Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T18:20:32.721Z Has data issue: false hasContentIssue false

Understanding team dynamics to promote team building in a radiotherapy department

Published online by Cambridge University Press:  25 September 2020

Krista Dawdy*
Affiliation:
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
Merrylee McGuffin
Affiliation:
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
Colette Fegan
Affiliation:
Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
*
Author for correspondence: Krista Dawdy, Odette Cancer Centre, Sunnybrook Health Sciences, 2075 Bayview Ave, Toronto, ONM4N 3M5, Canada. Tel: +1 416 480 6104. E-mail: [email protected]

Abstract

Background:

Teamwork is a central framework in healthcare delivery. Team dynamics can impact the team as a whole and has been identified within the literature as a contributory factor to quality and safety, patient satisfaction, staff satisfaction and overall performance. Within radiation therapy (RT), teamwork is essential in the delivery of high-quality care, yet team building and team development is under-reported.

Aim:

The focus of this research is to form a better understanding of what plays an impact on teams in a large urban RT cancer centre and how to better engage staff to work together, improve team dynamics and promote team building.

Materials and Methods:

An electronic search of the literature was conducted to better inform debate and aid in the development of team-building sessions in a busy radiotherapy department. Abstracts were screened and relevant articles selected if they met the search criteria that included relevancy related to team building, contributory factors on team dynamics, team-based learning, team performance and implication of civility.

Results:

A total of 45 articles were included in the final analysis. The majority were from the disciplines of medicine (45%), business (22%) and nursing (18%). Only 3 of the 45 articles (7%) focused on the profession of RT. Most articles discussed more than 1 theme with team dynamics and team building being the most common themes discussed in 16 articles each (36%). Other common themes included teamwork (31%), respect and civility (20%), leadership and hierarchy (11%), medical errors (11%) and team training (11%). Only 3 of the 45 articles (7%) focused on RT.

Conclusion:

There is a lack of longitudinal evidence to support the impact of team building sessions to improve team dynamics and promote a positive, cohesive team environment. Specifically within RT, the impact team building has on team dynamics has been under investigation.

Highlights:

