SEA-TB-274 Module No.7 of 8
Leadership and Strategic Management for TB Control Managers Module 7
Team Buliding
Acknowledgements These training modules on leadership and strategic management for TB control were initially prepared by the Indian Institute of Health Management Research (IIHMR), Jaipur, India with the WHO Regional Office for South-East Asia. The modules were field-tested at training workshops conducted at the IIHMR, Jaipur and the National Tuberculosis Institute, Bangalore. WHO acknowledges the valuable technical inputs of the following individuals and institutions: Vinod Arora, IIHMR, Jaipur, India; Christian Gunneberg, WHO country office, Nepal; S.D. Gupta, IIHMR, Jaipur, India; Barun Kanjilal, IIHMR, Jaipur, India; Prahlad Kumar, National Tuberculosis Institute, Bangalore, India; Franky Loprang, WHO country office, Indonesia; N. Mahadev, National Tuberculosis Institute, Bangalore, India; Monique Munz, Training specialist, Copenhagen, Denmark; Udai Pareek, Professor Emeritus, IIHMR, Jaipur, India; Tushar Kanti Ray, DANIDA, India; Alka Aggarwal Singh, WHO country office, India; Preetish Vaidyanathan, National Tuberculosis Institute, Bangalore, India: Uma Pocha, Communications specialist, Mumbai, India; Saroj Jha, Health Promotion Expert, Mumbai, India; Karin Bergstrom, WHO/HQ and Nani Nair, WHO/SEARO.
© World Health Organization 2008 All rights reserved. This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or for use in conjunction with commercial purposes. The views expressed in documents by named authors are solely the responsibility of those authors.
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Contents 1. Introduction ....................................................................................................................... 1 2. Define a team .................................................................................................................... 3 3. Build a team ...................................................................................................................... 4 4. Team effectiveness ........................................................................................................... 12 5. Summary of important points .......................................................................................... 14
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1 Introduction
As a TB Programme Manager, one of your primary responsibilities is to develop an effective team that works towards achieving the programme goals. In your role as team leader, you facilitate, motivate and guide the team. You have to transform a group of individuals into a team, by clarifying objectives, planning operations with consensus, co-ordinating resources and getting things done together, despite obstacles, stress and demanding pressures. This module introduces you to the concept of a team and will guide you through the process of building, leading, and enhancing the effectiveness of a team and its members. Learning objectives After completion of this module you should be able to: 1. Describe the importance of team building in the effective implementation of a TB control programme; 2. Understand and explain the five stages in team building, and 3. Prepare action points for strengthening team work in your programme.
Summary of exercises This module has four exercises. Plenary discussions will follow each exercise. 1. Game: Fitting together a broken square 2. Individual written exercise followed by group discussion: Defining roles and responsibilities. 3. Case study: Team Building 4. Individual Written Exercise followed by group discussion: Strengthen team building
STOP
Do Exercise 1
Before you start working through this module you will do Exercise 1. Read the instructions for Exercise 1.
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Exercise 1
Group work: Fit together a broken square
The purpose of this exercise is to practise team work. You will be divided into small groups. Each participant will be given an envelope that contains a certain number of cardboard pieces to make squares. You group’s goal is to make five squares OF EQUAL SIZE as soon as possible. The task will only be considered complete when every member makes a square of the same size as the other members of the group. You have 20 minutes to finish this task. Please observe the following rules while participating in this game. (1) No member should speak. (2) No member should demand or ask for pieces from others – either verbally or through gestures. (3) However, members can give pieces to other members and receive pieces from other group members. (4) Members may give pieces to others, but cannot throw them into the centre or anywhere else. There will be group discussion when all the groups have completed this task.
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2 Define a team
The term “team” is defined as a group of individuals working together for a common purpose and goal. Four elements characterize team behaviour: • • • • Team members must have common goals and a reason to work together; Team members must perceive a need for an interdependent working relationship; Individuals must be committed to the team’s efforts and The team must be accountable to a higher level within the organization.
