Funded projects

Healthcare professionals must work together effectively in teams to provide the best possible patient care. However, previous research shows such multi-professional teams often fail to perform to their full potential, as they are not clear ...

Healthcare professionals must work together effectively in teams to provide the best possible patient care. However, previous research shows such multi-professional teams often fail to perform to their full potential, as they are not clear about their objectives, disagree about goals, their leadership and how to work together; or they find themselves trying unsuccessfully to meet the conflicting demands of senior managers from different disciplines and departments. The Healthcare Commission has discovered that as many as half of all NHS staff may work in dysfunctional teams which jeopardise patient care and staff well-being. The overall aim of this research is to discover how we can best promote and sustain effective multi-professional team working that delivers high quality healthcare and improves health outcomes for patients, users and carers.We will examine a wide variety of factors that affect the performance of healthcare teams by focusing on multi-professional team working for two priority groups: adults and older adults with mental health problems. We will involve service users, carers and a wide variety of stakeholders in determining what constitutes effectiveness.Through combining this approach with rigorous measures developed in previous research, we will identify ways of ensuring integration between diverse groups of professionals; effective working between the different teams that contribute to care of patients (hugely important from the perspective of users and carers concerned with continuity of care); systems to ensure that teams naturally and regularly review and improve their performance; and discover how to improve the organisation, management and leadership of services in order to dramatically improve team working and therefore patient care.Our aim is to develop effective methods of promoting multi-professional team working that can be applied across the whole of the NHS in order to significantly improve the productivity and effectiveness of our health and social care services.

There is sufficient evidence to show that multi-professional team working (MPTW) can lead to significant improvements in productivity and patient/user care in health and social care settings. The key is knowing how to develop and ...

There is sufficient evidence to show that multi-professional team working (MPTW) can lead to significant improvements in productivity and patient/user care in health and social care settings. The key is knowing how to develop and sustain effective MPTW. The overall aims of this research are therefore first to identify the principle factors that are needed to create effective MPTW; and second to develop recommendations to establish or improve MPTW in healthcare. The difficulties of establishing effective MPTW in health and social care are well recognised but recent research based on the Healthcare Commission National Staff Survey suggests that as many as 50% of all NHS staff work in poorly structured or "pseudo" teams (Dawson, 2007). Such entities are associated with relatively high levels of errors, accidents and poor staff well-being. We propose to use an overarching theoretical framework to assess the factors that influence the effectiveness of MPTW. Furthermore, we will focus on four key areas of MPTW suggested by previous theory and research. First, research has shown that professional diversity can lead to different expectations of outcomes (El Ansari, 2003) and damaging team conflict; and we aim to discover how to prevent this while achieving the synergistic gains from diversity (West, 2004). Second, we will examine how to promote effective inter -team working which is crucial to MPTW effectiveness and to users and carers concerned with continuity of care (Richter, 2006). Third, we will examine how to promote team reflexivity - the extent to which teams review their performance and then initiate improvements (West, 2000). And fourth, we will examine key organisational and managerial factors in the whole system of service provision within which teams operate, since they are highly likely to influence MPTW effectiveness (West & Markiewicz, 2004).We propose to focus research resources in one sector (mental health). In line with recent policy imperatives, the first stage of the research will explore team working for two priority groups: adults and older adults with mental health problems experiencing significant levels of disability. Localities within each of twelve sites (trusts and associated local authorities) will be sampled across England. The first stage of the research will involve a series of workshops to develop measures of MPTW effectiveness by involving all key stakeholders using the Productivity Measurement and Enhancement System (ProMES; Pritchard, 1990). In the second stage we will apply standardised measures of team inputs, processes and outputs to determine which factors are most important in MPTW effectiveness. The third stage will involve a qualitative, in-depth study of teams to identify organisational, management and leadership processes associated with effective multi-professional team working. Finally, we will examine the effectiveness of MPTW interventions in healthcare from sites across the UK.Once best practice management is identified by our research findings we will build a comprehensive and accessible resource for cost-effectively developing MPTW in healthcare across the NHS. The development interventions proposed will build directly on relevant theory and research, existing good practice and the results of this programme.