Team to Achieve Milennium

1. One feature of the team in this case is frequent turnover among team members. How might turnover among team members affect team performance? What approaches can team leaders to take to minimize potential negative impacts of turnover and gain advantages, if any? Employee/team member turnover may be mostly a negative issue, yet it can become positive if only controlled by the organization correctly and appropriately. Turnover is often utilized as an indicator of the organization performance and it can easily be observed negatively towards the organization’s efficiency and effectiveness.

Also, turnover is a natural outcome of an organization which is why it has to be kept to a minimum. In order to minimize the impact of turnover is to first address and understand the issue and cause of the turnover. The purpose of knowing is to raise alertness as to investigate for the “why”. Once the organization finds out the reasons and cause of turnover, there are variety of actions that the organizations and leadership can execute in order to prevent the effects and impacts of turnover. By ensuring that management learns the cause of turnover and act accordingly, turnover may be reduces or controlled.

Lyman Coleman (1989) offers ideas on how to correct and prevent turnovers. His recommendation includes institution of exit interviews and other methods of finding reasons for people turnover. Also the following: * Get involved in finding our the cause of turnover * Bring attention to bottom line figures and how turnover affects everyone * Have an open door policy style of managing to allow members to comment on what might be bothering them about their job and roles. * Realize there is more that one problem and pay attention to all. Stay alert * Execute periodic audits of job satisfaction

* Have strict hiring standards * Develop and constant training strategies * Conduct member meetings One of the best recommendation is to have open door policy that will allows the team leaders/organization to hear of issues prior to escalating. Finding and learning about the member job satisfaction and exhaustion early can eliminate turnover. But on the other hand, turnover can be beneficial to the organization by learning which team member to elimination/terminating poor performances that affect the organizations performance, this allowing for internal promotion and hiring new team members with innovative ideas.

New team members can often bring positive input into the organization that can help handle turnover (Cintron, p4) In class lectures, team characteristics are discuss which are the following: * Team size, composition, and diversity: * Too few or too many members may reduce performance * Diversity affects way individuals perceive each other and how well they work together * Status differences: * May motivate others or act as source of conflict and tension * Psychological safety * Perceptions about consequences of interpersonal risks in work environment * Team norms

* Standard shared by team members regulating member behavior * Team cohesiveness * Extent members are committed to group task As a result it will follow into the model of team effectiveness. (HCA 6225, CH5) 2. Consumers or patients are sometimes involved in quality improvement teams, but in this role, they may feel that their voices are unimportant or that participation is symbolic rather than substantive. Do you think that consumers should be involved in the improvement teams in this case? Why or why not? If consumer involved, how can team leaders and members most effectively utilize their knowledge and insights?

Consumers or patients can play an important role in shaping managed care by expressing their voice on issues; by participating in governance, management or otherwise; through representatives; or by some combination of these. So I suggest yes that they should be involve on the team improvement teams. Their Participation refers to active involvement on implementation. They can participate in oversight, governance, operations, opinion surveys, and complaints. Also according to Rodwin, the aims of early Health Maintenance Organizations (HMOs) parallel those of consumer/ patient movements.

Managed care offers many benefits. It can increase access to primary and preventive care (with minimal or no out of pocket costs). It can also monitor and improve the practices of physicians and other health care providers and coordinate and rationalize the services of specialists. It can also control spending. Consumer involvement can put managers in touch with the experience and desires of customers. It can provide balance and perspective. Although they are being part of the team performance, their voice should be limited and watch over.

Consumer voice, participation and representation programs, however, need to be viewed critically because they might demand too many services and can become divided and polarize issues, leading to increased conflict. So therefore, future challenge is to foster balanced, appropriate and effective use of consumer voice. 3. Even when team improvement efforts achieve change, the sustainability of change remains a pervasive challenge. In fact, sustainability of the teams may be problematic. What are the particular obstacles to sustaining the improvements achieved by teams in this case?

Similarly, what factors might lead to the dissolution of the improvement teams over time? As a team leader, what strategic might be used to sustain change and to uphold the vitality of the team over time? Although teams have the capability to boost productivity and improve quality, they can also have the potential to increase costs and stress. As a result it can lead to lack of communication and motivation that can lead to the dissolution of the improvement of the teams over time. Team leadership should have skills pertaining to conflict resolution, overcoming communication obstacles, and effective structure techniques.

Understanding the five stages of team development, which are the following: Stage 1: Forming In the Forming stage, personal relations are characterized by dependence. Group members rely on safe, patterned behavior and look to the group leader for guidance and direction. Group members have a desire for acceptance by the group and a need to know that the group is safe. They set about gathering impressions and data about the similarities and differences among them and forming preferences for future subgrouping. Rules of behavior seem to be to keep things simple and to avoid controversy.

