Measuring teamwork and taskwork of community-based “teams” delivering life-saving health interventions in rural Zambia: a qualitative study

Abstract

BackgroundThe use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0–59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia.MethodsSix group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals.ResultsWe selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related.ConclusionCommunity and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries.

Factors Associated With Community Health Worker Performance Differ by Task in a Multi-Tasked Setting in Rural Zimbabwe

“…Our finding is consistent with prior studies linking supervision and recognition with improved motivation and performance. 31 , 39 – 41 The pregnancy identification task allowed CHWs and women to find out women’s pregnancy status immediately, and CHWs likely received immediate feedback from the women. Additionally, the supervisor’s skill providing constructive positive feedback may have motivated CHWs to perform this new activity.…”

Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

“…This prospective study assessed the level of teamwork and taskwork among community-based CHW–TBA teams supported by NHC members. We used an assessment tool developed through formative research with community leaders, health workers, CHWs and trained TBAs [ 23 ]. We carried out the assessment every six months from June 2011 to March 2013.…”

“…The teamwork skills and competencies included i) good communication; ii) respectful dialogue and action; iii) each helping the other, mutual support, and working hand in hand; iv) assess, make decisions and manage conflicts; v) trust and confidentiality of care-seekers/community members; vi) together monitor team task and team maintenance abilities; vii) evaluate successes and failures; viii) asking for feedback; and ix) motivate and encourage each other. The specific tasks and skills required for successful community teams were identified during earlier formative research [ 23 ].The training emphasized the importance of performing the joint tasks and the need to document tasks performed. They practiced and demonstrated how to perform these tasks.…”

“…Part B was administered separately to the CHW and trained TBA. It assessed 27 characteristics from eight teamwork processes identified during the formative research [ 23 ]: 1) mutual performance monitoring, 2) mutual trust, 3) decision making/planning, 4) team cohesion, 5) team motivation, 6) goals and objectives, 7) communication, and 8) conflict resolution/management. Data were collected from each member about whether, in his/her opinion, the characteristic was present in the team over the previous six months.…”

Measuring psychological safety in healthcare teams: developing an observational measure to complement survey methods

“…Psychological safety also facilitates "teaming", an active process which allows multidisciplinary healthcare teams to work together to deliver increasingly complex patient care [6,7]. In psychologically safe team's essential teamwork processes can evolve, including mutual performance monitoring, mutual trust, decision making, team cohesion, team motivation, and conflict resolution [8]. Moreover, how healthcare professionals relate to their co-workers is deemed an antecedent of job satisfaction [9].…”