls, and medication errors, can help evaluate team
performance.
Group functioning can be assessed by the level of work-group cohesion, involvement
in the job, and willingness to help each other. Conversely aggression, competition,
hostility, aloofness, shaming, or blaming are characteristics of poorly functioning
groups. Stability of members is an additional measure of group functioning.
Influencing team processes toward the attainment of organizational objectives is the
direct responsibility of the nurse manager. By publicizing team accomplishments,
creating opportunities for team members to demonstrate new skills, and supporting
social activities, the manager can increase the perceived value of group membership.
Members of groups who have a history of success are attracted to each other more
than those who have not been successful

13-Barriers to Effective Teams

A- External barriers

 Work load: members are often required to work on their team assignments in
addition to a full workload or are given more work than they are capable of
handling .
 Team does not model the norms of behaviors that support teams in being
successful
 Inadequate recognition for individual team members: Team leaders do not
control or release the team members adequately
 Teams are not given adequate resources

B- Internal barriers

 Inadequate support from key external stakeholders

 Team members don’t set appropriate goals for the team and do not
implement a plan for reaching them
 Team members don’t spend enough time planning how they will work
together
 Team members don’t resolve interpersonal conflict.
 Team members don’t conduct efficient meetings
 Team members don’t have compatible levels of problem-solving,
analytic, or project management skills

References
Sulivan,Eleanor J.(2011),Effective Leadership and Management in
.nursing ,'Building and Managing Teams',eight edition,pp.(144-153)

Diane, L.(2011),Leadership Nursing Care Management,'Building effecyive

.teams',six edition,pp.(350-355)

.Geneva.(2007),World Health Organization ,'Team Building',pp.(8)

.Manion.(2011),Team Building and Working with effective groups,pp.(120-125)

Senn.(2000),Leadership and Management ,'Team Building',pp.(17-24).

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