Improvement Teams

Part 1: Introduction

Part 2: The Power of Teams

Part 3: Selecting Members for a Team

Part 4: Defining Roles and Responsibilities

Part 5: Stages of Team Growth

Part 6: Tips from Successful Teams

Part 7: Supporting Information

Part 6: Tips from Successful Teams 

In addition to the prerequisites previously mentioned, successful teams emphasize the importance of an organized infrastructure to support the work. This section discusses tools that facilitate ground rules for meetings and effective meeting processes, including use of agendas and discipline for documenting the work.

Ground rules are a code of conduct for meetings. This is particularly important for Quality Improvement Teams as members should participate equally, regardless of the hierarchical role they may have in the delivery of care. Putting these rules on the table in the beginning facilitates the team dynamics by making the expected behavior explicit. Typically, ground rules are discussed and agreed to early on at an initial meeting of the team. Again, there are no required ground rules, but these are examples of those that teams often adopt: (5)

• Start the meeting on time
• Have a prepared agenda with an objective and expected outcomes
• End the meeting on time
• Parking lot discussion items that don't relate to this meeting's objective
• Complete action items as committed
• One person speaks at a time
• All team members are equals
• Leave rank at the door
• Address conflict by dealing with the issue not the person
• Turn of cell phones / pagers
• Notify the team in advance if you will be absent
• Listen actively
• Be a participant, not a lurker
• What's said in the room, stays in the room
• Have fun, but not at the expense of someone else's feelings
• Be present, both physically and mentally

Having a well-defined meeting process helps the entire team focus on the important meeting tasks.

Steps to an Effective Team Meeting

1. Provide an effective environment for the meeting. Team members should be in a room or area that is conducive to good communication. They should be seated at a table or in an open-ended circle with a flipchart at one end where all team members can easily see each other and the flipchart. Make sure there is an adequate supply of markers for writing on the flipchart. If the flipchart paper is not self-adhesive, have tape available so that the filled flipchart paper can be hung on a wall where it continues to be easily seen by everyone. This process of keeping all of the information visual to everyone is an important part of empowering the entire team.
2. Clarify the purpose and objectives of the meeting. Make sure that all team members are in agreement.
3. Determine who will be the timekeeper and recorder and review at what time intervals the timekeeper should give feedback based on the ground rules.
4. Review the prior meeting's action list. This provides team accountability for between-meeting assignments and brings relevant information to the current agenda.
5. Review the meeting agenda in detail and make sure that all team members understand and agree with the agenda and its time frames. If there is disagreement, the team leader should try to get a consensus agreement from the team on how the agenda should be changed.
6. Work through the agenda items within the time allotted to each. If time runs out on any item, the team must follow the ground rules to agree on how to proceed.
7. Review the meeting record by reviewing the flipchart information recorded during the meeting. Decide which charts or information should be included in the meeting record and which should be discarded.
8. Develop the items that should be included on the next meeting agenda and determine what assignments should be given to prepare for the next meeting.
9. Evaluate the meeting by asking what the team did well and what the team could do differently to improve the meeting process. This is an important step. Any improvement opportunities should be noted in the meeting record and incorporated into the next meeting.

Meeting Agenda

In order to have an effective team meeting, the team leader should develop a meeting agenda that uses the above steps. Every team member should have a copy of the meeting agenda and agree with its content.

It is very important that the meeting agenda include the time that each agenda item will begin. The team leader estimates the amount of time for each topic when preparing the agenda. The ability to estimate the time improves with practice. Using the ground rules, the team members should agree to adjust the time whenever necessary to accomplish their goals.

The team leader can develop a template in Word or Excel for the meeting agenda based on the following sample:

Meeting Outcomes/Actions

Creating a record of the outcomes and actions from each meeting is a vital part of the team communication process. Unlike keeping detailed minutes of a meeting, the following form identifies three key components of this record:

1. The key activities and decisions reached.>
2. Actions needed before the next meeting.>
3. Improvements to be embraced during the next meeting.>

The easiest way to prepare a record is for the team leader to make notes on his or her agenda related to each outcome, action needed, and improvement. Some of the information can also be collected from the items recorded on the flipchart by the recorder during the meeting. The following model works well for a record. The record should be distributed to each team member within several days after the meeting, so that team members are reminded to follow-through on the action items.

Special Issues

Even with clear guidance and an organized approach, difficulties may arise within a QI team that has a negative impact on the work. There are several resources available that provide insights into common situations within a team, although discussion is beyond the scope of this module. The number of successful QI teams is a testament that leadership support, a clear focus, and the tools to perform the work, enable most teams to overcome their challenges and achieve their aims.

Tool	Description
Team Building	This Web site compiles important concepts on motivation and team building.
Effectively Managing Team Conflict [PDF | 154KB]	Successful managers can effectively manage conflict. This ability is considered a core competency and required for leaders who want to grow and advance their organizations.
Teampedia	Teampedia is a collaborative encyclopedia of free-team building activities, icebreakers, teamwork resources, and tools for teams that can be edited.
SWOT Analysis Template [PDF | 42KB]	This a template for guiding the team's analysis of its strengths, weaknesses, opportunities, and threats (SWOT).
Free Team Building Tools	Free tools that teams may use to build and strengthen effective team skills.

In summary, an effective team includes members with diverse thinking styles, approaches, experience and knowledge. Diversity can support creativity through various viewpoints. When people with varying viewpoints, experiences, skills, and opinions are tasked with a project or challenge, their combined efforts can far surpass what an individual can achieve.