Building a Group into a Team

Most people are inclined to believe that they are part of a team environment in the work place. This is common misnomer for every one of these most people. Two separate types of healthcare organizations can be identified. Healthcare Organization Group believes they are a team. Healthcare Organization Team knows the reality of being a team and functions as a team. This article examines the contrast and comparison of the two healthcare organizations, one with a group environment and the other with a team environment.

Myers Briggs (1995) states “in the latter part of the 20th century, team building became recognized by many companies as an important factor in providing a quality service and remaining competitive. Yet as we move into the 21st century, the term team building can still sometimes seem a little bit obscure. People often know that they need it, but aren't quite sure what it is” (Myers Briggs, 1995, ¶1).

Healthcare Organization Group is a private healthcare office consisting of seven employees. There is of course the owner who is one of the physicians, two other physicians, who are not partners, and four employees. These seven people are a group who are providing healthcare to the public. They are not a team. Healthcare Organization Team is a hospital owned healthcare office consisting of five employees. They are one manager, one physician, and three employees. All of these people are, however, employees of a hospital in a practice setting. These five people are a team who are providing healthcare to the public.

Hodgetts and Hegar (2008) explain that “a group is defined as a social unit made up of two or more people who interact, at some point, with each other” (p.152). Hodgetts and Hegar (2008) explain that “a team is defined as a group of individuals responsible for the accomplishment of the team's goals” (p.152). In a group everyone depends on the other, yet each person is only there to accomplish the task that is set before them. A team, however, works together and depends on each other to work toward an ultimate goal that benefits the whole team and not just the individual. The following examination will compare the team building needs of group compared with the team skills and functionalities of a team.

Healthcare Organization Group has an unclear mission statement and no vision statement. The mission statement of Healthcare Organization Group is: Healthcare Organization Group is committed to provide outstanding healthcare to you, your loved ones, and your family. At Healthcare Organization Group each person is there to provide very good healthcare to the public, yet each person has their own job duties to accomplish. This group is so overwhelmed with meeting their personal goals that they forget about the ultimate goal of providing very good healthcare to the public. They forget the mission because there is no vision to back the mission and there is no set standard of behavior to keep the focus of the members of the organization. Healthcare Organization Team, on the other hand, works together as a team to provide very good healthcare to the public. Healthcare Organization Team has a mission statement that reads Healthcare Organization Team is committed to improving the physical, emotional and spiritual health of all individuals and communities we serve; to providing care with excellence and compassion; and, to working with others who share our fundamental commitment to improving the human condition. A vision statement that says Healthcare Organization Team wants to be remembered by each patient as providing the care and compassion we want for our families and ourselves. Healthcare Organization Team also has a standards of behavior based on dignity, excellence, integrity, compassion and teamwork. This team works together and is more concerned with the ultimate goal of providing very good healthcare, that they come together to help each other complete each others personal job duties and goals. This team is kept focused on the goal by having a vision and a standard of behavior to back the mission. The goals are clearly defined and reinforced constantly and consistently to keep the mission at the forefront of the organization. Robert Bucek (2005) states “…with a team everyone shares and desires this main goal” (Bucek, 2005, ¶1).

Yukl (2006) defines a team as a small task group in which the members have a common purpose, interdependent roles, and complementary skills (pg. 319). There are multiple types of teams that exist in the world of business. Larger companies have many teams that come together to form one large team. Smaller firms may have only one team that focuses on the benefit of the ultimate goal. Hodgetts and Hegar (2008) give examples these types of teams: For example a functional team is one that focuses on one aspect of business such as finance or marketing and solves the problems related to those areas. There are also project teams that are compiled to solve problems occurring through out the company. These teams are mostly quality and productivity teams. Also there are product development teams that develop new products, task force teams who work to fix short lived projects, and work teams that that have multiskilled employees who perform tasks done by previous individuals. Finally the cross-functional team, which labels Healthcare Organization Team, is one where all the employees have a specialty, yet they can complete all the tasks outside each employee's own area of specialty adequately enough to be useful and helpful (p. 154 – 156).

