MAY 2006 CREATING AND MAINTAINING HIGH-PERFORMANCE TEAMS

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1 MAY 2006 CREATING AND MAINTAINING HIGH-PERFORMANCE TEAMS Greetings from Carol Stone This issue of our newsletter focuses on creating and maintaining highperforming teams. Value Analysis Professionals sit on, direct, and rely on a number of different types of teams. Standing committees, ad hoc committees, functional departments, and institution/vendor teams all need your guidance, presence, and constant attention. We ll look at some of the theories behind creating high-performing teams, and then, as always, apply them to situations you are likely to encounter in your everyday activities. I hope you enjoy this issue. I appreciate your feedback, so please me with any comments or suggestions. And, if you know of others who would like to receive the newsletter, we would be happy to add them to our distribution list. me at [email protected]. Carol Stone Vice President, Corporate Marketing C. R. Bard, Inc.

2 CREATING AND MAINTAINING HIGH-PERFORMANCE TEAMS: T HEORETICAL P ERSPECTIVE In The Wisdom of Teams (Boston, MA: Harvard Business School Press, 1993), Jon Katzenbach and Douglas Smith define a team as "a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable." A team is inherently different than a work group or a committee. The work of a team is enhanced by collaboration, the need for and ability of the performance of the whole to exceed what could be achieved individually, and a common purpose. The goals and role of a team are different, and go beyond sharing of information or reporting of results from individual to individual, as might be the case with a committee or work group. Katzenbach and Smith provide excellent, usable distinctions to differentiate among the kinds of groups that may be found in contemporary organizations. TEAM, WORKING GROUP, OR NEITHER? 1 Working group: No significant incremental performance need or opportunity that would require it to become a team. The members interact primarily to share information, best practices, or perspectives and to make decisions to help each individual perform within his or her area of responsibility. There is no call for either a team approach or a mutual accountability requirement. 2 Pseudo-team: This is a group for which there could be a significant, incremental performance need or opportunity, but it has not focused on collective performance and is not really trying to achieve it. It has no interest in shaping a common purpose or set of performance goals, even though it may call itself a team. Pseudo-teams are the weakest of all groups in terms of performance impact. In pseudo-teams, the sum of the whole is less than the potential of the individual parts. They almost always contribute less to company performance needs than working groups because their interactions detract from each member's individual performance without delivering any joint benefits. For a pseudo-team to have the option of becoming a potential team, the group must define goals so it has something concrete to do as a team that is a valuable contribution to the company. 3 Potential team: There is a significant, incremental performance need, and it really is trying to improve its performance impact. Typically it requires more clarity about purpose, goals, or work products and more discipline in hammering out a common working approach. It has not yet established collective accountability. Potential teams abound in organizations. When a team (as opposed to a working group) approach makes sense, the performance impact can be high. The steepest performance gain comes between a potential team and a real team; but any movement up the slope is worth pursuing. 4 Real team: This is a small number of people with complementary skills who are equally committed to a common purpose, goals, and working approach for which they hold themselves mutually accountable. Real teams are a basic unit of performance. The possible performance impact for the real team is significantly higher than the working group. 5 High-performance team: This is a group that meets all the conditions of real teams and has members who are also deeply committed to one another s personal growth and success. That commitment usually transcends the individuals. The high performance team significantly outperforms all other teams, and outperforms all reasonable expectations given its membership. It is a powerful possibility and an excellent model for all real and potential teams. These distinctions between a team and a work group are very important because the way the group perceives itself, and how it operates, affects: The ability of people to contribute to the organization. Personal growth and satisfaction of group members. The return on resources (time, talent, money, etc.) expended by the group. The requirements for operating, growing, and maintaining the group. So... The fundamental factors that distinguish between work groups and real teams are the presence or absence of: A need or opportunity for enhanced performance. True interdependence of group members. Shared accountability for accomplishing a common goal.

