Healthcare providers and businesses who want to improve the quality of care or service, who want to steadily improve patient and client satisfaction and who want to decrease the cost of doing so will need to work on improving the team culture of the employees and to better engage the employees. One way to do this is using regular team meetings. Effective teams at a worksite can reach these goals.
Every team should have a goal(s). I have been a member of many teams in my career. Over the summer I have been part of a team whose purpose is to improve the quality of the sexual education programming that serves special needs students in our area. The group is beginning its second year of programming and wants to improve the impact of program for its student clients.
I am also a member of a team of providers at the Calvin College Rehabilitation Center whose goal is to write a grant for funding of a fall prevention study that partners with other local providers to improve the quality of life of seniors in the area. I have also in the past been a member of a quality engineering team whose goal was to reduce the cost of powder coating machinery and improve the quality at the same time.
As you can see, each of these three teams had clearly defined goals. In the latter two, the goals were achieved in a defined time period. Not all team goals need to be time limited. For instance, a team of clinicians at an ambulatory site may meet regularly in order to achieve several broad goals. These could include:
- Improve working relationships of team members
- Improve the processes of delivering care
- Recognizing achievements of team members in providing better care
- Brainstorming for ideas of how to deliver better care at a lower cost with greater satisfaction
Membership in a team should be well defined. Every team should have a core group of members that are present at all of the team meetings. Occasionally an individual may be added to a team in order to provide special information or skills but who may not be a long-term team member. The number of members on a team should be no more than 8-10, in my opinion. Any larger than this and the functionality of the team begins to suffer.
The team that works on improving the quality of the sex ed program for special needs students is made up of the program director, the in-classroom educators and myself, the evaluator. Over the past summer we invited the full-time teachers in each of the districts that we served the past year to join us in a meeting to get their input on how to improve the program.
If the team is made up of clinicians at an ambulatory site all the staff may be on team if there are only one or two physicians or nurse practitioners. For larger practices, representatives of the physicians, medical assistants and nurses can be members of the team. These representatives will be responsible for informing the rest of the staff of their work. Team membership can change over time if the team charter or rules dictate the length of time that a member can serve on the team.
There are general ground rules that make sense for any team.
(A.) Before every meeting an agenda should be published and sent to the team members. The items on the agenda can be decided by the team leader or a small group of team members. It may include old business as well as new business.
(B.) The meeting should start on time and end on time. It might be a good idea to have a timekeeper designated by the group whose job it is to keep the members focused on the discussion and making sure that the focus remains on topic. If some other important item surfaces at a meeting, it can be discussed at the next meeting or, if there is time, as a new agenda item near the end of the present meeting.
(C.) Be present. No one should be using smart phones, tablets or lap tops that can keep members from being focused. Any text messages or phone calls will have to wait.
(D.) Focus on the topic, not an individual. Personal attacks or other disruptive behavior is not allowed. A strong group leader can ensure that the focus is on the discussion and that no one becomes rude or disruptive. Such behavior stops progress. Disagreement and alternative suggestions are welcome so long as they are discussed objectively.
(E.) Decision rules need to be in place. If a decision needs to be made, rules should be in place beforehand to determine how members will make decisions. For instance, if the team is considering altering a process so as to reduce time waste, it may be that a majority vote is needed to advance the new process.
(F.) There will be no side discussions. This can be distracting to the rest of the team.
(G.) Since each team member should have equality with each of the other team members, each member is expected to contribute at the team meeting. It may be that the leader has to ask a member to contribute his/her opinion.
A local auto repair shop that I use, Arie Nol’s Auto, employs these rules consistently. They meet once a month to discuss the operations of the business and how to improve it. They provide outstanding customer service as evidenced by the full schedule of work that they have daily. One of the things that is discussed at each monthly meeting is the productivity of the team. They brainstorm ideas to improve their service. More experienced staff are always willing to help newer staff improve. The meetings stay objective and the management is supportive of the staff.
As you can see, team meetings are a necessity for the continuous improvement of service and care of any business. Management and individuals alone cannot achieve results necessary to continuously improve. Problems and challenges are best solved by a group. Groups can work effectively using the guidelines above.
Further information on this topic can be found in the American Medical Associations Stepsforward learning modules. Team meetings can be found here.