A group as defined by Robbins and Judge (2007) is two or more individuals, interacting and interdependent, who have come together to achieve particular objectives (pg. 300). There are also numerous types of groups. Hodgetts and Hegar (2008) explain the types of groups: The functional group is individuals who perform the same tasks, yet they are only concerned of the benefit for their group. The cross-functional group, which is found mostly in healthcare, includes people from such areas as radiology, nursing, and administration. If the roles are clearly defined it can be successful at times. A project group is one where people come together form different departments, complete a job in a timely manner, and return to their respective departments. A virtual group is where all the members meet without being in one place at the same time. The inter-friendship group is formed on the basis of common beliefs, concerns or activities. This group functions away from the job and feelings can be carried back to the job environment and place a strain on job duties and accomplishing the ultimate goal (p.129 – 130). Healthcare Organization Group is a combination of a cross-functional group and an inter-friendship group.

There are many problems with groups. They take time to develop, and there is too much concern with roles, status, and cohesiveness. There are also communication failures and a conflict in decision making styles which cause intergroup conflict. Also there is a power struggle with groups. According to Robert Bucek (2005), “within a group, many said goals can be different for everybody and that there is not as much focus on the main objective at hand” (Bucek, 2005, ¶1).

Groups form with five stages. The forming stage, the storming stage, the norming, stage, the performing stage, and the adjourning stage are all stages of group development. Robbins and Judge (2007) explain these stages: The forming stage is the beginning stage where everyone identifies their surroundings and to carefully identify what the tasks are and how it should get started on the task. Everyone is nice and polite, and some bonds are made to disclose personal insights. Also there are early efforts made to gaining power and building influence within the group. The storming stage has confrontation and questioning of the direction of the group and resistance to task assignments. The norming stage gives agreement regarding each individual's responsibilities and gives a sense of new cooperation. The performing stage gives openness among group members and willingness of group members to monitor their own performance and make necessary changes. The adjourning stage is a stage that only occurs with temporary committees, task forces and similar groups that have limited tasks to perform. Permanent work groups end with the performing stage. This stage prepares the group for disbandment, and wrapping up the project (pg. 302). Due to these stages of development many problems may arise. Roles are developed and misconstrued. A role is an expected behavior. This is acquired from a job description, but it may be vague. This leads to role ambiguity where the employee is uncertain of their role and duty within the company. Norms are developed that do not reflect the organizations rules. Norms are set by a group of how individuals should act and only are significant to the group. Also status is challenged among employees which leads to having a group cohesiveness problem. Also communication is either non existent or there are many barriers that break down the communication system.

In order to by pass these group problems an effective team must be developed. If a group does exist, there must be a primary goal to develop the group into a team. Robbins and Judge (2007) states “team building is the high interaction among team members to increase trust and openness. Team building is a process that works best in a climate that encourages and values the contributions of its members” (p. 656). Studer (2003) states “standards of behavior provide an important foundation for the organization as it establishes the code of conduct that all employees will live by” (pg. 77). This allows for the organization to have a standard to base a culture upon and value the contributions of its employees at the same time. This gives clear boundaries that should be set between a leader and subordinates, yet allows the subordinate to feel comfortable in sharing ideas and knowledge. According to Max Wideman (2001), “investing time in developing an effective team brings many benefits. Benefits include commitment to a project, the project manager and other team members. Other benefits include a sense of purpose and camaraderie, improved communications, better conflict resolution, and increased team member job satisfaction” (Wideman, 2001, Project Team Building, slide 12). Once the culture of excellence and a clear concise standard of behavior and clear concise goals and objectives are developed, the high interactions and trust will come forth. The willingness to overcome obstacles will be easier and no barriers will be present. The excellence that team members feel that they are apart of will inhibit any barriers from forming and will allow those who are not feeling as committed to become more committed or move out of the team.

