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By ISQua Wednesday. Oct 2, 2013

The Role of Team Effectiveness in Healthcare Delivery: a Case Study of Korle-Bu Teaching Hospital in Accra, Ghana

Teamwork in the KBTH is not at its “tipping point” where all the stakeholders expect it to be even though teamwork is one of its 9 core values. The objective of this study was to identify the role of team effectiveness on healthcare delivery at the Korle-Bu Teaching Hospital (KBTH). This study is very relevant because effective teamwork in the workplace benefits the organization by increasing individual productivity and ensures maximum utilization of manpower. A work team is a group of interdependent individuals who have complementary skills and are committed to a shared, meaningful purpose and specific goals. They have a common, collaborative work approach, clear roles and responsibilities, and hold themselves mutually accountable for the team’s performance as posited by Katzenbach (1993); Dyer (1984); and Guzzo & Dickinson (1996). Guzzo (1986) elaborates that the presence of the word “interdependency” is a key characteristic of work teams and is what distinguishes a work team from a work group.

Methods

A descriptive cross-sectional study was conducted with a sample of 210 health workers constituting an 85.4% response rate of the calculated sample size of 246. Respondents were purposively selected from different categories of health workers. The study period was from July 14th-September 31st 2012. Interviewer administered questionnaires, interviews and observations were used to collect the data. A 5-point Likert scale was used. Factor analysis was the statistical analysis performed. The Korle-Bu Teaching Hospital was founded in 1923 by Governor Guggisberg and attained a Teaching Hospital status in 1962 upon the establishment of the Medical School. It presently is a 2000 bed capacity.

Results

The study largely revealed that, 98.6% and 80.5% of respondents understanding of teamwork and effectiveness were at variance with related literature. 1.4% of respondents understood teamwork to be “members of a group working inter-dependently towards achieving a specific goal/objective.” Three factors (i.e. goal setting, decision making and participation) of the ten dimensions/factors accounted for 50.956% of the total percentage variance when the eigenvalue was set at 1.0. Goal setting was the weakest link (29.7%, p-value 0.9, p>0.05) of effectiveness. The team was effective only in role definition (p<0.05) and less effective (p>0.05) in all the other 9 dimensions (i.e. decision making, participation, listening, feedback, communication, leadership, conflict and creativity).

Discussion

The team is less effective in all the 10 dimensions (goal setting, decision making, participation, listening, feedback, communication, leadership, conflict resolution and creativity) assessed except role definition. There was also a lack of consensus and cohesiveness about what constitutes the teams’ goal which obviously does not augur well for team effectiveness (Goni, 1999; WHO, 2007; and Lee, 2009). More than two-thirds of the respondents (i.e. including all the respondents who claim to have had one training or the other in teamwork) are also working with an understanding of teamwork which is inconsistent with Guzzo (1986); Katzenbach and Smith (1993); CHSRF (2005) and WHO (2007). Wise (1994) sums it all up, that “getting a group of people to work together does not constitute teamwork”. This impliedly have implications on patient outcomes and the quality of service which is a measure of productivity of health service.

Conclusions

Team effectiveness assessment among health workers which examined 10 of the 12 dimensions was not found in the literature review; and this comprehensive combination of dimensions has never been examined in a statistically sound research as this.

More than two-thirds of health workers’ understanding of teamwork and effectiveness was inconsistent and at variance with several authors such as Katzenbach & Smith (1993); Guzzo (1986); Sundstrom (1999) and WHO (2007).

The team is effective only in role definition and less effective in all the other 9 dimensions assessed. Goal setting contributed the greatest (29.722% variance, p-value 0.900, p>0.05) to the teams less effectiveness.

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