3 Examples of situations where teams are needed could include sports teams or emergency room trauma teams. For both of these, there is a key performance need or opportunity, true interdependency and shared accountability. If these types of groups do not function as a team, the result is disaster. Clerks in a department store or waiters in a restaurant are examples of perfectly satisfactory work groups. In each one of these groups there can be similar individual objectives, but a lack of any group common objective. There is some form of coordination or collaboration, but usually not shared accountability or interdependency. Can only cross-functional groups be teams? Whether or not a group is defined as a team depends upon the presence of an incremental performance need or opportunity, true interdependence, and shared accountability, not crossfunctionality per se. You don't have to be a cross-functional group to be a team. However, many incremental performance needs or opportunities require a cross-functional approach to be addressed effectively. It is also helpful to remember that, while complementary skills among team members usually stem from differences in technical or functional skills that are job related (e.g., marketing, finance, clinical skills), complementary skills can also be viewed more generically, i.e., problem-solving, decision-making, and interpersonal skills. The length of time a group will be in existence should not generally define the group, unless the time frame for the life of the group is so short that it would be impossible to create a real team. Short- and long-term groups, permanent or semi-permanent (membership may change) groups, or temporary groups can be either teams or work groups. One of the most powerful actions a group can take is to determine what kind of group it currently is and what kind it needs to be to best serve the goals of the organization. Once defined, the group can operate and plan its own development with clear insight about its role. Depending on the type of group required, decisions can be made about the level of investment to make in the group. And remember, there are times a work group is a perfectly acceptable (sometimes preferable) option, if a true team is not needed for the situation or task at hand. FOOD FOR THOUGHT Pseudo-teams, potential teams, and high-performance teams exist in all of our institutions. Because of the many benefits that high-performance teams bring to the organization, it is desirable to encourage and nurture them where they exist to serve a significant performance opportunity. Potential teams should be assisted to move toward real team functioning. Pseudo-teams are very expensive to an organization because they consume resources without a commensurate return. A pseudo-team should be analyzed to determine if it should become a team or a work group, whichever is most appropriate for the specific situation. As an exercise, it might be helpful to identify the types of groups you work with, and think about what kind of group they currently are, compared to what kind of group they could be. Some examples to get you started below. Group/ Team Status Now Meet the Criteria of a Team? What Should it Be? Characteristics of High-Performing Teams Team members: Share a common purpose / goals Build relationships for trust and respect Balance task and process Plan thoroughly before acting Involve members in clear problemsolving and decision-making procedures Respect and understand each others "diversity" Value synergism and interdependence Emphasize and support team goals Reward individual performance that supports the team Communicate effectively Practice effective dialogue instead of debate Identify and resolve group conflicts Vary levels and intensity of work Provide a balance between work and home Critique the way they work as a team, regularly and consistently Practice continuous improvement Copyright 1998 by Reid Moomaugh & Associates. Permission is granted to reproduce this document for training and education.

4 CREATING AND MAINTAINING HIGH-PERFORMANCE TEAMS: P RACTICAL P ERSPECTIVE What Kind of Group Is Needed? Sometimes, there is a need for a team. Perhaps a health system has decided to purchase and install a completely new ordering and financial management system to integrate several different locations. In this scenario, a team may be needed to understand all of the issues likely to arise, and to address those issues early on in the transition process. In other situations, a work group may be just fine. A work group may be all that is needed when there is an ongoing, routine requirement to report or share information perhaps sharing overall expenditures and use of linens, for example. So, before trying to convert a work group into a highperforming team, first step back and determine what the true role of the group is, and what it should be. Is the group in question a real team or a work group or something in between? What type of group is needed for the situation? Is a committee or a functional work group just fine, or is a true team necessary to the task at hand? Clearly, and accurately, defining the role of the group, considering the broader goals of the organization, can save time and effort that would be wasted trying to make a perfectly satisfactory work group operate according to much higher expectations associated with a high-performing team. Meshing Different Personalities of Team Members A high-performing team cannot be created without recognizing that the team is comprised of individual members. The personalities of team members shape the team. Team members may automatically gravitate to roles on the team that feel most comfortable, or, members can be assigned specific roles by the team leader. On the team, there should be someone who is task focused, someone who is people focused, someone who is a true visionary, and someone who is a great facilitator. Taking advantage of innate strengths and preferences allows team members to contribute more, and to enjoy being part of the team more. Many problems with teams stem from trying to harness and redirect different personalities on the team. Members come to the team with different skills, histories, backgrounds, training, and inherent personality traits. All of these impact team behavior. The uniqueness of individual members can manifest in team behaviors that lead to: Members who dominate discussions/members who never contribute; Too much discussion/not enough discussion; Revising decisions/making decisions too quickly; Too much