At Healthcare Organization Group each person in the group knows that they are there to provide very good healthcare to the public. They do not do it well. Conflict resolution is not established and communication is broken down. Each employee has a task and is more focused on the task and making themselves appear important that the patient gets overlooked. For instance, the front desk assistant is there to greet and make the patient feel comfortable, file charts and schedule appointments and answer the phone. The massage therapist is there to perform massage therapy for patients in need of this care. The office manager is there to manage the overall business of the office. However, if the front desk assistant is on the phone the patient is never greeted by anyone even if the massage therapist, who is not busy, is in plain view of the patient. If the patient file is to be pulled to take to the physician and the front office assistant is busy the massage therapist will not pull the chart making the patient wait longer than expected. This leads to complaints of the front desk assistant to the physician who then has a bad conception of the office manager. The communication of the front desk assistant for help is misconstrued by the physician, who should not be concerned with this anyway, and is relayed to the office manager, which the front desk assistant should have notified first, in a negative way from the physician. In this situation status of the office manager is challenged by the front desk assistant, and the massage therapist faces role ambiguity, where her duties have not been clearly defined to help in another department when needed. The confrontation is between that of the massage therapist and the front desk assistant. However, the physician is brought into the conflict and there are more problems than ever. The office manager should be the first person to be notified, however, the doctor is first notified and the office manager's status is challenged. Now there is a power struggle between the owner and the office manager, and the cohesiveness of the massage therapist and the front desk assistant is non existent.

At Healthcare Organization Team the team knows that they are there to provide very good healthcare to the public. They do it well. Each team member knows what they have to do personally but each team member steps outside of their role, when needed to accomplish this goal. There is also no question as to who is in charge of what job and who to go to if there is a concern or conflict. If filing needs to be done, it gets done by some member of the team if it is that person's duty or not. Even though each person has a particular job description it is still clearly stated that in order to reach the ultimate goal of providing very good healthcare each person must aid in an area to accomplish a task at hand. If a conflict arises every team member knows that the office manager is the first to go to for conflict resolution, if the conflict between two members can't be settled amongst themselves. There are also no struggles in power between any team member and cohesiveness and trust is there. There are clearly defined goals, rules, and a clearly defined chain of command. Not only is a goal defined but there are many accountability measures that are constantly kept up to date a relayed as information to the team.

Healthcare Organization Team gives very good healthcare much more successfully than Healthcare Organization Group due to the fact that the goals and guidelines of the team are laid out and established from the beginning. The mission statement is clearly defined, the vision is clearly defined, and standards of behavior are in place and expected to be followed. The culture of excellence has been developed, and is expected to be followed. Studer (2008) states “if our culture does not deeply embed core values and key processes, then we will never be able to sustain excellence in our organizations” (pg. 61). Hodgetts and Hegar (2008) states twelve characteristics of team building: “There is a high level of interdependence among the team members, the team leader has good people skills and is committed to a team approach, each team member is willing to contribute, the team develops a relaxed climate for communication, the team develops and mutual trust, the team and individuals are prepared to take risks, the team is clear about goals and establishes targets, team member roles are defined, the team can examine personal and team errors without personal attacks, team efforts devoted to the achievement of results, the team has capacity to create new ideas, and each team member knows he or she can influence the team agenda” (Table 4.2 p. 155). In order for Healthcare Organization Group to become more than a group all of these qualities need to be developed with in the group. The physician must first let the office manager mange during operating hours, and the physician should focus mainly on the treatment of patients. The team as whole must develop trust in one another to understand who is in charge and how and when to communicate with each other without undermining one another. First and foremost the office as a whole should develop clearly defined goals and make sure everyone is working to accomplish those goals.