Teams are different from groups. A group is a collection of individuals who may not have any of the four elements mentioned. A team has the potential to accomplish much more than the most efficient working groups that do not work as a team. A team usually has a team leader who is responsible for what the team does as a whole, and for who does what within the team towards this end. The team leader is also a team member. As a TB Control Programme team leader you need to have the knowledge, skills and capability to build a team as well as ensure that the team works together to achieve a common goal. You would also need to adopt a managerial style that helps your team to work more effectively. A team has four essential elements: a common goal, interdependence, commitment and accountability.
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3 Build a team
Team building and development are important for several reasons: • • • • As a key tool for good management. Stress among team members is reduced as problems are solved through sharing of the workload. More innovative and creative ideas are generated; this enhances team performance. Teams can solve complex, multi/interdisciplinary and interpersonal problems more effectively than a group of individuals.
It is important for you as a manager, to build an effective team in which various players (your staff) work harmoniously together, with an understanding of each other’s position, role, tasks and capabilities. You as a manager, need to focus on the following: • • • • setting goals and priorities deciding means and methods to work examining ways in which the team works exploring the quality of working relationships
You would also need to adopt a managerial style that helps your team to work more effectively. The success of a team is dependent on a common understanding among members of the team, of their roles and responsibilities. Team members should: • • • • Be clear about the objectives of the team. Know what their job is and how it relates to the work of others in the team. Understand the work and duties of other team members. This is especially important to avoid duplication, overlooking of key tasks, or one person taking on too much. Be aware of how each one’s work relates to the team’s goal.
STOP
Now do Exercise 2
When you have reached this point in the module, you are ready to do Exercise 2. Tell your facilitator when you have reached this point. While you are waiting, read the instructions for Exercise 2 beginning on the next page of this module.
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Exercise 2
Individual written exercise followed by group discussion: Defining roles and responsibilities
In this exercise you will identify the roles and responsibilities of the team builder/team leader, and of the team members. Write down what you feel are the roles and responsibilities of each member of a TB team.
Team Leader: District TB Officer Role:
Responsibilities
Team Member 1: Medical Officer of TB Unit Role
Responsibilities
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Team Member 2: Supervisory staff Role
Responsibilities
Team Member 3: DOTS Centre in-charge Role
Responsibilities
Let your facilitator know when you have finished this exercise.
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Team building consists of five stages. Each stage has a general theme. The model shown in Table 1 requires that a team’s activities be accomplished and problems resolved at each stage, before moving on to the next stage. Table 1: Model of Team Building Stage 1. Theme Awareness Activities Make each member aware of the goals and objectives, and his/her roles and responsibilities. Outcomes Each member will accept the goal as a common goal, and recognize the importance of his/her role in achieving it, and be committed to reaching the goal. Each member’s viewpoint is clarified resulting in a higher sense of belonging and ownership. Each member will support other members. Greater cohesiveness and productivity. Team tasks are completed and each member is satisfied.
2.
Conflictresolution
Manage and resolve conflicts at work.
3. 4. 5.
Cooperation Productivity Separation
Involve all members in decision-making. Work on each other’s problems. Recognize contributions and achievements.
Stage 1: Awareness The first stage, awareness, is the formative stage of team building when team members, including volunteers, learn about the goals and objectives of the programme and their respective roles. Relationships among team members are defined. Team members need to understand and be committed to the common goals. This gives meaning to the team’s existence. The desired outcomes for the first stage are acceptance and commitment. These outcomes are critical to team development and are necessary before moving on to the next stage. To get team members to commit themselves to the team, have them: • • • • • Agree on the team’s purpose, goals and objectives Understand what the team is supposed to do and why Define progress, achievements and success Establish boundaries for what is and is not included in the team’s work Know their own roles and responsibilities and that of other team members
Stage 2: Conflict-resolution The second stage of team development is dealing with conflicts. Conflict in a team is normal and can be a healthy sign of a team’s development, showing that ideas are being tested. However, it may also be necessary to reduce conflict and resolve feelings of hostility in order to keep the team
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focused on the work to be done. Team building behaviour at this stage includes acknowledging and confronting conflicts openly and listening with understanding to others. All team members are part of developing an atmosphere that encourages and supports the expression of opinions and a sense of belonging to the team. The desired outcomes at this stage are clarification and belonging. To deal with conflict: • • Define the problem clearly. Identify the causes of the problem or conflict and when it started. A personal conflict may have started long before the existence of the team. If this is the case, you may not be able to resolve the problem. Encourage those concerned to discuss their differences outside the work environment. Make it clear to those concerned that their antagonism is affecting the rest of the team negatively. Clarify issues by separating areas of agreement and disagreement. Remain neutral by using objective criteria and focusing on the issue, not the person. Think of problems as team issues; avoid blaming individuals. Listen carefully to each member’s point of view. Insist on maintaining respect for others when expressing ideas and opinions. Deal with communication barriers, e.g. avoid judgemental language, incomplete or unclear information or explanations, etc. Encourage sharing of ideas and opinions, and learn how to work together to find compromises to differences of opinion. Members may need to bargain or negotiate, letting go of some ideas, while maintaining others in order to resolve conflict. Agree on specific action to be taken.
