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by Pamela Weisse
Coleman Associates

When you think about improving ambulatory care, do you think about organizing staff into teams? You should, because the concept of self-managing teams is one of the most important recent trends practiced by successful organizations all over the country. And it’s time for health care organizations to also adopt self-managing teams as the best way to deliver patient care.

“Teams have the capacity to increase productivity and improve quality significantly, and are an important answer to competitive challenge. Teams do work!” say Charles C. Manz and Henry P. Sims, Jr., authors of Business without Bosses: How Self-Managing Teams are Building High-Performing Companies. (A review of this book, When Bosses Become Obsolete can be found in the Team Culture section of this website.)

In Patient Visit Redesign™, teams are utilized both to develop and test a new way of seeing patients (Redesign Team) and to deliver patient care (Patient Care Team). Just calling yourself a team does not make a group of people a real team, however. The success of a “group” is measured by the individual performance of its members. What differentiates a team from a group is that a team holds itself collectively—as well as individually—responsible for achieving results. If the team fails, all its members also fail.

A real team possesses:

• A rich mix of skills and talents.
• A passionate belief in its mission.
• A clearly defined goal.
• The determination to be utterly successful.
• An “all-for-one and one-for-all ethos”.
• Heartfelt intimacy among members.
• A requirement that each team member contribute significantly to the team’s work.
• A direct connection to top managers.

An example of a self-managing team in a health care setting is a Patient Care Team. This small, cross-functional team is comprised of health care staff who work together on a daily basis to provide care to a defined panel of patients. A Patient Care Team typically includes a clinician as well as nursing and clerical staff. Read Clinic Speeds Up Care, Slashes Patient Waits in the Small Office Redesign section of this website for an excellent example of how Patient Care Teams were utilized in a family medicine practice with very few staff. Also check out some of the Success Stories found on this website to read more about teams and what they have accomplished.

“Working on a team has changed everything for me at work,” commented a nurse on a Patient Care Team. “My work day is completely different from what it used to be like. We used to point fingers and blame each other when things went wrong. But since I’ve started working in a team, I have more respect for my teammates, and somehow instead of blaming each other, we’re now praising each other, because we have a better understanding of everyone’s role in taking care of the patients. I’d never go back to working in the old way.”

Another type of team is the Patient Visit Redesign Team, whose members are chosen by top leadership to redesign the way patients are seen in the clinic. Great candidates for this team are people who:

• Love change.
• Are consummate team players.
• Are excellent communicators.
• Are frustrated by the current processes.
• Interact with patients regularly in their current jobs.

Read about a successful redesign team in Anatomy of a Patient Visit Redesign™ Team in the Team Culture section of this website. And download some tools you can use, to start making changes in how you work, including Selecting a Redesign Team and Work Session CueCard. The latter provides some guidance to teams on conducting team-based effective and optimally productive work sessions.