Team Leadership

Overview
By the very nature of adopting a model of shared leadership on interprofessional teams, “leadership” should be treated and thought of more as a competency, than as an assigned role. Each team member should be able to provide leadership during situations where their skills sets and knowledge are most valuable.

What is Team Leadership?
Zaccaro, Rittman, and Marks (2002) had this to say about team leadership:

“Team leadership represents a…characteristic of effective team performance. Most teams contain certain individuals who are primarily responsible for defining team goals and for developing and structuring the team to accomplish these missions. These roles exist even in self-managing teams, although the conduct of leadership roles in such teams varies considerably from similar roles in more traditional teams.”

What is Shared Leadership? Why is it Important on an Interprofessional Team?
Tesluk and Marrone (2007) define Shared Leadership the following way: “An emergent team property that results from the distribution of leadership influence across multiple team members. It represents a condition of mutual influence embedded in the interaction among team members that can significantly improve team and organizational performance.”

The Canadian Interprofessional Health Collaborative identified this as a key competency domain for effective interprofessional collaboration: “Learners and practitioners work together with all participants, including patients/clients/families, to formulate, implement and evaluate care/services to enhance health outcomes” (CIHC, n.d.)

“Shared leadership is a people- and relationship-focused approach to team leadership that is based on the premise that answers can be found among the collective knowledge of the team. It reflects shared accountability that addresses power and hierarchy, and utilizes structures and processes to advance exemplary care” (RNAO, 2013). According to the Registered Nurses’ Association of Ontario’s 2013 report, Developing and Sustaining Interprofessional Health Care, this model is based on six principles:

  • Promote a shared leadership process that is based on the belief that at different times and depending on the need, situation and requirements, different people assume the leadership role and there are times when the nominal leader might not even be visible
  • Structure a learning environment that supports continuous self-development and reflection. The team members are encouraged to learn together and from each other, and to cultivate practices of open-mindedness, mutual trust, seeking constructive feedback, and viewing conflict as an opportunity for growth.
  • Supporting relationships and interconnectedness that value honesty, mutual respect, expecting the best from others, and the ability to exercise personal choice. Shared leadership focuses on facilitating the ability of the team to live those values towards a shared vision that allows people to set common goals and direction.
  • Fostering shared power that implies a shared responsibility and accountability for decision making and for learning. Power is found at the center of the team rather than at the top of the hierarchy.
  • Practicing stewardship and service focuses on ensuring that the interests and needs of others are being served rather than focusing on personal power and control.
  • Valuing diversity and inclusiveness implies respect for individual differences which will result in freedom to learn together and for the exercise of collective ownership.

What are the Roles and Responsibilities of a Team Leader?
It is the responsibility of each team member to support interprofessional collaborative practice by exhibiting the following leadership characteristics (CIHC, n.d.):

  • Work with others to enable effective patient/client outcomes
  • Advance interdependent working relationships among all participants
  • Facilitate effective team processes
  • Facilitate effective decision-making
  • Establish a climate for collaborative practice among all participants
  • Co-create a climate for shared leadership and collaborative practice
  • Apply collaborative decision-making principles
  • Integrate the principles of continuous quality improvement to work processes and outcomes

Keep the Following in Mind

  • It is critical for whomever serves as team facilitator at any time to lead in ways that promote cohesion
  • Exhibit value and respect for each team member, and their roles and contributions to the team
  • Frame decisions by describing the benefits and drawbacks of the team’s options
  • Address social and emotional aspects of teamwork—remember, each team member comes from a different personal and professional background
  • Adopt the role of a coach—leaders foster the ability in others to perform to their highest potential
  • Consider the effects of the organization and team culture

High-functioning teams composed teams make better decisions than a single expert—a diverse set of viewpoints, and multiple participants, are more likely to make a more informed decision.

References
Axelsson, S.B. & Axelsson, R. (2009). From territoriality to altruism in interprofessional collaboration and leadership. Journal of interprofessional Care, 23(4), 230-330. Retrieved fromhttp://content2.learntoday.info/shu/NU520_Spring_11/Media/Week05/from%20…
Canadian Interprofessional Health Collaborative. (2010). A National Interprofessional Competency Framework. Retrieved fromhttp://www.albertahealthservices.ca/careers/docs/WhereDoYouFit/wdufstu-s…
Carson, J.B., Tesluk, P.E., & Marrone, J.A. (2007). Shared leadership in teams: an investigation of antecedent conditions and performance. Academy of Management Journal, 50(5), 1217-1234. Retrieved from http://www.ilo.bwl.uni-muenchen.de/download/unterlagen-ws12_13/leadershi…
learning/literature_hoegl1/carson_et_al_2007.pdf
Harris, S. (2013). Leadership in academic medicine: interprofessional care teams require complex leadership approaches. Association of American Medical Colleges. Retrieved fromhttps://www.aamc.org/newsroom/reporter/november2013/362062/leadership.html
International Affairs & Best Practice Guidelines. (2013). Developing and Sustaining Interprofessional Health Care: Optimizing Patient, Organizational, and Systems Outcomes. Retrieved fromhttp://umanitoba.ca/programs/interprofessional/media/IPC_Summary.pdf
International Affairs & Best Practice Guidelines. (n.d.). Conceptual model for developing and sustaining interprofessional care. Nursing Best Practice Guidelines. Retrieved from http://pda.rnao.ca/content/conceptual-model-developing-and-sustaining-in…
Lamb, B. & Clutton, N. (2011). Leadership development for interprofessional teams using crew resource management for improvement & patient safety. CAIPE. Retrieved from http://caipe.org.uk/silo/files/bryony-lamb-and-nick-clutton-presentation…
Lingard, L., Vanstone, M., Durrant, M., Fleming-Carroll, B., Lowe, M., Rashotte, J., Sinclair, L., & Tallett,S. (2012). Conflicting messages: examining the dynamics of leadership on interprofessional teams. Academic Medicine, 87(12), 1762-1767. doi: 10.1097/ACM.0b013e318271fc82. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/23095927
Reeves, S., Macmillan, K., & van Soeren, M. (2010). Leadership of interprofessional health and social care teams: a socio-historical analysis. Journal of Nursing Management, 18(3), 258-264. doi: 10.1111/j.1365-2834.2010.01077.x. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20546465
West, M.A., Borrill, C.S., Dawson, J.F., Brodbeck, F., Shapiro, D.A., & Haward, B. (2003). Leadership clarity and team innovation in health care. The Leadership Quarterly, 14, 393-410. Retrieved fromhttp://www.peru.pitt.edu/coursematerial/Healthcare%20Innovations%20Fall%…
Zaccaro, S.J., Rittman, A.L., & Marks, M.A. (2001). Team leadership. The Leadership Quarterly, 12, 451-483. Retrieved fromhttp://www.qub.ac.uk/elearning/media/Media,264498,en.pdf