“Turning a group into a team is not an easy process” (Hodgetts and Hegar, 2008, p. 153). Hodgetts and Hegar (2008) explain that “most people are not inherently team players, and some people only want to be recognized for their individual accomplishments” (p. 153). According to Max Wideman (2001), the definition of true team building is “the process of planned and deliberate encouragement of effective working practices, while diminishing difficulties and obstacles which interfere with the team's ability to perform” (Wideman, 2001, Project Team Building, slide 2). In order to effectively do this, the team must be coordinated and committed. For coordination and commitment to occur a skills inventory and a role inventory should be developed in order to effectively communicate roles and responsibilities, clearly define accountability and expectations and ensure the member wins when the team wins (Wideman, 2001, Project Team Building, slides 8-10). Max Wideman (2001) also states “in order for a team to be coordinated there must be effective communication” (Wideman, Project Team Building, slide 10). In order for this to occur there must be an established leader that gives and offers support to all team members, and all team members must be kept informed of everything whether it pertains to them or not. A waterfall of information should occur from upper level management down to low level subordinates, communicated all along the way by supervisors and middle management. Max Wideman (2001) also gives examples of communication that are very effective. They are formal and informal channels, meetings and written reports (Wideman, 2001, Project Team Building, slide 10). Myers Briggs (1995) provides a more simple explanation, “'team building' is the process of enabling that group of people to reach their goal” (Myers Briggs, 1995, Groups Section, ¶1). A successfully built team involves clarifying the collective goals, identifying the problems that are barriers a team from those goals and removing those barriers, putting in place a manager that assists the team, and finally, measure, evaluate and monitor progress so that set goals and objectives become realities. Lipman (2007) states “in order to achieve these functions a company must facilitate activities that kick out the need to be right, to look good in front of others, to be perfect, to protect egos, and the need to judge” (Lipman, 2007, Lesson 3, ¶3). Lipman (2007) explains “by authenticating a day with as few of these needs as possible, I find that participants engage, take risks, share, cooperate, and learn more about themselves and others” (Lipman, 2007, Lesson 3, ¶3). In the end when everything is coordinated and written in stone, everyone is held accountable, and communication is effective, the goals will be worked toward for the good of the organization and everyone will keep focus for the organization and not mainly on themselves.

Studer (2003) states “when an organization commits to excellence, it creates a culture where employees want to work” (pg. 53). Building a team atmosphere within healthcare can be difficult overall. Not only should each healthcare office be concerned with such things like job descriptions and communication problems and role identities, but overall patient satisfaction, overall employee satisfaction and progress, and growth of the practice. A culture of excellence must be a standard that each organization develops for the employee to experience excellence in the field but also to provide excellent care, while at the same time having the patient experience that excellent care and knowing it when they receive it. “Studer Group coaches are continually sharing best practices, discussing challenges, and collectively exploring to how to improve performance” (Studer, 2007, Must Haves, ¶1). “The Studer Group looked at more than 250 organizations and started to identify the specific actions that were common to those organizations achieving great results” (Studer, 2007, Must Haves, ¶1). In this review three key elements surfaced as must haves of effective team building. The three key behaviors that surfaced were thank you notes to team members, the selection process and the first 90 days of employment, and leadership evaluations that align with all other behaviors of the healthcare practice (Studer, Must Haves, Sequence List, ¶1). A team can be successful when the employees are thanked for jobs well done and their overall commitment to the organization as a whole. Repeated praise and thanks motivate and drive employees to increased job satisfaction and increased commitment. This reduces turnover of employees and keeps the employee informed of progress that is good or bad. Studer (2003) also states that the selection process should be slow and the deslection process should be quick. This ensures that each person coming on as a team member are clear on objectives and are willing to commit to the overall organizational goals as a whole. Studer (2008) states “to achieve results that last, leaders must be constantly and consistently trained to develop the skills they need to (1) drive the achievement of organizational goals and (2) improve their own individual leadership performance” (pg. 132). These implications are that leadership should be evaluated in order to ensure that each leader is providing quality encouragement to employees that align with the behaviors that have been set by the organization. If the leader is not getting the job done employees cannot be expected to follow the guidelines correctly with out correct leadership. The leadership evaluation is designed to keep leaders focused on the organizations goal and keep the leader leading by example. If the leader is effective in the team, the culture of the team will be transparent and each team member will know the organizations goal and have an invested interest in the goals as well. Studer (2008) states “leadership development must be treated as thought it is the premium fuel that keeps your company's engine stoked and purring smoothly for the long haul” (pg. 125). Studer (2003) states “the fish starts rotting at the head” (pg. 12).

