Jan 05 Core Skills Team Leaders

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HEALTH SERVICE TEAM BASED PERFORMANCE MANAGEMENT
CORE SKILLS TEAM LEADERS
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Objectives For Today

• Understand Role of Team Leader
• Review - Setting SMARTER Objectives
• Review Giving and Receiving Feedback
• Leadership

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Role of Team Leader

• See Appendix B Team Leader Guide to T.B.P.M.
  Process
• (Performance Management Agreement 2003)

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Your Team

• A group of people who share common objecties and
  who work together to achieve them
• All team members may not all be directly
  responsible to you

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The Process

• Performance Review Period is the calendar year
  to co-incide with Service Planning Process
• Involves 4 formal meetings per year

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The Process Contd/

• January Meeting
• Review last years performance
• Identify Key Performance Areas and Agree
  Objectives for the coming year
• Meetings April, July and October to review
  progress and decide on actions required

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The Process Contd/

• Core of process is identifying Key Performance
  Areas and agreeing SMARTER Objectives
• Identify 3 to 4 Key Performance Areas which
  team needs to perform well in order to meet
  requirements of Service Plan/Operational Plan
• From these Key Performance Areas agree up to
• 3 objectives

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The January Meeting

• Good preparation is the key to a good meeting
• Plan and arrange meeting well in advance
• Decide on most appropriate way to meet your
  team (e.g. teams provide a 24 hours service)

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January Meeting contd/

• Familiarise yourself with Service
  Plan/Operational Plan and be clear on Key
  Performance Areas for your team
• You may need to discuss these K.P.A. with your
  Head of Department and with other teams whose
  services are inter-dependent with yours

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Running the Meeting

• Welcome Team Members
• Emphasise the importance of participation by
  all members
• Review progress for previous year
• In areas where objectives were met
• - identify underlying strengths
• - working methods
• - what factors contributed to success
• - how can these strengths be further developed
  by the team?

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Running the Meeting Contd/

• In areas where objectives were not reached
  discuss
• - things which were not in the immediate
  control of the team
• - role of team leader is to indicate to the team
  what you will do to bring these issues to the
  attention of those in a position to exercise
  positive influence

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Running the Meeting Contd/

• Things which were in control of the team discuss
• - Local Systems ways of working
• which could be improved
• - Making better use of resources space,
  materials etc
• - Skills which need to be developed
• - Improved use of existing information
• - Improved communications and involvement

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Running The Meeting Contd/

• Avoid defensiveness
• Explore issues with the team
• Agree on specific changes/developments to
  which all can commit
• Summarise key points to be recorded on
  Performance Review Form

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Running the Meeting Contd/

• Move on to the coming year
• Review Service Plan/Operational plan which
  impact on team
• Inform team of Key Performance Areas you feel
  are relevant and discuss these with team members

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Running the Meeting Contd/

• Discuss practical difficulties which members
  forsee in achieving the objectives
• Identify any changes/developments required to
  support the achievement of objectives
• Aim to get buy in and avoid all commitments
  being left with Team Leader

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Running the Meeting Contd/

• Indicate where the Performance Management Form
  will be kept
• Agree date for review meeting in 3 months
• Offer team members opportunity to discuss
  their development needs ( team development
  needs and P.D.P.s).

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After the Meeting

• Complete the Documentation
• - Performance Review Form
• - Details of Action Plan
• Develop the habit of discussing objectives,
  giving and receiving feedback in your everyday
  relationship with team members
• Ensure that you deliver on your commitments
  articularly relating to training and development

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Interim Review Meetings

• Held every quarter (April, July and October)
• Style the same as January meeting
• Review progress regarding achievement
• of objectives
• Open discussion leading to team agreeing
  necessary action to correct shortfall if
  objectives are not being met

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Review Meetings

• If priorities change or completely
  unpredictable events dictate objectives may
  need to be changed
• Discuss with team how objectives are re-set
• Prepare for this by reviewing updates to
  S ervice Plan/Operational Plan and discussing
  new Key Performance Areas with your Head of
  Department