• • • • • •
•
Stage 3: Cooperation The third phase of team building involves building cooperation through involving members in decision-making, to increase consensus and harmony. The desired outcomes for teams in the third stage are involvement and mutual support. To work effectively and cooperatively, team members need to: • • • • Respect commitments concerning deadlines and carry out their particular responsibilities and activities towards their deadlines. Recognize and respect individual differences. Contribute usefully to discussions, decision-making and carrying out programme activities. Learn to give and receive constructive feedback.
Stage 4: Productivity The fourth stage focuses on increasing productivity through interdependence and focusing on goals and objectives. Team members are encouraged to contribute ideas and solutions and to
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value the contributions and ideas of others. Desired outcomes for this stage are increased cohesion and productivity. Techniques for team members to maintain focus and work collaboratively and productively include the following: • • • • • Develop workplans and show the indicators that will help to measure progress of the planned activities. Identify who needs to work together on the various steps or activities. Decide on realistic target dates for activities. Identify the resources required and ensure they are available when necessary (e.g. transport, drugs, equipment and material, etc.). Hold objective-oriented meetings to monitor progress, discuss delays and accomplishments, share information and ideas, and find collective solutions to problems.
Stage 5: Separation The last stage of team development relates to teams that have a specified lifetime. It may be that a specific activity is completed or that there is a need to change the composition of the team. It is important to mark the end of being a team on a positive note by recognizing, recording and rewarding all contributions that were made, as well as whatever success was achieved. During this phase, activities involve recognizing and rewarding team efforts towards achieving the desired outcomes. The main events that take place before actual separation occurs are: • Evaluate and document the team’s work, achievements and lessons learnt. This helps to provide a sense of completion of the work that was undertaken and can also help identify areas for future improvement. Share results with other colleagues, programmes, organizations or communities. Recognize and celebrate the contributions that made the team’s achievements possible. This includes lessons learnt, as there may be times when an actual objective could not be fully met. Include everyone’s contributions, from within or outside the team. This will also give departing team members a chance to say farewell.
• •
STOP
Now do Exercise 3
When you have reached this point in the module, you are ready to do Exercise 3. Tell your facilitator when you have reached this point. While you are waiting, read the instructions for Exercise 3 beginning on the next page of this module.
