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Contemporary Central Service Managers increasingly facilitate the work of teams rather than direct the performance of individual staff members. Managers should be committed to the use of teams and work toward their implementation within their department. There is an old saying that “none of us is as smart as all of us.” The collective wisdom and productivity of a good team almost always out performs even the most talented and motivated individuals. Effectively facilitated teams can overcome organizational barriers and increase communication within and among departments. Cross-functional teams help to tear down “functional silos”—the lack of cooperation and communication between departments caused by strict vertical (functional) management within an organization. These special teams enable the establishment of common goals, and they allow the staff members’ diversity to contribute to the decision-making and problem solving processes that allow the facility to move toward attainment of its mission.
The concept of “high-performance teams” is frequently discussed in management literature. Common characteristics of the very best work teams include effective communication, team member alignment around priority initiatives, the development and follow-through of short-and long-term plans, and accountability for the team’s actions.1
It has been reported that the average work team achieves only about 63% of its strategic plan objectives. Figure 1 identifies reasons for the 37% failure rate (gap between plans and results).
Managers of high-performance teams recognize that it is important to track their performance against priorities and against objective time schedules. They also follow- through with communication, and they learn about performance bottlenecks by observing and communicating with team members. These most effective managers also know that continued gaps between plans and performance can yield a culture of under-performance which actually creates a “status quo” that 100% success is not expected.
Strategies to build and maintain high-performance teams include:
Central Service managers should develop and emphasize a culture of high-performance teams, including those comprised entirely of staff members from their department and those with cross-functional membership. Note: The remainder of this lesson addresses tactics helpful in facilitating high-performing cross-functional teams.
A cross-functional team is a group of employees with different functional (departmental) expertise and experience who address an organizational challenge. For example, supervisors from several departments can work to improve a process that impacts each of their departments. Assume there are on-going complaints about the content of instrument sets ordered by specific physicians for specialized procedures. A traditional within-department Central Service work team might “blame” operating room personnel for “communication problems,” while a team representing the surgical unit might “decide” that the problem rests solely within Central Service. A cross-functional team comprised, in part, of representatives of both the Central Service and Surgical departments will be more likely to set aside blame and work cooperatively together to resolve the issue.
There are several benefits to effectively facilitated cross-functional teams:
The advantages to cross-functional teams can be tempered with some potential pitfalls. For example, they can limit the members’ professional growth if projects have a narrow focus and require lengthy commitment. As well, projects which are too large in scope are not normally candidates for use of cross-functional teams, nor are those with impractical/no deadlines which lack urgency.
Central Service Managers desiring to organize a cross-functional team effort should first assure that their healthcare facility is aligned to support cross-functional teamwork. Is the concept supported by the organizational culture and structure? Are strategies in place to plan team projects and the systems (examples: information gathering, training, and rewards) which will help facilitate team success?
Managers have several important responsibilities as cross-functional team projects are planned and facilitated. For example, they should:
Explain reporting expectations.
Provide an appropriate orientation about the project’s topic and assignment in an initial team meeting so all members are “up to speed” about the challenge prompting the project and the manager’s expectations about the team’s role in its resolution.
Communication barriers, if not managed effectively, can create problems for cross-functional teams. For example, there can be “turf battles” between functional areas, and specific departmental jargon (language typically understood only by persons working within a specific functional area) can also create problems. Other communication barriers arise from different work orientations and more/less interest in a team’s goals and its success. Finally, without effective communication there can be greater concern for “harmony” or consensus (also known as “group think”) than for team success.
Functional managers may appoint leaders of cross-functional teams or, alternatively, a team may “self-select” a leader by a formal or an informal method. Either way, the leader of the cross-functional team must coach (facilitate) rather than “manage.” In other words, the team leader should assist with decision-making rather than make unilateral decisions, and he/she should promote team performance that best assures alignment with the project’s goals. A team leader should serve as a spokesperson for the team, encourage participation from all team members, resolve team conflicts, and respect team members.
Because team members will represent several departments, they can be strangers, colleagues, or friends. Regardless, they must be technically competent, be effective communicators, and be able and willing to compromise their positions in efforts to achieve consensus.
The best cross-functional teams are committed to goal attainment, and these goals should be agreed upon very early in the team decision-making process. Key members should serve on the team from the project’s initiation to its completion, and all members should follow agreed upon “ground rules” including responsibilities, expectations, and meeting mechanics.
Cross-functional teams must be delegated the necessary authority (power) to achieve their goals, and the team members themselves must be empowered if they are to be effective. Upfront decisions about conflict resolution tactics are needed, and the team may need access to additional essential organizational resources as the project evolves. A process must be in place to assure progress is made, and stakeholders must be kept informed about the team’s efforts and successes. Most importantly, team members must be rewarded for their achievements.
How many persons should serve on a cross-functional team? The short answer is, “small is best” because teams with fewer members are generally are more productive. First, there should be at least one representative from each affected functional area. A small team increases the involvement of those on the team and this, in turn, leads to increased participation and trust among team members. If the team must be comprised of more than approximately four to six members, it is normally best to divide the team into sub-groups.
Some management writers make a distinction between work groups and work teams. In a work group, employees tend to look at their jobs in isolation. They focus on doing their own jobs well, and they don’t think about how their jobs relate to those of co-workers and how everyone must work together for the benefit of the “customers.” Persons in work groups are not committed to an overall goal or even to each other. They may think, “I get my job done—and good luck with yours.”
By contrast, members of a work team have the philosophy that “We’re all in this together.” They know that communication, trust, commitment, and clearly identified goals can transform work groups in to work teams. As this occurs, the first step toward high performance work teams has been taken.
1 Mankins and Steele. Turning Strategy Into Great Performance. Harvard Business Review. August, 2005.
2 See, for example, Jack Ninemeier. Aligning People With the Organization: “Planning the Plan.” Communiqué. International Association of Healthcare Central Service Materiel Management. January-February, 2009.
This column was written by Jack Ninemeier, Ph.D, CHA of the Eli Broad Graduate School of Management at Michigan State University. Dr. Ninemeier is the editor of Central Service Technical Manual (5th Edition), Supervision Principles: Leadership Strategies for Healthcare Facilities (2nd Edition), and Material Management and the Healthcare Industry, all published by IAHCSMM.