High-quality patient care can be linked to team collaboration and cohesiveness. Changing the culture within a team and engaging in civility and respect in everyday practice has the potential to improve team dynamics, patient safety, staff and patient satisfaction.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lacerenza, CN, Marlow, SL, Tannenbaum, SI et al. Team development interventions: evidence-based approaches for improving teamwork. Am Psychol 2018; 73 (4): 517531.10.1037/amp0000295CrossRefGoogle ScholarPubMed
Porath, CL, Gerbasi, A, Schorch, SL. The effects of civility on advice, leadership and performance. J Appl Psychol 2015; 100 (5): 15271541.10.1037/apl0000016CrossRefGoogle ScholarPubMed
Kohn, LT, Corrigan, JM, Donaldson, MS. To Err is Human: Building a Safer Health System (Vol 6) Washington D.C. National Academies Press, 1999.Google Scholar
Goh, SC, Chan, C, Kuziemsky, C. Teamwork, organizational learning, patient safety and job outcomes. Int J Health Care Qual Assur 2013; 26 (5): 420432.10.1108/IJHCQA-05-2011-0032CrossRefGoogle Scholar
Greenwalt, J, Mittauer, K, Liu, C et al. Reducing errors in radiation therapy through electronic safety checklists. Appl Rad Oncol; 2014. https://appliedradiationoncology.com/articles/reducing-errors-in-radiation-therapy-through-electronic-safety-checklists.10.1016/j.ijrobp.2014.05.574CrossRefGoogle Scholar
Udowicz, M, Civitella, M and Gunning-Mooney, K. Optimizing teamwork in radiation therapy: a Canadian experience. Geneva, Switzerland: ESTRO Forum, 2013.Google Scholar
Yardley, J. Team dynamics: the role it plays in shaping service delivery. NRC 2014; 16 (5): 284286.10.12968/nrec.2014.16.5.284CrossRefGoogle Scholar
Song, H, Ryan, M, Tenulkar, S et al. Team dynamics, clinical work satisfaction, and patient care providers: mixed method study. Health Care Manage Rev 2017; 42 (1): 2841.10.1097/HMR.0000000000000091CrossRefGoogle Scholar
Babiker, A, El Husseini, M, Al Nemri, A et al. Health care professional development: working as a team to improve patient care. Sudanese J Paedeatr 2014; 14 (2): 916.Google Scholar
van de Ven, J, Houterman, S, Steinweg, R et al., the TOSTI-trial group. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study); a randomized control trial BMC Preg Childbirth 2010; 10 (59). doi: 10.1186/1471-2393-10-59 CrossRefGoogle Scholar
Ezziane, Z, Maruthappu, M, Gawn, L et al. Building effective clinical teams in healthcare. J Health Organ Manag 2012; 26 (4): 428436.10.1108/14777261211251508CrossRefGoogle ScholarPubMed
Chera, BS, Jackson, MJ, Lukasz, MM et al. Improving quality of patient care by improving daily practice in radiation oncology. Semin Radiat Oncol 2012; 22: 7785.10.1016/j.semradonc.2011.09.002CrossRefGoogle ScholarPubMed
Pacelli, R, Caroprese, M, Palma, G et al. Technological evolution of radiation treatment: implications for clinical applications. Semin Oncol; 2019; 46 (3): 193201.10.1053/j.seminoncol.2019.07.004CrossRefGoogle ScholarPubMed
White, E, Kane, G. Radiation medicine practice in the image-guided radiation therapy era: new roles and new opportunities. Semin Radiat Oncol 2007; 17: 298305.10.1016/j.semradonc.2007.07.001CrossRefGoogle ScholarPubMed
Salas, E, Rosen, MA. Building high reliability teams: progress and some reflections on teamwork training. BMJ Qual Saf 2013; 22 (5): 369373.10.1136/bmjqs-2013-002015CrossRefGoogle ScholarPubMed
Castka, P, Bamber, CJ, Sharp, JM et al. Factors affecting successful implementation of high performance teams. Team Perform Manag: Int J 2001; 7 (8): 123134.10.1108/13527590110411037CrossRefGoogle Scholar
Wing, LS. Leadership in high performance teams: a model for superior team performance. Team Perform Manag 2005; 11 (1/2): 411.10.1108/13527590510584285CrossRefGoogle Scholar
Landry, L. 6 Characteristics of An Effective Leader, 2018 https://online.hbs.edu/blog/post/characteristics-of-an-effective-leader.Google Scholar
Edmonds, SC. Is incivility eroding your organization’s culture? Unfortunately the odds say yes. 2017 https://www.forbes.com/sites/forbescoachescouncil/2017/04/14/four-steps-proven-to-cultivate-workplace-civility/.Google Scholar
Pearson, CM, Porath, CL. On the nature, consequences and remedies of workplace incivility: no time for “nice”? think again. Acad Manag Execut 2005; 19 (1): 718.Google Scholar
Osatuke, K, Moore, SC, Ward, C et al. Civility, respect, engagement in the workforce (CREW). J Appl Behav Sci 2009; 4 (3): 384410.10.1177/0021886309335067CrossRefGoogle Scholar
