CRCST
Technical Continuing Education (TCE)
SELF-STUDY PLANS

This series of self-study lessons on Central Service topics was developed by the International Association of Healthcare Central Service Materiel Management (IAHCSMM). The lessons are administered by Purdue University’s Continuing Education Division.

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Lesson Plan CRCST 92
Building Effective Teams
[Reprinted from Communiqué: January/February 2007]

Objective 1: Indicate how effective teams benefit the Central Service Department.

The Central Service department requires knowledgeable and trained staff to best serve its patients. Because each staff member’s work relates directly to that done by others, the staff must work as part of a team. Those who sterilize medical devices, for example, depend upon others to complete earlier processing steps, and those with inventory and distribution duties depend upon their co-workers to fulfill their responsibilities. Everyone must work closely together to assure that the patients are receiving the best possible care. If only one staff member does not perform the work correctly, in fact, the consequences can be tragic. What one staff member does—or fails to do—affects the work of the whole team, and the success—or failure—of the Central Service department.

Teamwork is beneficial in several ways. Good teamwork can:

• Increase patient satisfaction levels by raising their awareness of the individual CS staff members roles in their care.

• Improve productivity through increased staff cooperation and reduced interpersonal competition.

• Increase employees’ job satisfaction.

• Improve the work environment by creating a common agenda (purpose) for the staff.

• Decrease job-related stress.

• Yield creative team problem-solving approaches.

Objective 2: Explain characteristics of effective teams.

Effective teams typically share many characteristics. Among these are:

• Common goals are defined and accepted by team members.

• Team members cooperate with and help each other.

• Teams share the resources necessary to attain their goals.

• While the atmosphere in which the team members work is comfortable, meaningful disagreements can still take place between team members.

• Team members participate in discussions about matters affecting them.

• Members of the group are creative; they are free to express their feelings, and do so without fear of ridicule.

• There is generally group consensus—not just a simple majority—about decisions that affect the team.

• Team members objectively analyze each other’s ideas and positions, rather than subjectively criticizing them.

• Assignments are made and accepted when action must be taken.

• There is seldom a power struggle between team members.

• The team leader does not always dominate, nor does the team’s attention focus on who is in control. Instead, the primary concern is what must be done.

• Team members know how the group operates.

• Team members trust each other.

Objective 3: Identify two types of teams.

Central Service technicians are members of two types of teams: formal and informal groups. Effective teamwork is important in both types of group.

A healthcare facility is comprised of a formal group of employees who are accountable to, at the highest organizational level, the hospital administrator and board of directors. As staffing plans are developed, smaller work groups are established. The facility is divided into several large units, with one, Materiel Management, typically responsible for specific functions. One formal group within Materiel Management—Central Service—provides sterilization and supply services for other departments, among other functions. Work in Central Service may be divided into additional formal groups, including those relating to specific work units and work shifts. Each formal work group has a leader responsible for coordinating, directing, and controlling the group.

A task group is another type of formal group. Members work together to perform generally non-routine activities. For example, a committee might address a specific concern, and a work team will develop a job breakdown for training purposes. After the work of a task group is completed, the group is typically dissolved. Members then become available to work in other task groups, as needed, perhaps with other staff members who were not part of the previous task group.

Informal groups develop because of common interests among members, economic reasons, a desire to relate to others in a similar situation, and an interest in satisfying specific, common personal needs. Employees who eat lunch, take breaks, participate in after-work activities, or car-pool together are examples of informal groups.

Informal work groups are not necessarily “good” or “bad.” These groups can help, harm, or have no impact whatsoever on the facility’s or department’s efforts to attain its goals. The casual communication system (or “grapevine”) that often arises from these informal groups can spread rumors, which is not desirable, or provide helpful information, which is very desirable, depending on the situation.

Because informal groups tend to form among people with common interests, it is likely that CS staff with positive attitudes about the facility and their work will be drawn to others who share these attitudes. It is also likely that those with negative attitudes about the Central Service department will also form groups together.

Objective 4: Review tactics to build and maintain effective teams.

Successful teams do not happen by chance alone. Central Service managers and other team leaders play a significant role in establishing and maintaining an environment in which individuals work effectively as teams. The team leader must identify and use each member’s strengths to achieve their goals. This requires coordinating the team and making the best use of each team member’s skills.
Effective team leaders consistently demonstrate several traits:

• They have great interpersonal (people) skills. They work to develop a team approach, and give a priority to team building activities.

• They allow team members to make decisions, and, when appropriate, share management responsibilities with team members who have the knowledge, skills, and experience necessary for the tasks at hand.

• They allow team members to establish or, at least, contribute to planning goals for the team and identifying achievable results that can help measure progress toward reaching those goals.

• They solicit comments from team members about strategies for improving work methods, productivity, and other matters affecting departmental goals.

