A failure of function: Teamwork in primary health care

What fosters or prevents interprofessional teamworking in primary and community care? A literature review

“…West and Poulton's (1997) Support for innovation, a process of developing new and improved ways of doing things, was identified as influencing teamworking in 60% of studies. West and Wallace (1991) advocated innovation in their report of an exploratory study of eight primary healthcare teams using questionnaires, achieving a 72% response, since they found that team innovativeness was highly associated with team collaboration and suggest the importance of these teams being innovative in order to be effective.…”

“…Cartlidge et al (1987) suggest that good interpersonal relations can promote teamworking by inhibiting team conflict, but from the reviewed studies only one reported lack of team conflict (Molyneux, 2001), while others identified some form of team conflict as a barrier to teamwork either at an interpersonal or interprofessional level. West and Markiewicz (2004) argue that debate is desirable in teams, and the team's diversity and differences should be a source of excellence and creativity, but when conflict is experienced as unpleasant by members it can destroy relations and lower team effectiveness. Lack of understanding of each other's roles and tasks, absence of clear goals and poor organisation support are regarded as facilitating the appearance of such conflict (Payne, 2000).…”

“…Experts in the area of teamwork suggest that audit and individual rewards provide a way of appraising team members and acknowledging their contribution while offering incentives for further improvement and increasing members' commitment towards achieving their team's goals (West and Markiewicz, 2004). Furthermore, recent research investigating human resource management practices in relation with organisational performance in 61 hospitals in England revealed that appraisal had the strongest relationship with patient mortality (West et al, 2002), with the bigger the extent and sophistication of appraisal systems used, the lower levels of patient mortality encountered.…”

“…Clear goals and objectives facilitate good team functioning as they help to clarify each professional's roles and responsibilities and provide the team with a vision, so that individual creativity can be pooled to produce creative team outcomes (West and Markiewicz, 2004).…”

“…Lastly, audit is a vital process by which the team's effectiveness can be evaluated in order to sustain good performance or improve performance in areas where this is warranted (West and Markiewicz, 2004 Audit is essential for providing teams with effective feedback in order to sustain and improve their performance, and for providing energy and incentives to team members by giving publicity to team successes (West and Markiewicz, 2004). Moreover, work within organisational psychology suggest that regular team feedback on team performance and the competitive nature of relations are contextual factors influencing team effectiveness (Hackman, 1990;Tannenbaum et al, 1992).…”