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U.S. Department of Health and Human Services
Health Resources and Services Administration
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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 5: Stages of Team Growth 

According to The Team Handbook, teams go through fairly predictable stages of growth as they learn to work effectively together. (4) The following subsections briefly describe each stage.

Stage 1: Forming

At this stage, team members are exploring the boundaries of acceptable group behavior and are trying to establish their positions and status within the team. While being somewhat excited about the opportunity to be on a team, they may be suspicious and anxious about the job ahead. It is normal at this stage to see little progress, as the team may complain about the task and have lofty, abstract discussions, which cause some members to become impatient.

Stage 2: Storming

At this stage, team members realize the task is different and more difficult than first imagined. Some may become impatient with the lack of progress and begin to assert their ideas, resisting the need to collaborate. Some simply withdraw as discussions become contentious and argumentative. They are beginning to understand one another and realize how the different communication and social styles are affecting them. Storming takes on many different forms, but it almost always occurs before progress can begin.

Stage 3: Norming

This is the stage team members begin to accept the individuality of each person, trust the ground rules to maintain equality in the process, and realize competitiveness must yield to cooperation. They look forward to the contribution of others on the team, and a sense of team spirit and dedication to a common goal unfolds. With this shift in team energy, they start to make significant progress.

Stage 4: Performing

Team members now have insights into personal and group processes in this stage. They recognize, and even anticipate, how they can each contribute to the mission. They quickly identify and resolve interpersonal communication problems and develop a synergy that enables rapid progress.

Evidence about the characteristics of successful teams can be gleaned from understanding the pitfalls associated with failure. In the Risk of Quality Team Project Failure Index (RTFI), the following characteristics can be extrapolated as correlating with success or failure of the team:

  1. Training regarding teamwork, quality methods, and problem solving sequences
  2. Facilitation skills
  3. Measurable objectives
  4. Visible senior leadership support
  5. Regular meetings at minimum monthly
  6. High percentage of team member attendance at every meeting
  7. Small tests of change that can be successfully implemented in a short time
  8. Disciplined to follow change methodology

Regardless of the strategies employed, leading a QI team requires a balance of cheerleader and task master. Knowing team dynamics, understanding differing proclivity to change, and bringing the best out in individuals all contribute to a successful QI team.

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