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OBJECTIVE SETTING
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Objective - Definition

• Something which has to be accomplished
• a point to be aimed at (a target),
• a plan or a project to be implemented or
  completed,
• a standard of performance to be achieved and
  maintained
• or values to be maintained

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Advantages of Objectives

• Provide clear direction
• Help to clarify roles of team members
• Provide a focus for communication and review
• Clearly indicate success
• Facilitate strong sense of fulfilment for the
  team

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SMART(ER) Objectives

• Specific clear, unambiguous, straightfordward,
  understandable
• Measurable can be related to quantified or
  qualitative performance measures
• Achievable Objective should be realistic and
  within known resources
• Relevant Linked to operational/service plan
• Timebound Building in target date review dates
• Extending Capabilities Stretching team
  performance
• Recognition Acknowledgement of team achievement,
  reflection, learning

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Performance Measures

• Measures should focus on results
• Measures should be real and observable
• Teams must have access to relevant data
• Existing measures should be used or adapted
  wherever possible

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How to Measure?

• IDENTIFICATION- What are we going to measure?
• DATA COLLECTION- How do we gather the
  information?
• CHARTING / DISPLAY- How to present the
  information to make it useful?
• ANALYSIS- How to interpret and analyse the
  information ?

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What to Measure?

• Impact completion of project, attainment of a
  standard, level of take up of a service, changes
  in behaviour
• Finance Budget, Employment Ceiling, Value for
  Money
• Reaction e.g. satisfaction survey, internal
  external customers
• Time speed of response, waiting times

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Why Measure?

• If you cant measure you cant manage
• Ensure everyone is working towards the common
  objective
• Encourage innovation and problem solving as a
  route to improvement

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Setting Objectives

• Example
•  
• Key Performance Area
• Reduce Non-Attendance at Clinics
• Objective
• Reduce the incidence of non-attendance at our
  Outpatient Clinic by 10 during the coming year.

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Example Contd/..

• Objective To reduce the incidence of
  non-attendance at our Outpatient Clinic by 10
  during the coming year - Carry out a patient
  satisfaction survey
• - Undertake discussions with IT Department with
  a view to setting
• up automatic reminders to patients
  one week prior to appointment date (e.g. text
  messages).
• - Initiate follow-up arrangements for
  non- attendees

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Example Contd/..

• Objective To reduce the incidence of
  non-attendance at our Outpatient Clinic by 10
  during the coming year - Carry out a patient
  satisfaction survey
• - Undertake discussions with IT Department with
  view to setting up automatic reminders to
  patients one week prior to appointment date
  (e.g. text messages).
• - Initiate follow-up arrangements for
  non- attendees

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Exercise

• Select a Key Performance Area from your
  Operational/Service Plan (for the coming year)
  and set a SMART(ER) OBJECTIVE for this.
• Once you have agreed your Key Performance Area
  and SMART(ER) Objective/s complete Part 1 of your
  Performance Review Form
• (see Appendix A)

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GIVING AND RECEIVING FEEDBACK
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Basic Rules of Feedback

• Feedback may be used to strengthen a behaviour
  that is considered to be positive as well as to
  change a behaviour that is considered to be
  negative.
• Giving feedback is based on fact and not
  subjective judgement.

