Day 2: Equipping your Team for Success

Allied Team Training for Parkinson (ATTP): A

program of the National Parkinson Foundation

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Day 2: Equipping your Team for Success

Denise Kornegay, MSW

In collaboration with:

Disclosures

None



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REVIEW HOMEWORK

• # of teams in Forming mode?

• # of teams in Storming mode?

• # of teams in Norming mode?

• # of teams in Performing mode?

DISCUSSION• Do you always move forward through the

stages?• What can cause change in a team’s

performance?

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Managing Human Behavior

• Developing Ground Rules for Team interactions before you need them

• Developing Respect for one another• Living our Vision and Values



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Ground Rules: Worksheet

Effective Ground Rules are negotiated BEFORE they are needed

Effective Ground Rules are ENFORCED

Things to Cover: Attendance; Behavioral Expectations; Communications; Respect; Meeting Content and Agenda format; Meeting Assignments

• Other?

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Report and Discuss



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HOW DO TEAMS “ OPERATE”

• Teams are not committees– Hold successful meetings– Reasonable agendas– Appropriate behavior by members

Characteristics of Successful Meetings

• Begin AND end on time

• Have an agenda

• Have a record of actions taken

• Previous “assignments” are reviewed and

updated

• Sense of accomplishment

Sample Meeting Recorder Instrument in

handouts



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Setting Reasonable Agendas

• Review past assignments• “Under plan” to allow time for thinking and dialogue

• Clear time frame for each agenda item• Bulk of time should be spent updating patient status / treatment plans

• Clear articulation of expectations for next meeting

• Team process issues should be on agenda on a monthly / bi-monthly basis

Review and Discuss



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Team Behavior

GITT Video:

Case of Mrs. Lin Tsai

(Handout)

THINGS TO CONSIDER

• Ideal versus Real

– Or Textbook vs. Workplace

• Perfect versus Works

• Outcome versus process



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Steps to Develop an Effective Plan

• Complete Client and Team Needs Assessment

• Establish Ground Rules

• Articulate Goals / Expected Outcomes

– Establish Benchmarks / SMART Objectives

• Define Data Needs

• Define Data Collection Process

• Develop an Implementation time line

• Determine plan roles and accountability

• Identify Program Evaluation Process and

Timelines

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• Set client focused Team Meeting Schedule and develop standard agenda

• Set Team Development meeting Dates• Schedule Client Feedback Cycle / Process• Schedule Team Feedback Cycle / Process• Other?

See IDC TEAM Checklist in Handouts

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???’s to ASK• Personnel: Do you have the right people?

• Staff Development: Are staff functioning at the appropriate level?

• Resources: Do you have access to the required equipment, assessment instruments, and other resources?

• Administrative Support: Is it formal, inferred, or needed?

• Referrals: Do you have a viable network?

• Promotion & Marketing Strategies: – Do you have a marketing plan?

TOOLS TO CONSIDER (in handouts)

• SWOT Analysis

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GOALS AND OBJECTIVES (Worksheet)

• Develop both client and team goals• Be realistic about what you can do• Be realistic about what you can measure• Don’t measure what you cannot control

Define your client centered benchmarks for excellence

• Tie benchmarks to specific Goals / Objectives

• Identify how will you collect the data?

• Define your measures of effectiveness using SMART objectives

• Others?



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MEASURING EFFECTIVENESS

• Methods to Analyze Effectiveness– Surveys of team– Survey of patients– Survey of caregivers– Patient Records– Other?

• Data Collection and Analysis– Were targeted goals met?– What barriers still exist?

SMART OBJECTIVES

– Specific: Addresses one question– Measurable: Has a data point tied to the

question– Achievable: Is under the control of the

team– Realistic: Is not grandiose– Timed: Has a scheduled review

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Checklist to Analyze Effectiveness

• Clear goals defined• Goals divided into SMART objectives• Appropriate data collection (baseline and progression)

• Set schedule for review/ evaluation

Expectations and Timelines

• Assign responsibility to members based on agreed upon goals and objectives

• Clarify scheduled updates and reporting expectations



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Now YOU try it!