In the scenario with the massage therapist and the front desk assistant at Healthcare Organization Group, the massage therapist is only concerned with her efforts of giving good massages and not concerned with the overall goal of giving the patient a very good experience from the start of the visit. Here the ultimate goal should have been clearly laid out. Also each person's role should have been clearly defined and each person's individual duties should have been extended farther than that of just their departments. There is no formal chain of command that is followed by all members of the group. The owner is not willing to give total control of daily office procedures by translating a problem in a negative way to the office manager, instead of telling the front office assistant to go to the office manager first. The front office assistant has no formal guideline to follow that states that she should have expressed her problem to the office manager first. Above all each person should have been made known that everyone should be willing to contribute to the whole office process and be cross trained to due multiple tasks outside their departments. The contributions should not be separated from those of other team members. Also a reward could have been offered in order to ensure that the member has won when the team has won its goal of giving very good healthcare to the public. As well as the break down in communication, this firm has no common measure of the progress to get to the goal of providing very good healthcare to the public. Obviously there is no leadership evaluation that keeps the office manager abreast with keeping the front office assistant with the aligned behaviors of the organization.

Overall Healthcare Organization Group has no team building techniques that ensure any type of progress to achieving any type of goal. There are no educational trainings, meetings, or measures of progress. Everyone is determined to work toward a goal but cannot see past themselves in order to reach that goal. They are not kept accountable and there is no reward or consequence system in place.

At Healthcare Organization Team multiple steps have been taken in order to ensure that a team is in place and if effective. Every role is laid out in a very descriptive job description. Also there are team meetings once every month in order to ensure that the ultimate goal is being met. These meetings not only ensure that progress in being made in order to achieve the ultimate goal, they also ensure that each team member is satisfied with their surroundings through effective communication. With this communication, no one is attacked and all problems are brought to the attention of the whole team. The team solves the problem as a whole in order to again ensure that everyone is acting to achieve the ultimate goal of providing very good healthcare. There are also multiple chances for team members to go to educational courses that are related to the firm as a whole. As stated before there are multiple goals that are set to be achieved. Although each person has their own goal, they are kept focused on the ultimate goal through effective communication of set goals by management. They are aware that there is a bigger picture to accomplish than just their own set goals.

Overall Healthcare Organization Team has developed a clear and concise plan in order to develop team building techniques and an overall team. Team members are constantly recognized and rewarded for steps taken to achieve the ultimate goal. Also there is a reward consequence system in place to weed out people who are not interested in being a team player. Also the leader is evaluated to make sure that he is relaying that the behaviors are to be followed set by the organization. He does this by example.

Effective team building can occur in any organization, whether corporately owned or privately owned. It must be planned and deliberate, and there must be a plan put in place in order to achieve this team atmosphere. In this plan a culture of excellence and a standard of behavior must be included. This will ensure that barriers and conflicts are few and resolvable. There must be an overall set of clear and concise goals that are known by all team members. It must be continuously and consistently measured to ensure that the steps in order to achieve this goal are being met. Also there must be an effective communication model that is set out and defined with the roles of each team member set out and explained with great detail. There must be a leader established and he must be evaluated continually and consistently in order to ensure that the team is provided with adequate leadership. Again this process can be difficult or easy depending on the commitment of upper level management. Upper level management must also be able to relay this to middle management and middle management must be able to communicate to the team members in an effective way. There must also be a weeding out process as to who is a team member and who is not. Those who are not team players must unfortunately be dismissed for the good of the organization. There must be constant feedback and the ultimate goal should be consistently reinforced to all team members that are involved.

Healthcare Organization Group can mold themselves into team. They must have overall team commitment, and be willing to accept the changes that come with developing a team. They should set aside a model that is set using all the above stated guidelines or they can hire a professional coaching consultant in order to keep owners from blowing up the whole system. Still Healthcare Organization Group could model themselves after Healthcare Organization Team or some other organization that has a standard set of behaviors and guidelines that are clearly established.