analysis/not enough analysis; Too much/not enough structure around team operations; Conflict between members/ ambivalence between members. It is up to the team leader to know the individuals on his or her team/and to be constantly vigilant about how the personalities of individuals are impacting the success of the team. Team leaders may find that different personalities are needed at different stages of the team s work. In the early, forming stages of the team, it may be important to have strong innovators to help set team direction, individuals with a people focus to help the team bond, and strong facilitators to allow the team function as a new group. Over time, what is needed from members may change. It may be important to have individuals strongly focused on task, to help the team achieve goals on time, individuals with analytical skills, to ensure that decisions are made with the appropriate amount of information, or individuals with good communication skills to keep the broader organization and management well informed about the team's activities and progress. Ideally, team members should be able to adapt so that they can play the right role on the team at the right time. Good team leaders will recognize the changing needs of their team, and guide team members into new roles as necessary. Dealing with the One Bad Apple Often on teams there is one individual who just doesn t fit. Team leaders try to ignore this one individual, assuming that if the rest of the group is functioning well this person won t impact much. This is generally not the case. It is painfully obvious to each member of the team that something is wrong. Inordinate amounts of energy are spent attempting to integrate or accommodate the team member that is not a fit. When this situation occurs, it is imperative that the team leader act quickly to either resolve whatever issues are creating a problem with this team member, or act to have this member immediately replaced. What Is an Effective Team Member? A good team member: Puts team goals above his or her personal goals and ego Supports other team members Is open to new ideas Shares information and ideas with others Recognizes and utilizes differences in others Participates fully on the team by sharing ideas and asking questions Keeps commitments gets done what has been promised, on time, in a quality way Understands and fulfills his or her role on the team

5 SHARE Your VIEW Donna Samuels has been a Value Analysis Manager for the last 5 years. She is responsible for managing several work groups and teams, including the Product Analysis Committees, the Service Line Team for Cardiology, and the Product Utilization Committee. Her groups tend to spend countless hours in meeting, discussing, debating, and revisiting decisions. After a while, team members avoid coming to meetings because they are so frustrating. In her most recent performance review, running teams was highlighted as an area of poor performance for Donna, and her supervisor stressed the need for improvement in this area. He noted that teams and teamwork are the ways that the department gets things done in the institution, and reminded Donna that if she couldn t manage and develop her teams, her position would be in jeopardy. Donna used that performance review as a real wake-up call, and she is now interested in learning everything about high-performance teams, and doing everything she can, to get each of her groups to operate as a high-performing team within the next 6-12 months. Where does she begin? SCENARIO 1 Donna should immediately take a course on developing highperformance teams. She doesn t have much time, so she should bring back as much information as possible from the course to share with team members. SCENARIO 2 Donna should immediately hire a consultant to work with each of her teams and help them to become a high-performing team. Each and every team should develop a mission, purpose, norms, and expectations for group members. If people know what they are supposed to do, and how to do it, the performance of the groups will automatically be enhanced. SCENARIO 3 Donna should first take a step back and determine the role of each of the groups she works with. Should some function as a work group simply reporting on information? Should some operate as a team? Why? Are there groups operating as a pseudo-team that need a better definition? This preliminary background work is necessary before Donna and her teams invest the time and resources necessary to transform a group into a high-performing team. your thoughts on this case to [email protected]. A sample of responses will be published in the next issue. Teams can be formed to make decisions or implement decisions. It is important to select team members based on the team s purpose. Every team member should be clear about the reason that they are on the team, what they are expected to contribute, and what role they need to play in their functional areas as the team representative, and what decisions they can make. What s Your Reality? Suggestions for dealing with daily issues... Most experts writing about enhancing team performance concentrate on criteria that look inward at the team s mission, norms, composition, activities, and resources. In his book, The Ten Minute Team, Thomas Isgar focuses on the fact that the work of a team touches and impacts many people in an organization beyond the team itself. He contends that a highperforming team considers external influences, as well as their internal processes. Some external stakeholders have information or resources important to the team s goals, and so should be identified and utilized. Some external stakeholders may have the power or authority to undermine the team s activities. These people should be carefully included in the team s activities to be sure they are well informed, and to ensure that differing opinions and concerns are addressed. High-performing teams have someone who coordinates the team s activities and serves as the communication liaison between the team and outside groups. Often, that is the role of the Value Analysis Professional. The Value Analysis Professional, as the team leader, needs to make sure the team has looked inward clarifying mission, goals, objectives, and norms for operating. He or she also needs to make sure the team has looked outward identifying those individuals touched by or impacted by the team s activities. Who are some of those individuals for your key groups? Have you thought about ways to integrate them into the overall team process?