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FIVE MAJOR CHALLENGES OF REAL TEAMS

1. Communication

2. Resources

3. Respect and Professionalism

4. Lack of systematic approach(es) and

protocols

5. Follow Through within team and with

upper management

Based on survey of participants at

Chattanooga training in March 2014



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1. COMMUNICATION

• Between nursing and rehab staff• Changing or competing visions for the team• Physician “Buy-In” to interdisciplinary care• Addressing ineffective team members• Participation and/or commitment from all disciplines

• Other: personality differences, not open to constructive criticism, assessing each

member’s orientation to team work

2. Resources

1. Getting referrals

2. Staffing (turnover, right disciplines, over

extended staff)

3. Scarcity of time

4. Productivity challenges (budget vs.

services)

5. Money

Other: treatment space, physical coordination of services,

coordination with non facility based resources



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3. Respect / Professionalism

1. Complaining / negativity

2. Hijacking team process by individual

modifying team decisions or assuming

inappropriate leadership

3. Interruptions

Other: Demoralization, egos, competition between team

members, “Been there – done that” attitude, conflict

resolution, bringing personal problems to work, selfish

motivations, resistant to change, leave before work is done

4. Lack of Systematic Approach

1. Getting started

2. Lack of identified team or teams of only

one discipline

3. Lack of measures / measurement

4. Team growth / progressing to the next

level

5. Division of Labor

Other: lack of accountability, isolation of services,

organization of the team, continuity of care protocols



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5. Follow Through

1. Buy in with concrete follow through on

commitments from upper management

2. Follow through by team members on tasks

assigned

3. Follow through by team members in

communicating their interactions with

clients

TROUBLESHOOTING

What to do when the team is in a slump or just not

performing!



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Signs of trouble

• Lack of attendance at team meetings• Cliques form on social basis• Disrespect uttered or inferred between professionals

• Do not meet benchmarking goals

• Other?

Positive Management Strategies

• Create a sense of urgency

• Review ground rules with team

• Enforce any consequences set forth in ground rules

• Re-direct hostilities

• Confront offenders

• Re-affirm goals and benchmarks

• Seek validation from others

(through surveys, etc.)



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Effective Conflict Resolution Strategies

• Direct confrontation – privately• Group discussion• Re-direct and Re-focus• Active listening and echoing• Ignore and suffer• Education

Understanding and building “consensus”

• It is reached after lively interchange among peers

• It is reached by listening, learning, and compromise

• It is not “winning” or “losing” – but rather growing into a joint decision



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5 Dysfunctions of a Team

I. Absence of Trust

II. Fear of Conflict

III. Lack of Commitment

IV. Avoidance of Accountability

V. Inattention to Results

Lencioni, Patrick. The Five Dysfunctions of a Team. Josey-

Bass Publishing. 2002

Absence of Trust

“Trust is the confidence among team members that their peer’s intentions are good, and that there is no reason to be protective or careful around

the group.”

Lencioni, Patrick. The Five Dysfunctions of a Team. Josey-Bass Publishing. 2002



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Teams with an absence of trust…

1. Conceal their weaknesses from one another

2. Hesitate to ask for help

3. Hesitate to offer help

4. Jump to conclusions

5. Fail to recognize other’s skills and experiences

6. Waste time and energy

7. Hold Grudges

8. Dread meetings


Members of Trusting Teams…

1. Admit weaknesses and mistakes

2. Ask for help

3. Accept questions and input from others

4. Give one another the benefit of the doubt

5. Take risks in offering feedback

6. Appreciate and use one another’s skills and experiences

7. Focus time and energy wisely

8. Offer and accept apologies easily

9. Anticipate meetings and opportunities to work as a group




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Overcoming Trust Challenges

1. Create opportunities for shared experiences to occur

2. Celebrate instances when follow through is achieved

3. Conduct exercises to provide in-depth understanding of unique attributes of team members

4. Use Personality and Behavior preference tools to create understanding and conversations

5. Consider implementing 360 degree feedback


FEAR OF CONFLICT

“Conflict is considered taboo in many situations, especially work.

It is important to distinguish between productive conflict and destructive

fighting.”