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Exercise 3
Case study: Team building
The purpose of this exercise is to identify factors and steps in successful team building. Read through the case study and answer the questions at the end. There will be a group discussion when all participants have finished the exercise. A big teaching hospital in the city was approached by an international organization to organize a five-day training programme for National Health Programme Managers from ten countries. The international organization had prepared the modules for the course and identified facilitators to conduct the training. It would provide the necessary funds for the training programme. It requested the hospital director to host and organize the programme, provide the space, classroom materials, necessary boarding and lodging facilities and manpower for organizing and conducting the training programme. The hospital director called for a meeting of his administrative staff. He explained the project to them and stressed that it was a very prestigious event that they had been asked to host and that no effort should be spared to make the programme very successful. It would bring great honour to the institute if everything went smoothly. He outlined all areas that would need to be looked into, namely receiving the participants at the airport, arrangement for transport, accommodation, food, laundry facilities, recreation, space for conducting the training, classroom materials, access to computers, arrangement for disbursement of money and maintaining accounts. He appointed the head clerk in charge of establishment to coordinate the various activities. She was not willing as she said that she already had a lot of work and responsibilities. The director assured her that he would arrange for extra help for her daily routine work, so that she would be free to attend to this challenging task. He said that he depended a lot on her organizational capabilities. He then asked for volunteers to take charge of each of the areas mentioned above. They could choose the people they would need to do the various tasks, give them their job responsibilities and supervise their work. He said they should report to the head clerk about the progress at each stage and for any help required. There was a bit of grumbling from some of the staff, but when they were asked to voice their problems, these were sorted out in an amicable way, and all staff got very motivated and enthusiastic. They even offered to take on more responsibilities if need be, and help each other out. Detailed plans for each day were developed. All the necessary materials were procured. Accounts were meticulously kept. The five days of the training went off without a hitch. All arrangements had been efficiently taken care of.
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The international organization was extremely pleased with the way the hospital had organized the whole programme and publicly thanked the hospital and its staff for their superb cooperation. After the training programme was over, the certificates distributed and all the participants had departed, the director invited all concerned staff, right from the head clerk to the cleaning staff, for tea. He expressed his gratitude and admiration to each staff member who had contributed and informed them that he was very proud to have such a dedicated and efficient staff. • What was the goal of the team?
•
Who were the leaders of the team?
•
Who were the members of the team?
•
What were the factors that led to the success of the training programme?
•
Identify the steps involved in the transformation of a group of individuals into a team.
Let your facilitator know when you have finished this exercise.
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4 Team effectiveness
An effective team is one that achieves its specific objectives in the most efficient way, making the best possible use of resources and in the shortest time. It is always in a position to take up more challenging tasks. Such a team will have reached high levels on the desired outcomes of each stage in the team building process. To use the Johari Window concept (please refer to Module 4: Personal Effectiveness), an effective team is one in which team members give their opinions and comments without hesitation — (reducing the team’s closed areas), listen to and examine opinions, comments, and feedback given by colleagues at all levels — (reducing the team’s blind areas) and are sensitive to the needs of other members in the team (perceptiveness). Yet another way of analysing team effectiveness is to view the level of team empowerment by looking at four characteristics — clarity of roles within the team, the level of autonomy of the team, the support provided to the team in terms of resources, and the accountability of the team to achieve the goals to which a commitment has been made.
STOP
Now do Exercise 4
When you have reached this point in the module, you are ready to do Exercise 4. Tell your facilitator when you have reached this point. While you are waiting, read the instructions for Exercise 4 beginning on the next page of this module.
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Exercise 4
Individual written exercise followed by group discussion: Strengthen team building
The purpose of this exercise is to review the team building activities within your team, following the five stages for team building. Your team might have been working together for a long time. However unless you have systematically applied the five stages, there may be team outcomes that could be enhanced. (1) Review the description of the process in chapter 3. (2) Determine at what stage the team you work with is at the moment. (3) Review how outcomes for each stage that the team has passed through could be enhanced and list those activities in the column to the right below. (4) Reflect upon how you could ensure an optimum outcome for the remaining stages if the team has not yet passed through all stages.
Stage
Theme
Outcomes
Activities to enhance the outcome levels in your team
1.
Awareness
Each member will accept the goal as a common goal, and recognize the importance of his/her role in achieving it, and be committed to reaching the goal. Each member’s viewpoint is clarified resulting in a higher sense of belonging and ownership. Each member will support other members. Greater cohesiveness and productivity. Team tasks are completed and each member is satisfied.
2.
Conflictresolution Cooperation Productivity Separation
3. 4. 5.
Let your facilitator know when you have finished this exercise.
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5 Summary of important points
• A team is a group of people working together to achieve a common goal. • A team has the potential to achieve much more than a group of talented individuals not working as a team. • As a TB Programme Manager, your ability to build and lead a team is crucial to the success of the programme. • The process of team building involves five stages. • The team members must evolve from one stage to the next in order to be an effective team.
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