• They serve as the link between the team and other healthcare administrators. In this role, they work with higher management levels to gain commitment and access to the facility’s resources that are necessary for the CS department to attain its goals.

• They practice the “art and science” of supervision in efforts to maximize morale levels, to minimize unnecessary turnover, and to make the best use of the limited resources that are available.

• They encourage active participation in problem-solving and decision-making, and they encourage creative alternatives that the manager and team members can analyze for application.

Successful team leaders are driven by their facility’s mission statement, what the facility wants to achieve, and how it intends to do so. They share the facility’s mission statement with their team, and lead the development of a departmental mission statement that is driven by that of the facility. This helps establish the context within which team goals are developed. In the process, the CS department will become better able to attain its mission and, in turn, can help in achieving the facility’s broader mission. This process allows each team member to know how he or she, the team, and the CS department contribute to the facility and its mission.
Effective team leaders set expectations, facilitate team plans to attain goals, and monitor performance as work evolves. They also solicit suggestions for corrective action from the team, to better attain pre-established goals.

Team leaders build and reinforce the commitment of their team by encouraging team input in planning, decision-making, and problem-solving. By involving the team, the tactics to address challenges the department faces are better accepted by the team and team members have a significant interest in their success.
Effective team leaders ensure that staff members are competent. They provide access to training and professional development opportunities that will provide the knowledge and skills necessary for team members to be successful. Team leaders help the team assemble the necessary resources—including leadership—necessary to reach their goals. This also means that the team leaders themselves are committed to, and involved in, on-going training and professional development programs.

The best leaders empower their team members by giving them authority to make decisions within their areas of responsibility. This helps give the team a sense of ownership for the decisions they make in performing their jobs.

Team leaders know how to manage information to best serve their teams. They provide the necessary information to help teams plan and monitor progress towards their goals. Good leaders encourage team members to offer diverse opinions and ideas, and they encourage communication, networking, and feedback which, in turn, becomes input for additional team discussions.

The team leader should use and promote creative thinking. New ideas should be encouraged, and teams should be rewarded when successful new methods are proposed and implemented.

Central Service managers who build successful teams encourage their team members to be service-minded. First, they act as role models, exhibiting attitudes, words, and actions that emphasize customer service. Second, they make training in customer service available to all staff, and encourage participation in it. Third, they reward team members who provide the levels of service that are envisioned in the facility’s and department’s mission statements, through positive reinforcement on the job and favorable input during performance appraisals.

Objective 5: Explain how effective teamwork can assist with the decision-making process.

Hopefully, Central Service managers and supervisors recognize the advantages of group decision-making. If so, their teams have great opportunities to generate and evaluate alternatives for decision-making and resolving problems the department faces.

In some healthcare facilities, Central Service technicians are able to participate in decision-making and problem-solving as part of a cross-functional team. This involves employees from different departments within the healthcare facility working together to resolve problems, such as instruments that are not available when needed in the operating room. A traditional approach to the problem, in which only operating room personnel address the issue, may determine that the majority of the instrument problems are due to the CS department. While this conclusion may be partially correct, operating room personnel may also be causing problems with instrument availability. Therefore, a cross-functional team—comprised of staff from the Operating Room, Central Service, and other departments—may yield solutions that would not be considered when only a group with a more narrow focus addressed the issue.

Objective 6: Discuss the concept of self-directed work teams.

A self-directed work team is a natural extension of empowering CS employees. In addition to individual empowerment, this allows the staff to experience team empowerment. As the title suggests, a self-directed work team requires little on-going direction from a supervisor. The team will be responsible for making most—if not all—of the decisions that affect them. For example, the team will likely determine the members’ job assignments and develop their work schedules. They may also develop their own wage/salary compensation system, and recruit, hire, train, and supervise their own team members. The team may also develop and implement their own performance appraisal system, and may even discipline and terminate group members, as necessary.

Most healthcare facilities may be far from accepting self-directed work teams. If such teams are formed and take on only a few of these possible responsibilities, however, it is clear that supervisors will, in the future, assume different kinds of obligations, and will perform different types of work tasks.

Conclusion

Effective team leaders have a well-defined vision of the goals they want to reach, in both the short and long term, and they share this vision with their team members. As this takes place, team leaders are better able to merge their goals with those of their Central Service staff. The team can then be empowered to accomplish the goals that they have identified. On-going communication with team members is an excellent way for team leaders to keep sight of their vision for the department.

Endnotes

This lesson is adapted from:

1. Ninemeier, J. Chapter 22 in: Central Service Technical Manual. Seventh Edition. Chicago, Il., International Association of Healthcare Central Service Materiel Management. In process.
2. Ninemeier, J. Supervision Principles: Leadership Strategies for Healthcare Facilities. Second Edition. Chicago, Il., International Association of Healthcare Central Service Materiel Management, 1997. (See Chapter 12.)