Editorial

Citation

Downey-Ennis, K. (2006), "Editorial", International Journal of Health Care Quality Assurance, Vol. 19 No. 3. https://doi.org/10.1108/ijhcqa.2006.06219caa.001

Editorial

As this is my first editorial of the International Journal for Healthcare Quality Assurance I pondered for some time on what to write about. Teamwork came to my mind back in November when I had the great honour of becoming co-editor of this prestigious journal and meeting with Professor Gourlay alas to say goodbye. Professor Gourlay has for the past number of years steered this journal to help and assist all healthcare professionals in their quest for a better health service through quality management. The reason teamwork became obvious was that this edition was developed through teamwork, Professor Gourlay sourcing and editing the papers with my contribution being to write the Editorial. Both of us knew clearly what our goal and tasks were; that was to have this edition on time for publication in 2006. Thus I felt there was no better topic to begin as teamwork, one, which I feel is the concept that healthcare needs so badly. While many practitioners would espouse to work in teams I would challenge each one to explore how good they really are at working as part of a team and explore if teams they are involved in really do click or as (Levine, 1994) argue have chemistry.

Teamwork according to many is the panacea of an effective service within healthcare, so how then is it so hard to achieve. One can resolutely say that team working is a fact of life when delivering modern health care as even the simplest contact of patients and health care provider requires the input and knowledge of several individuals. In more complex situations, the number of individuals and interactions involved becomes ever more numerous and difficult to control. However, traditionally teams within healthcare have arisen historically with professional agendas rather than patient centered agendas dominating. There are many good exemplars of team working within healthcare and in fact a substantial number of employees indicate that working as part of a team gives them the opportunity to share knowledge, experience, skills and responsibilities (McHugh and Bennett, 1999). Indeed through personal contact I have witnessed a multidisciplinary team that works together effectively to ensure that patients are provided with the best possible care within an acute setting. This was achieved through all having respect for each other’s professional status, good communication and with well-defined goals that of a patient centered service, but above all this team had a “can do” mentality and strong leadership.

Teamwork is also a simple concept and one, which many of us use in our day-to-day life the most noticeable being sports and orchestral sessions both of which display a single unitary behaviour which is characterised by cohesion, co-operation, respect and harmonious relationships. So how do we harness healthcare to fully embrace the concept. The most frequently cited successful factors to produce good team working according to (McHugh and Bennett, 1999) include managerial commitment to the communication process; freedom to make decisions; staff enthusiasm and people understanding the concept of teamwork. Conversely low staff motivation; lack of enthusiasm; lack of management and staff commitment all militate against good teamwork. Traditionally teams have been steeply hierarchical with the loudest voice having more of a say than other team members, which ultimately leads to resentment, poor motivation and entrenched silos. To deal with this challenge several options some that require new thinking suggest themselves.

Firstly from an individual perspective there is a requirement to participate in and know your role as a team member; to work towards identifying and achieving the objectives of the team; value the diverse skills of other team members, to actively listen and above all to respect each person’s position in relation to the task in hand. Secondly considerable potential exists when teams have clear team and individual goals, meet regularly, develop new ways of working together and offer support to each other. However this does occur by magic, it requires good leadership in order that key performance areas are identified; that team members work together to set and agree SMARTER objectives; to agree action plan for achievement of objectives; to set measures that underpin selected objective; to monitor team performance; to address issues in a timely and constructive manner and to hold regular review and to give and receive feedback. Thirdly organisations have a duty to provide both a culture and a structure in which teams can flourish and should consider how teams are managed and developed.

The advantages that teamwork can bring to an organisation include the utilisation of a large pool of experience and information with subsequent diversity in approaches and attitudes. Further when team members are passionate their enthusiasm and commitment is catching and they become role models for others. Evidence also suggests that members of well functioning teams experience a reduction in stress levels with subsequent increased performance thus anything less than this is a disservice to the organisation and above all to the staff who work in organisations who depend critically on highly efficient teamwork to ensure high quality patient care.

So the question to be answered simply is: is teamwork new to healthcare – I think not – but organisations would be prudent to fully embrace the concept and develop the culture where it becomes the norm.

Kay Downey-EnnisCo-Editor