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Embedding and adapting Team Based Working for better team performance

Aneurin Bevan University Health Board – 2013

It may have taken a little longer than originally envisaged but with the support of senior executives, Team Based Working is becoming embedded at Aneurin Bevan – helping teams to be more effective and supporting the drive for quality and patient safety.

 

Why Team Based Working?
Recognising the need to improve team working across the organisation, the Health Board looked for a structured approach that would integrate with other initiatives as well as providing a day-to-day framework for helping teams through all sorts of issues.

The Affina Team Journey emerged as the best solution. Its diagnostic and development tools could identify teams most in need of help and pinpoint areas for development. OD leads were also reassured by the quality of research on which the tools were built, having previously been involved in studies carried out by Lynn Markiewicz and Professor Michael West to investigate the links between effective team working and sickness absence within the organisation.

How was it used?
Those heading the programme quickly established The Affina Team Journey as the key tool for improving team performance. They used the Team Journey to introduce Team Based Working (TBW) wherever they could. Interventions varied in nature: some were proactive and large scale, for example to support the development of teams as they moved to a new hospital; some were more reactive, such as responding to the need to improve performance in a small number of associated teams. And of course much activity still focussed on those teams perceived to be ‘in trouble’, but increasingly activity is about celebrating successful team working!

The Board trained 14 team coaches in the concepts and practices of TBW and the majority continue in the role today. Initially each coach was allocated to work closely with one of the Executive Directors and his/her immediate reports so that TBW could be introduced top-down. But while cascading was successful in part, a squeeze on resources eventually gave way to a more pragmatic approach. Requests for help faced a much greater scrutiny and diagnostic tools were used with teams to focus resources on those most in need and to ask: What are the real issues here? What do we need to do?

TBW was key to a package of measures targeting 20 areas in the organisation with the highest sickness absence, lowest appraisal rates and highest use of agency staff. It was also integrated into other initiatives, particularly Transforming Care, part of a national programme to improve healthcare in Wales. Here TBW was delivered as an integral part of the Transforming Care Leadership Day. TBW helped with major transition too. Ward sisters facing a challenging move to a new hospital in Caerphilly worked with their coach to complete a full 23 week Team Journey.

More recently the Affina Team Journey has become an integral part of leadership development programmes within the Health Board.

Walk the walk
Nowadays TBW is simply the way that everybody works, including the execs and board who are fully behind the approach and use it themselves. “As team coaches, we walk the walk as well,” says Jill Evans, Senior Education and Development Manager. “I found this incredibly helpful in terms of credibility, to be able to say authentically – yes, we struggle with that ourselves.”

And finally…
“On the whole the AOD approach gives us some really fantastic supportive tools to introduce and embed TBW”, says Sue Ball, Head of Development and Wellbeing, “tools that help team leaders to be more effective and the whole team to feel the benefits.”

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