Abstract
This two-part study aims to contribute to the body of knowledge on team development by examining the development of self-managing teams (SMTs) in healthcare. Based on an exploration of the team development literature, a perspective on SMT development was created, which suggested that SMTs develop along a non-sequential pattern of three processes-team management, task management and boundary management and improvement-that is largely the result of individual, team, organizational and environmental-level factors. The perspective on SMT development was assessed in a Dutch mental healthcare organization by conducting 13 observations of primary mental healthcare SMTs as well as 14 retrospective interviews with the self-management process facilitator and advisors of all 100 primary mental healthcare SMTs. Empirical results supported the perspective on SMT development. SMTs were found to develop along each of the three defined processes in a variety or possible patterns or simultaneously over time, depending on many of the identified factors and three others. These factors included individual human capital, team member attitudes and perceived workload at the individual level, psychological safety, team turnover, team size, nature of the task and bureaucratic history at the team level, and management style and material and social support at the organizational level. This study provides a non-sequential model of SMT development in healthcare, which healthcare providers could use to understand and foster SMTs development. To foster SMT development, it is suggested that cultural change need to be secured alongside with structural change. Even though various team development models have been described in the literature, this study is the first to indicate how SMTs in the healthcare context develop toward effective functioning.
Highlights
Nowadays, healthcare organizations are searching for more cost-efficient ways of delivering care as the current economy asks for reduction of costs, while patients demand a higher quality and more diverse and flexible care
This study is divided in two healthcare major parts: the first part of this study provides a theoretical exploration of the team development literature to arrive at a perspective on self-managing teams (SMTs) development in healthcare
The present study contributes to the body of knowledge on team development by examining the development of SMT’s in healthcare
Summary
Healthcare organizations are searching for more cost-efficient ways of delivering care as the current economy asks for reduction of costs, while patients demand a higher quality and more diverse and flexible care. To adequately deal with these demands, healthcare organizations have placed more reliance on organizational flexibility and respond by decentralization. That is, attributing responsibility and autonomy to the workforce by organizing employees into self-managing teams (SMTs) (Yeatts et al, 2004; Renkema et al, 2018). They share the responsibility for making a product or service and have authority over decisions such as task assignments, working methods and scheduling of activities (Cohen et al, 1996). The rationale for adopting SMTs in healthcare derives from the proposition that they are more effective at allocating their resources, and more flexible in adapting structures to a variety of tasks, situations and conditions in comparison with traditional, hierarchical teams (Wageman, 1997)
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