Teamwork+&+mutual+support

non-technical skills toc =Teamwork = **A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they are mutually accountable.** Katzenbach and Smith, 1993



Hopi proverb
 * One finger cannot lift a pebble **

These has been so much written and said about teamwork, that this site will only scratch the surface. It is worth emphasising, though, that effective teams are more effective (more likley to achieve desired outcomes) and better for the members (more satisfied and less stressed). Effective teams are characterised by:  1) agreed goal(s)  2) agreed way of achieving goal(s) with complementary roles for team members  3) effective communication between members.

Real team: a definition
**Collection of individuals with complementary skills who have become committed to common purposes, goals and working methods.**

GRIPS mnemonic for teamwork


This is also applicable to leadership; leadership and "followership" are flip sides of the same coin.

Common deficiencies in team processes (from a study in ER)

 * 1) Too little cross monitoring of actions between actions
 * 2) Failure to advocate/assert a position/corrective action
 * 3) <span style="font-family: Georgia,serif;">Failure to hold team members accountable for their responsibilities
 * 4) <span style="font-family: Georgia,serif;">Failure to prioritise tasks
 * 5) <span style="font-family: Georgia,serif;">Failure to seek information for decision making

<span style="font-family: Georgia,serif;">While these were deficiencies in a clinical setting, there are implications for non-clinical activities outdoors:
 * 1) <span style="font-family: Georgia,serif;">Always double check any important actions another team member makes (e.g. checking their knots when climbing, checking the decision of the navigator). This is especially important in adverse conditions (such as stress, fatigue, extreme weather) but it is in those that the temptation to omit this double check tends to be overpowering. The results can be fatal.
 * 2) <span style="font-family: Georgia,serif;">If you "know" you are right (as much as you can), then challenge others who disagree in a constructive and assertive way. This might be when a group leaders has made a decision about a route to take that you feel is unnecessarily risky.
 * 3) <span style="font-family: Georgia,serif;">If someone was meant to have done something but has not, that needs to be addressed. Failure to do something simple but important such as collecting water when the opportunity arises) can result in failure of an expedition, or expose team members or a casualty to avoidable risk.
 * 4) <span style="font-family: Georgia,serif;">The important and urgent tasks must be tackled first.
 * 5) <span style="font-family: Georgia,serif;">"Winging it" and hoping things will turn out OK is not acceptable clinical practice. It is not acceptable in an outdoor setting.

This video shows how effective clarity of goal and mutual support can be: media type="youtube" key="LU8DDYz68kM" height="315" width="420"

This video demonstrates less effective team working: media type="youtube" key="ERbt1J_7bRk?version=3" height="315" width="420"

Video demonstrating the importance of the "first follower" and of leaders treating followers as equals:

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[|Video about team dynamics (from sports context)]

LTEM: leadership & teamwork in emergency medicine: [| ltem v2.pdf]

The better the team, the safer the world

<span style="font-family: Verdana,Geneva,sans-serif;">Conflict and assertiveness
<span style="font-family: Georgia,serif;">A team that does not address conflict will become less effective. <span style="font-family: Georgia,serif;">Constructively dealing with different viewpoints is a characteristic of a really good team. <span style="font-family: Georgia,serif;">One of the key parts of communication within teams is that any member should be able (and encouraged) to question what other, senior, team members say or do.

<span style="font-family: Georgia,serif;">**Constructively** handling a conflict results in **collaboration**: both parties achieve their goals without damaging their relationship.

