Forming a multi-disciplinary team to take action: Facilitation and Team Building Skills

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• Forming a multi-disciplinary team to take
  actionFacilitation and Team Building Skills

• Sheraton Wall Centre Vancouver
• 25 Jan 2012

• Connie Davis cld_at_conniedavis.ca

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Facilitator

• An individual whose job is to manage a process
  of information exchange. While and expert role
  is to offer advice, particularly about content of
  a discussion, the facilitators role is to help
  with HOW the discussion is proceeding.the
  facilitators responsibility is to address the
  journey, rather than the destination.
• Bacal, 2006

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Challenges to Facilitation

• Organizational structure
• Complexity of Task
• Receptivity of the Practice
• Translation of Knowledge
• Facilitation Capacity
• Guiding Facilitation in the Canadian Context, 2006

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Interdisciplinary Team

• People from several professions
• Each trained to use different tools and concepts
• Whose labor is organized around a common problem
• With continuous communication and frequent
  reflection on both the groups work and its
  process
• Usually with group responsibility for the final
  product

Dr David Ryan, University of Toronto
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Expanding the team to include the patient/student
and family

• Why?
• How?

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Aspects of building a team

• Team development
• Professional roles
• Team culture
• Power structure
• Personal styles

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Evolution of a Group to a Team
Performing Concerns SuccessAre we
learning?How can we be most effective?What
actions should we take? Relationship
OpenCommunicationSupportConsensus Activities
LearningMaking decisionsSupporting
othersTaking actions
Norming Concerns OpennessWhat do you
think?How can I help you?How can I find out
more? Relationship TrustIdeas/feelingUnderstan
dingSupport Activities AdoptRulesCommunicatio
nGathering dataConfronting issuesGiving
feedback
Storming Concerns ControlWhat role should I
play?Why is he/she taking charge? Relationship
ConflictEmotionalArgumentative Activities
ConfrontationControl conflictsAttempting to
set rules
Forming Concerns Inclusion Why am I here?Do I
want in?Will we be successful? Relationship
GuardedBasic informationLow trust Activities
IntroductionsOrientationsHidden agendas
Associates for Process Improvement, 2005
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Dr David Ryan, University of Toronto
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Informal team roles

• Task roles
• initiating/energizing
• information/opinion giving
• information seeking
• reality testing
• coordinating
• orienting
• technician

• Maintenance roles
• harmonizing
• gate keeping
• encouraging
• following
• acclimatizing

• Individual Roles
• blocking/aggression
• out of field
• digressing
• recognition seeking

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CareOrgeon
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We are trained to think differently(professional
models)

• Focus of our efforts
• How we assess
• Locus of responsibility
• Pace of action
• Decision making expectations
• Beliefs about professional independence
• Stereotypes

Based on Qualis and Czirr, 1988
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Team culture

• Power focused
• Role focused
• Task focused
• Personal culture
• Relationship focused
• Customer focused

Dr David Ryan, University of Toronto
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Partnering across cultures
Education
Health care
CYMH
Family
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Power structure

• Legitimate power
• Power to reward
• Personal/referent power
• Expert power
• Information power
• Network power

Based on Hughes et al, 1995 and Grewal, 2009
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Fostering Effective Teams

• Understand the stages of team growth.
• Avoid overreaction
• Set realistic expectations and develop a common
  purpose (aim)
• Foster team growth.
• Use methods to provide structure
• use methods to foster ongoing team improvement
• Balance attention to task (the CYMH module) and
  process (the teams culture)
• Recruit for the right mix of skills
• Value diversity

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Some Methods To Provide Structure and Foster Team
Development

• Define roles of team members such as member,
  leader, timekeeper, recorder.
• Prepare for meeting with a timed agenda and let
  PDSAs and data drive most of the agenda for
  improvement teams.
• Establish team rules.

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Teams Rules Can Be Useful

• Time expectations for meetings.
• Respect allotted time in agenda.
• Time expectations outside of meetings.
• Procedures for dealing with teamwork problems.
• Procedures for making decisions. How do you make
  decisions?
• How group wants to handle interruptions, breaks,
  absences, substitutions.

Institute for Healthcare Improvement Associates
for Process Improvement
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Example of Team Rules

• We will meet for 1 hour every week
• Everyone participates
• Listen first, then comment
• Do not interrupt others - except for
  clarification
• Communicate intentions when it is necessary to
  leave the room
• Share Responsibility
• Criticize ideas, not people
• Absent only if ill, vacation - no substitutes

Institute for Healthcare Improvement Associates
for Process Improvement
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Recap Collaborating in Diverse Teams

• Why a team
• Team developmental stage
• Personal styles
• Informal team roles
• Professional models
• Team culture
• Power structure
• Fostering team development

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Handling Difficult Situations in Groups
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Reflections
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What now?