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Benefits of Feedback

• Improves performance strengthens positive
  behaviour and changes negative behaviour
• Helps people appreciate how their actions affect
  others
• Improves communication and strengthens working
  relationships
• Promotes a more open working environment
• Increases job satisfaction and teamwork

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Getting Feedback Right

• Be proactive  
• Be specific   
• Develop a progress plan  
• Link team performance to team objectives

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Giving Feedback

• ASK, dont tell
• DESCRIBE, dont judge
• BEHAVIOUR, not personality
• BE SPECIFIC
• BE CONSTRUCTIVE

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Receiving Feedback

• BE OPEN, not defensive
• LISTEN AND CLARIFY
• SEEK SUGGESTIONS FOR DOING THINGS DIFFERENTLY
• REJECT FEEDBACK THAT TARGETS Personality
  Is based on Inferences /Indirect Is
  Judgmental
• RECEIVE GOOD FEEDBACK AS A GIFT

GOLDEN RULE Dont give feedback unless you can
take it
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Common Pitfalls
Focus on BEHAVIOUR What the teamDOES? What you
SEE? What you canDESCRIBEin actions?
Avoid Describing thePERSON (-ALITY) MakingINFER
ENCES (indirect) MakingJUDGEMENTS. and this
team will never change
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Good Feedback Versus Poor Feedback
GOOD Purpose, to help Future focused Current
specific examples Describe Behaviour Share own
feelings Listens End on a positive plan
POOR Vague or Judgmental Describes
personality Quotes others Hides own feelings,
except temper Does not listen Has the last word
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Team Leadership
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Stages of Group Development

• FORMING
• STORMING
• NORMING
• PERFORMING
• MOURNING

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PHASES A GROUP GOES THROUGH TO BECOME A
TEAM PHASE 1 - FORMING
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Characteristics of Phase 1 - Forming

• The team leaders roles are unclear or unstated.
• Members are unclear as to why they are together
  and what they are to accomplish.
• Members are either new to one another or need a
  new introduction
• They depend on the Team Leader for direction and
  motivation
• Members may be enthusiastic and eager to work on
  specific problems / process improvements.

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Potential Problems Real and Related and
Perceived

• The goal of the team may be unclear.
• The organisation may not have committed resources
  that the team might need.
• Unclear Team Leaders role will cause confusion.
• Members may complain about barriers to the
  projects success.
• There may be some testing of what is acceptable
  behaviour.
• Discussion of issues may be broad, lofty and
  abstract.
• Members may discuss other problems that are
  unrelated to their task.
• Members want to jump to finding solutions right
  now, too impatient to lay the proper groundwork
  for the team to function.

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PHASES A GROUP GOES THROUGH TO BECOME A
TEAM PHASE 2 - STORMING
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Characteristics of Phase 2 - Storming

• Members express concerns that the projectis more
  difficult than expected.
• Conflicts arise among team members or around the
  project and its timetable.
• Members may be impatient about the speed of the
  project.
• Members may argue over what approach to take.
• Members may be unwilling to cooperate.

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Potential Problems in Storming

• There may be resistance to the task and to new
  or different problem-solving methods.
• Members attitudes about the team and its chances
  of success may fluctuate and hinder progress.
• If members argue among themselves, they may
  create alignments and form sub-groups.
• Some problem behaviours like dominating and
  withdrawal may emerge.
• Objectives may remain unrealistic and resources
  may be lacking.

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Helpful Maintenance Roles
1. Encouraging 2. Harmonising 3. Expressing
Group Feelings 4. Gatekeeping 5. Compromising
6. Standard Setting and Testing
Being friendly, warm and responsive to
othersAccepting others and their
contributionsRegarding others by giving them an
opportunity to contribute or be
recognized. Attempting to reconcile
disagreementsReducing tensionGetting people to
explore their differences Sense feelings, mood,
relationships within the groupSharing ones own
feelings with other members Helping to keep
communication channels openFacilitating the
participation of othersSuggesting procedures
that permit sharing remarks When ones own ideas
or status are involved in a conflict, offering a
compromise which yields statusAdmitting
errorModifying ideas in interest of group
cohesion or growth Checking whether the group is
satisfied with its proceduresSuggesting new
procedures when necessary.
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Hindering Roles
1. Dominating 2. Withdrawing 3. Avoiding 4. D
egrading 5. Uncooperative
Asserting authority or superiority to manipulate
the group or certain membersInterrupting
contributions of othersControlling through use
of flattery and patronising Removing oneself
psychologically or physically from the groupNot
talking, answering any questions briefly Changing
the topicBeing uncomfortable with
conflictMissing meetings Putting down others
ideas and suggestionsDeflating others
statusJoking in a sarcastic way Disagreeing and
opposing ideasResisting stubbornly the groups
wishes for self-centered reasons
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Hindering Roles
Whispering and having private conversations. Comp
laining about problems or past historyWhining
about the merit of new ideasAgitating others by
seeking their support against new ideas Asking
unrelated questions or telling long
storiesDwelling on the history of a
problem Operating only out of perceived
self-interestSeeking to maintain status and
control With or without notice, arriving late to
meetingsDisrupting by asking what has already
been discussed
6. Side Conversations 7. Whining or
Agitating 8. Diverting 9. Turf Building or
Protecting 10. Arriving late
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PHASES A GROUP GOES THROUGH TO BECOME A
TEAM PHASE 3 - NORMING
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Characteristics of Phase 3 - Norming