<span style="font-family: Georgia,serif;">**Destructive** ways of handling conflict include: <span style="font-family: Georgia,serif;">- **compromise** - neither party really gets what they want, so not a long term "fix" <span style="font-family: Georgia,serif;">- **accommodation** - the focus is on maintaining the relationship at the expense of the "task". If the task is crucial for safety this is not acceptable. <span style="font-family: Georgia,serif;">- **avoidance** - no-one faces up to the conflict; it will tend to fester and grow bigger (think of an abscess that is not incised in a timely manner - it will be much worse for all concerned when it is finally treated) <span style="font-family: Georgia,serif;">- **dominance -** the "senior" team member tells the other what the "right" anaswer is

[|resolving team conflict] [|the DESC approach to assertively handling conflict]

=<span style="font-family: Verdana,Geneva,sans-serif;">Mutual support = <span style="font-family: Georgia,serif;">Part of teamwork and mutual support is honest communication. effective teamwork will entail critical, but constructive, communication. This includes saying something if you think an unsafe course of action is being followed or is planned. See communication for the CUS tool.

<span style="font-family: Georgia,serif;">[|Presentation] on mutual support from the Team STEPPS programme

<span style="color: #008000; font-family: Georgia,serif;">Epicurus
 * <span style="color: #008000; font-family: Georgia,serif;">It is not so much our friend's help that helps as the confidence of their help **

<span style="font-family: Verdana,Geneva,sans-serif;">Tips for effective teamwork
<span style="font-family: Georgia,serif;">(from recommended book)
 * 1) <span style="font-family: Georgia,serif;">Practice effective teamwork in a non-crisis situation //before// needing to rely on it in a genuine crisis
 * 2) <span style="font-family: Georgia,serif;">Adequate //interaction// and //information exchange// need to become routine (links to GRIPS approach)
 * 3) <span style="font-family: Georgia,serif;">Don't expect others in your team to read your mind - communicate your thoughts
 * 4) <span style="font-family: Georgia,serif;">A hsared mental model is needed for effective teamwork; this relies on effective communication between members
 * 5) <span style="font-family: Georgia,serif;">Mutual support can reduce the workload for everyone
 * 6) <span style="font-family: Georgia,serif;">Effetive teamwork needs effective leadership (though that role may not reside with only one person)
 * 7) <span style="font-family: Georgia,serif;">Everyone involved in completion of the "task" is part of the team

<span style="color: #000000; font-family: Verdana,Geneva,sans-serif;">Links
[|team effectiveness assessment] <span style="font-family: Georgia,serif;">LTEM teamwork presentation: <span style="font-family: Georgia,serif;">[| teamwork ssc.pdf] <span style="font-family: Georgia,serif;">Does your team work? <span style="font-family: Georgia,serif;">[| how to work in a team.pdf] <span style="font-family: Georgia,serif;"> [|Belbin's team roles] <span style="font-family: Georgia,serif;"> [|Tuckman's model of team development] <span style="font-family: Georgia,serif;"> 12 point checklist for effective teams <span style="font-family: Georgia,serif;"> Effective team building <span style="font-family: Georgia,serif;">[|Why do only some teams work?] [|Team dynamics] (forming, storming, norming, performing) [|team self evaluation using GRIPS approach] [|How to be a good team player]
 * [[image:http://ssc2008.wikispaces.com/i/mime/32/application/pdf.png caption="external image pdf.png" link="http://wildernessmedicine.wikispaces.com/space/showimage/teamwork+ssc.pdf"]] ||
 * external image pdf.png ||
 * [[image:http://ssc2008.wikispaces.com/i/mime/32/application/pdf.png caption="external image pdf.png" link="http://wildernessmedicine.wikispaces.com/space/showimage/how+to+work+in+a+team.pdf"]] ||
 * external image pdf.png ||

<span style="font-family: Verdana,Geneva,sans-serif;">Recommended book
<span style="font-family: Georgia,serif;">[|Crisis Management in Acute Care Settings]

<span style="font-family: Verdana,Geneva,sans-serif;">Mastery quiz
<span style="font-family: Georgia,serif;"> <span style="display: block; font-family: Georgia,serif; height: 1px; left: -40px; overflow: hidden; position: absolute; top: -25px; width: 1px;">Part of teamwork and mutual support is honest communication. This includes saying something if you think an unsafe course of action is being followed or is planned. See the CUS tool above.