Tsz-Sum Lee, C, Doran, DM. The role of interpersonal relations in healthcare team communcation and patient safety: a proposed model of interpersonal process in teamwork. Can J Nurs Res 2017; 49 (2): 7593.10.1177/0844562117699349CrossRefGoogle Scholar
Hakanen, M, Soudunsaari, A. Building trust in high-performing teams. Technol Innov Manag Rev. https://timreview.ca/article/567.Google Scholar
Coletta, J. Google’s Goals for Civility in the Workplace, 2018 http://hrexecutive.com/googles-goals-for-civility-in-the-workplace/ Google Scholar
O’Leary, KJ, Ritter, CD, Wheeler, H et al. Teamwork on inpatient medical units: assessing attitudes and barriers. Qual Saf Health Care 2010; 19 (2): 117121.10.1136/qshc.2008.028795CrossRefGoogle ScholarPubMed
Xyrichis, A, Ream, E. Teamwork: a concept analysis. J Adv Nurs 2008; 61: 232241.10.1111/j.1365-2648.2007.04496.xCrossRefGoogle ScholarPubMed
Srivastava, R. Speaking up: when doctors navigate medical hierarchy. New Engl J Med 2013; 368 (4): 302305.10.1056/NEJMp1212410CrossRefGoogle ScholarPubMed
O’Leary, KJ, Sehgal, NL, Terrell, G et al. Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement. J Hosp Med 2012; 7 (1): 4854.10.1002/jhm.970CrossRefGoogle ScholarPubMed
Gorman, J. Team coordination and dynamics: two central issues. APS 2014; 23 (5): 355360.10.1177/0963721414545215CrossRefGoogle Scholar
Weaver, SJ, Dy, SM, Rosen, MA. Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf 2014; 23 (5): 359372.CrossRefGoogle ScholarPubMed
Neily, J, Mills, PD, Young-Xu, Y et al. Association of a medical team training program and surgical mortality. JAMA 2010; 304 (15): 1693–700.CrossRefGoogle ScholarPubMed
Delice, F, Rouseeua, M, Feitosa, J. Advancing teams research: what, when and how to measure team dynamics over time. Front Psychol 2019; 10 (1324): 120.CrossRefGoogle ScholarPubMed
College of Medical Radiation and Imaging Technologists in Ontario (CMRITO). Standards of Practice. 2019. https://www.cmrito.org/news/2017–11–08-cmrto-revised-standards-of-practice-and-code-of-et/.Google Scholar
Bleakley, A, Allard, J, Hobbs, A. Towards culture change in the operating theatre: embedding a complex educational intervention to improve teamwork climate. MedTeacher 2012; 34: e635e640.Google ScholarPubMed
Brou, R, Doane, S, Bradshaw, G et al. The role of individual differences in dynamic team performance. Proceedings of Human Factors and Ergonomics Society 49th Annual Meeting pp. 12381242. Orlando, Florida.10.1177/154193120504901305CrossRefGoogle Scholar
Chirabu, DS, Harrison, DA. Do peers make the place? conceptual synthesis and meta-analysis of coworker effects on perceptions, attitudes, OCBs and performance. J Appl Psychol 2008; 93 (5): 10821103.Google Scholar
Green, B, Oeppen, RS, Smith, DW et al. Challenging hierarchy in healthcare teams: ways to flatten gradients to improve teamwork and patient care. Brit J Oral Maxillofacial Surg 2017; 55: 449453.10.1016/j.bjoms.2017.02.010CrossRefGoogle Scholar
Hahtela, N, McCormack, B, Brendan, P et al. Workplace culture and patient outcomes: what’s the connection? Nurs Manag 2017; 48 (12): 3644.CrossRefGoogle ScholarPubMed
Lamb, BW, Sevdulls, N, Rora, S et al. Teamwork and team decision-making at multidisciplinary cancer conferences: barriers, facilitators, and opportunities for improvement. World J Surg 2011; 35: 19701976.10.1007/s00268-011-1152-1CrossRefGoogle ScholarPubMed
Leiter, MP, Price, SL, Spence Laschinger, HK. Generational differences in distress, attitudes and incivility among nurses. J Nurs Manag 2010; 18: 970980.10.1111/j.1365-2834.2010.01168.xCrossRefGoogle ScholarPubMed
Lingard, L, Espin, S, Whyte, S et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care 2004; 13: 330334.10.1136/qshc.2003.008425CrossRefGoogle ScholarPubMed
Payne, GT, Benson, GS, Finegold, DL. Corporate board attributes, team effectiveness and financial performance. J Manag Stud 2009; 46 (4). doi: 10.1111/j.1467-6486.2008.00819.x CrossRefGoogle Scholar
Salas, E, Cooke, N, Rosen, MA. On teams, teamwork and team performance: discoveries and developments. J Hum Fact Ergon Soc 2008; 50 (3): 540547.10.1518/001872008X288457CrossRefGoogle ScholarPubMed
Sandaniantz, B. Civility costs nothing and buys everything. Nur Lead 2015; 13 (3): 4548.CrossRefGoogle Scholar
Zwillinger, E, Hustler, T. Cultivating a high-performing team. Nurs Manag 2017; 48 (12): 2634.10.1097/01.NUMA.0000526911.54593.96CrossRefGoogle ScholarPubMed