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Teams with fear of CONFLICT…

1. Have boring meetings

2. Create environments where back channel politics and personal attacks thrive

3. Ignore controversial topics

4. Fail to seek all member’s opinions and perspectives

5. Waste time and energy with posturing and egos


Teams that engage CONFLICT…

1. Have lively, interesting meetings

2. Extract and exploit the ideas of all team members

3. Solve real problems quickly

4. Minimize politics

5. Put critical topics on the table for discussion




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Overcoming Conflict Challenges

1. Acknowledge that conflict is healthy and can be

productive

2. Individuals accept responsibility to become

“miners” – extracting buried disagreements and

bringing them forward

3. Affirm one another during conflict, reminding

everyone that it is “OK” to disagree


Lack of Commitment

“Commitment is a function of

two things:

clarity and buy in.”




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Teams that Lack Commitment…

1. Create ambiguity about direction and priorities

2. Watch windows of opportunity close due to excessive analysis and delay

3. Breed lack of confidence and fear of failure

4. Revisit discussions and decisions repeatedly

5. Encourage second-guessing among members


Teams that have strong Commitment…

1. Create clarity of direction and priorities

2. Align around common objectives

3. Learn from past mistakes

4. Take advantage of opportunities

5. Move forward without hesitation

6. Change direction without hesitation or guilt




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Overcoming Lack of Commitment

1. Create ways to achieve buy-in without achieving total concensus

2. Unite behind decisions – “a decision is better than no decision”

3. Make decisions boldly and correct them boldly when necessary – no waffling

4. Repetition of decisions made reinforce team direction

5. Clear use of deadlines to create commitment


Avoidance Of Accountability

“The willingness of team members

to call their peers on

performance or behaviors that

might hurt the team.”




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Teams That Avoid Accountability…

1. Create resentment between those with different standards

2. Encourage mediocrity

3. Miss deadlines and key deliverables

4. Place undue burden on team leader as sole disciplinarian


Teams that hold one another ACCOUNTABLE…

1. Ensure poor performers feel pressure to improve

2. Identify potential problems swiftly

3. Establish respect among members who are held to the same high standards

4. Avoid excessive bureaucracy around performance management and corrective actions




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Overcoming Avoidance of Accountability…

1. Publication of goals and standards

2. Simple and regular Progress Reviews

3. 360 degree Feedback

4. Team Rewards rather than individual

rewards


Inattention To Results

“The ultimate dysfunction of a team is the tendency to care about something other than the

collective goals of the group.”




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Teams displaying Inattention to results…

1. Stagnate, fail to grow

2. Lose achievement oriented employees

3. Encourage members to focus on their own careers and goals

4. Are easily distracted


Teams focused on results…

1. Retain achievement oriented employees

2. Minimize individualistic behaviors

3. Enjoy success and suffer failures acutely

4. Avoid distractions




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Overcoming inattention to results…

1. Reward only actions / behaviors that contribute to results

2. Publicize results

3. Create public commitment to achieve specific results

4. 360 degree feedback


CHECKLIST

• Needs Assessment (Clients, Team)• Ground Rules• Goals and Expectations• Establish Benchmarks for Success• Developing an interdisciplinary Implementation Plan (Timelines &

Responsibilities)



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Additional Tools

• 360 degree Tools at a Glance• 360 degree Feedback Template• Work/Life Balance test• Dealing with Criticism Handout• Skill set and Behavior Assessment

Wisdom from the front lines…

• Do not argue with an idiot. He will drag you down to his level and beat you with experience.

• Light travels faster than sound. That is why some people appear bright until you hear them speak.

• Knowledge is knowing tomatoes are fruits; wisdom is not putting them in a fruit salad

• A clear conscience is usually the sign of a faulty memory



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OBSERVATION

EXERCISE

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Points to Ponder…

• Why do Americans choose from just two people to

run for President and 50 for Miss America?

• When tempted to fight fire with fire, remember

the Fire Department usually uses water

• You are never to old to learn something stupid.



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A challenge…

Our deepest fear is not that we are inadequate.

Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us….

Your playing small does not serve the world.

There is nothing enlightening about shrinking so that others won’t feel insecure around you…

And when we let our own light shine, we unconsciously give others permission to do the same…

As we are liberated from our own fears, our presence automatically liberates others.

---Marianne Williamson

Documents

Day 2: Equipping your Team for Success