Serious topics and feelings are avoided. The major task functions also concern orientation. Members attempt to become oriented to the tasks as well as to one another. Discussion centers around defining the scope of the task, how to approach it, and similar concerns. To grow from this stage to the next, each member must relinquish the comfort of non-threatening topics and risk the possibility of conflict. Stage 2: Storming The next stage, called Storming, is characterized by competition and conflict in the personal- relations dimension an organization in the task-functions dimension.

As the group members attempt to organize for the task, conflict inevitably results in their personal relations. Individuals have to bend and mold their feelings, ideas, attitudes, and beliefs to suit the group organization. Because of "fear of exposure" or "fear of failure," there will be an increased desire for structural clarification and commitment. Although conflicts may or may not surface as group issues, they do exist. Questions will arise about who is going to be responsible for what, what the rules are, what the reward system is, and what criteria for evaluation are.

These reflect conflicts over leadership, structure, power, and authority. There may be wide swings in members’ behavior based on emerging issues of competition and hostilities. Because of the discomfort generated during this stage, some members may remain completely silent while others attempt to dominate. In order to progress to the next stage, group members must move from a "testing and proving" mentality to a problem-solving mentality. The most important trait in helping groups to move on to the next stage seems to be the ability to listen. Stage 3: Norming

In the Norming stage, interpersonal relations are characterized by cohesion. Group members are engaged in active acknowledgment of all members’ contributions, community building and maintenance, and solving of group issues. Members are willing to change their preconceived ideas or opinions on the basis of facts presented by other members, and they actively ask questions of one another. Leadership is shared, and cliques dissolve. When members begin to know-and identify with-one another, the level of trust in their personal relations contributes to the development of group cohesion.

It is during this stage of development (assuming the group gets this far) that people begin to experience a sense of group belonging and a feeling of relief as a result of resolving interpersonal conflicts. The major task function of stage three is the data flow between group members: They share feelings and ideas, solicit and give feedback to one another, and explore actions related to the task. Creativity is high. If this stage of data flow and cohesion is attained by the group members, their interactions are characterized by openness and sharing of information on both a personal and task level.

They feel good about being part of an effective group. The major drawback of the norming stage is that members may begin to fear the inevitable future breakup of the group; they may resist change of any sort. Stage 4: Performing The Performing stage is not reached by all groups. If group members are able to evolve to stage four, their capacity, range, and depth of personal relations expand to true interdependence. In this stage, people can work independently, in subgroups, or as a total unit with equal facility. Their roles and authorities dynamically adjust to the changing needs of the group and individuals.

Stage four is marked by interdependence in personal relations and problem solving in the realm of task functions. By now, the group should be most productive. Individual members have become self-assuring, and the need for group approval is past. Members are both highly task oriented and highly people oriented. There is unity: group identity is complete, group morale is high, and group loyalty is intense. The task function becomes genuine problem solving, leading toward optimal solutions and optimum group development. There is support for experimentation in solving problems and an emphasis on achievement.

The overall goal is productivity through problem solving and work. Stage 5: Adjourning The final stage, Adjourning, involves the termination of task behaviors and disengagement from relationships. A planned conclusion usually includes recognition for participation and achievement and an opportunity for members to say personal goodbyes. Concluding a group can create some apprehension - in effect, a minor crisis. The termination of the group is a regressive movement from giving up control to giving up inclusion in the group. The most effective interventions in this stage are those that facilitate task termination and the disengagement process.

Reference: Burns, L. , Bradley, E. , and Weiner, B. (2012). Shortell & Kaluzny's Health Care Management: Organization Design & Behavior, (6th Edition), Clifton Park, New York: Delmar Cengage Learning. Cintron, Rene. Employee Turnover: Causes, Effects, and Prevention. Retrieved on February 09, 2013 from www. renecintron. com/files/Employee_Turnover. doc Coleman, L. G (1989, December 4) Human Resources Management: An Experimental Approach )2nd custom edition) Upper Saddle River, NJ Prentice Hall. HCA 6225-01. Chapter 05 powerpoint. Retrieved on February 08,2013 from https://bb. csueastbay.

edu/webapps/portal/frameset. jsp? tab_tab_group_id=_30_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D%20_396854_1%26url%3D Marc A. Rodwin, May 1998. Address comments to Marc A. Rodwin, Associate Professor, School of Public and Environmental Affairs, Indiana University, Bloomington, IN. 47405 Tuckman, B. (1965) Developmental Sequence in Small Groups. Psychological Bulletin, 63, 384-399.? Tuckman, B. & Jensen, M. (1977) Stages of Small Group Development. Group and Organizational Studies, 2, 419- 427. http://www. drexel. edu/oca/l/tipsheets/Group_Development. pdf