I have been reading up recently on some of the work being undertaken on organisational cultures in some of our most notoriously high risk industries – airlines, nuclear energy, and although a different type of risk, investment banking.
I had been hoping to find the silver bullet for safety culture, however it turns out it’s actually more of a golden thread: team-working. It seems that teams aren’t just important for productivity; fundamentally, when formed right and working well, they mitigate risk.
We take for granted working in teams in healthcare. The skills and knowledge of the workforce is carved up into discrete professions or specialties so we are naturally co-dependent. It’s no surprise then that 90% of us say that we work in teams. But perhaps more of a surprise is research shows that only 40% of people do team-working.
So we structure ourselves as teams, but more often than not, we don’t work together as teams.
How the team works is an important thing to consider and get right early on in any quality improvement (QI) effort, whether we’re talking about an existing team, or a specially formed project team.
The ideal team is 8 or 9 people; it is diverse in terms of backgrounds, skills, views and approaches (critical to the risk-mitigating function of a team). The ideal team will also have a very clear purpose. Each member of the team will be signed up to this, and will understand not only their own contribution towards achieving this, but also the contribution of each of the other team members.
The “how” of team-working is the bit that we are most inclined to miss – often in our drive to just get on with the work. But like it or not, teams function on social capital (see this article).
I believe there are five steps you can take to create social capital in a team:
1 – Start with respect
A group of researchers at MIT have observed that one of the most apparent features of high performing teams is that in them, each of the members is given roughly equal time to talk. This is about demonstrating respect for each member of the team. I think it’s a really important starting point, and one which is fairly easy to practice.
2 – Build trust
Someone somewhere once upon a time designed a trust equation. It’s really widely used in management consultancy, and it goes like this:
Firstly though, building trust is usually a work in progress – credibility might be a given, but reliability and intimacy build over time. But there are a few steps we can make to get it going in the right direction
The surest way to start to build trust in a team is by giving trust – as a team is forming, we need to trust its members so that they have opportunity to prove that they are reliable and we need to make sure the team meets regularly to build intimacy.
3 – Create constructive conflict
There is a tendency to define the success of a team based on the level of consensus within it. But the happiest teams aren’t always the most effective teams, and in fact “group-think” is very definitely not conducive to safety cultures.
A certain level of constructive conflict is healthy. We should help people understand how to challenge constructively, help them build what the MIT research team call “social sensitivity”, but what we might call emotional intelligence, and encourage and embrace this sort of conflict.
The team at Pixar are probably the best cited example of this, with their “Kill it” approach. Although you would probably want to find some different terminology in our context (!), the idea of creating a defined place and time to critically evaluate one another’s work, and building into creative processes the opportunity to “kill” projects that aren’t working is a great example of constructive conflict.
4 – Hold one another to account
This is usually a by-product of healthy conflict. The ultimate goal for any leader should be to build a team that manages itself. Encouraging side conversations (conversations outside of whole team meetings) is a good start.
5 – Focus on results
Feeding back to the team and its individual members regularly on their progress and performance in relation to the team’s defined goal is essential.
Sometimes it feels like we believe there are two types of people: the people who are focused on “the fluffy stuff”, and the people who are focused on results. In reality, a blinkered focus on results is guaranteed not to achieve results (or at least not in a way which is at all sustainable), and building a cohesive motivated team is only useful in so far as it delivers results.
I believe it is important to focus on the “human side of change”, but let’s always keep the end improvement goal in mind.
Let us know what you think in the comments section below and thanks.
Rebecca – @Rebecca3005