6 SHARE YOUR VIEW... In the last issue, we met Cindy Mano, just hired as a new Value Analysis Coordinator. Cindy was experienced as a critical care nurse, but brand new to Value Analysis. Her manager left her without much direction, thinking she was ready to act on her own considering she knew the institution and the players. Unfortunately, without any formal training, Cindy was less than successful, and ultimately returned to clinical nursing after a year. We offered three scenarios for Cindy and her manager. SCENARIO 1 The manager should have spent at least an hour with Cindy explaining her role and his expectations. Yes, the manager should have spent more time with Cindy initially. However, he also needed to spend time with her on an ongoing basis, or assign her, or help her to identify a mentor. Just because she knew the institution and people, she didn t have a clue about the value analysis process. Too bad a potentially effective employee was soured on the process by a bad orientation. SCENARIO 2 The manager needs to delegate, reduce his stress and therefore be more satisfied with the work of his employees, including Cindy. This could be one piece of the puzzle. If the manager is really too busy to manage, he needs to find a way to delegate some of his work, so he can do the important tasks associated with being a manager including training new employees. If his department becomes a revolving door of employees in and out because they are never incorporated into the department appropriately, he ll never get ahead. He ll probably be the next one out the door either because he'll be fired, or burned out. SCENARIO 3 The manager should recognize that even though Cindy had been employed by the hospital for 16 years that Value Analysis was completely new to her. He needed a formal training plan to help her transition from clinical to business goals. This is the crux of the issue. Value analysis skills and tasks are very different from clinical skills and tasks. The Value Analysis Professional needs to understand financial terms, financial management, cost structures, reimbursement structures, accounting, contracting, and a whole host of areas that are very different from what a clinical nurse needs to know to do her job. The manager really should see these differences and have a training program in place. The clinical skills and background are a tremendous asset to the Value Analysis Professional but they are now only a piece of Cindy s job. EDITORIAL BOARD Cindy Abele, RN Clinical Standardization Manager Covenant Health System, Knoxville, TN Michelle Allender, RN, MS Corporate Director, Clinical Resource Management Bon Secours Health System, Inc., Marriottsville, MD Angela Barker, RN, CNOR, CRNFA Resource Utilization Manager Franciscan Missionaries of Our Lady Health System, Baton Rouge, LA Wendy Lemke Editor Manager, Corporate Marketing C. R. Bard, Inc., Murray Hill, NJ [email protected] Carol Stone Editor-in-Chief Vice President, Corporate Marketing C. R. Bard, Inc., Murray Hill, NJ [email protected] Gina Thomas, RN, CMRP Director H*Works The Advisory Board Company, Washington, D.C. This newsletter series is sponsored as a service for the value analysis, contracting, and materials management professionals by C. R. Bard, Inc. Comments or suggestions on newsletter format or topics of interest may be forwarded to Margaret Gardner, Global Medical Communications LLC, [email protected] or (908) This newsletter is produced by Global Medical Communications LLC, Somerville, NJ on behalf of C. R. Bard, Inc., Murray Hill, NJ Sources used for this issue include: 1. Ten Minute Team by Thomas Isgar. Boulder, CO: Seluera Press, Wisdom of Teams by Jon R. Katzenbach and Douglas K. Smith, Boston, MA: Harvard Business School Press, 1993.