BUILDING AND MANAGING TEAMS 145
bodies, such as committees for education, standards, disaster, and patient care evaluation. Others are established to meet a specific need (e.g., to formulate a new policy on substance abuse).
Teams are real groups in which individuals must work cooperatively with each other in order to achieve some overarching goal. Teams have command or line authority to perform tasks, and membership is based on the specific skills required to accomplish the tasks. Similar to groups described above, teams may include individuals from a single work group or individuals at similar job levels from more than one work group, individuals from different job levels, or in- dividuals from different work groups and different job levels in the organization. They may have a short life span or exist indefinitely.
Metropolitan Hospital has established a clinical ladder system for nursing staff. Each quarter, members of the clinical excellence committee meet to review applications from staff nurses who are seeking promotion to the next clinical ladder level. The committee is made up of staff nurses and nurse managers from each service line. Each applicant is responsible for completing a comprehensive application. The committee members evalu- ate each application and make recommendations to the vice president for patient care on those nurses who should be considered for promotion.
Not all work groups, however, are teams. For example, groups of individuals who perform their tasks independently of each other are not teams. Competing groups, in which members compete with each other for resources to perform their tasks or compete for recognition, are also not teams.
A work group becomes a team when the individuals must apply group process skills to achieve specific results. They must exchange ideas, coordinate work activities, and develop an understanding of other team members’ roles in order to perform effectively. Members appreciate the talents and contributions of each individual on the team and find ways to capital- ize on them. Most work teams have a leader who maintains the integrity of the team’s function and guides the team’s activities, performance, and development. Teams may be self-directed, that is, led jointly by group members who decide together about work objectives and activities on an ongoing basis.
In a given service area, the entire staff might not function as a team, but a subgroup may. For example, case managers for the inpatient and ambulatory cystic fibrosis population in a chil- dren’s medical center might be called a team. Individual members of an interdisciplinary team, such as this one, may report formally to different managers, but in delivering care to the cystic fibrosis population there is no designated individual in charge. In meetings, the team members discuss clients’ problems and jointly decide on plans of action.