• Members begin to resolve conflicts
  amongstthemselves.
• Members focus on common team goals and feel more
  commitment.
• Members update their ground rules and use them in
  meetings.
• Previously competitive relationships among group
  members become more cooperative.

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Potential Problems of Phase 3 Norming Contd/

• The team leader delegates more of the
  responsibilities.
• Members are more friendly, respect one anothers
  ideas, and trust one another more
• More work is getting done, in a timely fashion.
• Unresolved conflict may still emerge

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Phase 3 Norming Contd/

• Foster open climate of discussion
• Avoid insulating the group from outside criticism
• Assign everyone the role of Critical Evaluator
• Avoid being too directive or exerting undue
  influence upon group

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PHASES A GROUP GOES THROUGH TO BECOME A
TEAM PHASE 4 - PERFORMING
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Characteristics of Phase 4 - Performing

• Members now function as a high-performance team.
  They are cohesive and effective.
• Members know their roles and readily take on the
  work.
• The resources of the team members are utilised.
• Relationships are friendly and trusting. Members
  count on one another.
• an ability to be a facilitator.

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Characteristics of Phase 4 - Performing

• They know how to use problem-solving methods and
  apply them to their tasks.
• The projects tasks get accomplished on time.
• Some team members emerge as leaders or demonstrate

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Potential Problems of Phase 4 - Performing

• Members might realise that the rest of their
  organisation is not at the same level of
  understanding as their team they might show
  impatience with others.
• They are so cohesive that they might act
  exclusively.
• If team members arent given more
  responsibilities, they could get restless, bored,
  or demotivated.

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PHASES A GROUP GOES THROUGH TO BECOME A
TEAM PHASE 5 - MOURN/ADJOURN
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Characteristics of Phase 5 Mourn/Adjourn

• The team needs recognition for what it has
  accomplished.
• Members need to review what they learned from
  this experience
• They often do not know how to end this experience
  or say good-bye
• However..
• Some teams do not adjourn, the challenge is to
  continue to improve

RESET THE OBJECTIVES, RESET THE TEAM!
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Potential Problems of Phase 5 Mourn/Adjourn

• Members could feel let down if there is no
  celebration or recognition for their
  accomplishments

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REVIEW
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Development of Team Leaders

• Individual Team Leaders require different levels
  of training/development/support
• Any additional requirements you may have should
  be discussed with your head of function
• Consider option of completing a P.D.P.

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Team Based Service Delivery Improvement Links
to Other Processes
Accreditation ISO Standards Clinical Audit Risk
Management Assessment Learning

• Team Based
• Performance
• Management

Service Plan Operational Plan
Quality Service Improvement Plan
Service Objectives
Improved Service To Patient/Client
Group Training Plan
Development Needs
Multi-Disciplinary Team Working Project
Management Process Mapping/Cause
Effect Systematic Problem Solving Personal
Development Planning Process
PDP Process
Individual
Team
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