Healthcare Perspectives


Creating High-Functioning Leadership Teams - Part One

Jan 31, 2017
By: Tina Nazier

The race is on for talent in the health care industry. While hiring talented staff and managers certainly impacts success, what health care organizations really need to survive and thrive is healthy teamwork.

As the industry continues to evolve, ensuring teamwork becomes even more critical to providing excellent, quality care. But assembling teams is much easier than actually making them function effectively, especially at the leadership level. Creating a high-functioning leadership team requires work. It won’t happen solely by hiring the best, the smartest, or the most dedicated individuals. It takes a stronger plan.

Generally, there are five elements that must be firmly in place and continually nurtured in order to create and sustain high-functioning teams. It’s common for organizations to focus their team-building energies at the very top of the pyramid in the pursuit of results (e.g., productivity, efficiencies, cost savings). However, focusing only on the tip of the iceberg won’t create effective teams. It is critical that the rest of the elements are soundly in place and in support of results.

And the most important element of all is at the very foundation—TRUST.

Defining Trust

Trust is a necessary precursor for all relationships including the relationships we have at work. Before an individual believes he or she can rely on another, before cooperation can occur, before credible communication can take place, trust must be established.

Trust is important at a fundamental level and at an emotional level. With trust, an individual is willing to be vulnerable in front of others. There’s a willingness to be comfortable exposing personal failures, weaknesses, and even fears around other team members.

Trust also means having the ability to believe in someone else; it is not the ability to predict the behaviors of others.

Therefore, trust is an essential condition for performance. It is the basis for creating a strong team and a healthy work environment. A team that fails to build trust will fail to become an effective team.

Organizations must also recognize that achieving a foundation of trust is difficult. Individuals naturally harbor inclinations toward self-preservation. Furthermore, trust requires reciprocity. People are not naturally inclined to put themselves at risk, and when they do, it’s rarely rewarded. The mantra, “looking out for number one” is a harsh reality of our society that must often be overcome, as are other values with which individuals are raised that can impact the ability to establish trust.

Organizations that seek to create high-functioning teams must first seek to build trust.

Building Trust

There is no magic pill for building trust. It is earned through an investment of time and effort, and it requires ongoing maintenance over time. Yet it isn’t altogether rocket science either. It simply requires doing the hard work of doing the right things. Complete openness and honesty without filters are further necessary, and the work must be done in a respectful manner.

There are a variety of practical tools, exercises, and approaches organizations can use to help foster trust within their teams. Typically, the first step is to conduct an objective assessment to determine how well team members already trust one another and how well individuals trust the team as a whole. This process is recommended any time a new member joins the team or whenever forming a new team—for instance, when combining leaders of a clinic with those from a hospital—as well as periodically.

Organizations should then introduce trust-building exercises that help members go beyond their professional relationships to instead view their teammates on a more personal level. Such exercises should strive to encourage team members to share personal experiences. This can involve storytelling and simple questions or prompts that gradually get individuals comfortable with sharing, revealing, and potentially exhibiting vulnerability without probing too deep or getting too intrusive.

The goal with such exercises is to build empathy and help team members understand how their teammates became the people they are today. This further helps overcome the fundamental attribution error many people make, that of attributing others’ behaviors to their character but our own behaviors to the environment.

Other exercises can also focus on cultural and individual differences while emphasizing commonalities. To really round out a healthy trust-building process, add in opportunities for regular communication and bonding on a social level.

Organizations should also employ some type of behavioral assessment tool to help with trust development. Tools such as the Predictive Index® survey, Myers-Briggs Type Indicator®, Caliper Profile, and others can help identify personalities, work preferences, and associated behaviors and emotions. They provide a doorway to communication and understanding and support the ability of team members to effectively interact.

Behavioral assessment tools also let teams identify tensions and potential conflicts, recognize strengths and weaknesses, and avoid pitfalls.

Creative Conflict: The Second Element of High-Functioning Teams

Conflict is necessary and healthy. It’s also vital to team performance. Leadership teams have an obligation to engage in healthy, creative conflict in order to get the best results and achieve their organizational goals. As a popular truism goes, we find comfort among those who agree with us, but growth among those who don’t.

Yet not everyone views conflict with such profound optimism. Conflict is often quite uncomfortable. Many people are fearful of it, and most would prefer to avoid it at all costs. To create high-functioning leadership teams, however, organizations need their team members to master respectful, passionate debate of differing points of views and opinions around the critical issues they face.

Part of mastering conflict is mastering a balanced response. Conflict has a response continuum that ranges from exceedingly constructive (manifested as artificial harmony) to far too destructive (personal attacks, violence). The key is to find the fulcrum and create an ideal point of balance between the two extremes. Conflict resolution also requires checking our own motives, honestly examining our desires, and making sure behaviors follow accordingly. Here again, a conflict assessment can be conducted to determine how well team members handle conflict, and exercises can help uncover ways to help them improve their skills.

Perhaps the most important insight team members should be taught about conflict is that it is multidimensional or multilayered. Typically, there is more than one factor in question and at issue. By recognizing the following four conflict barriers, team members can adjust their approach when bogged down in the resolution process and address the appropriate factor/factors.

  • Informational. Often it’s the actual content at the heart of the conflict. Team members should determine whether conflict exists simply because the other party lacks the facts or has a valid perspective that hasn’t yet been shared.
  • Environmental. The atmosphere in which a discussion takes place can also influence, prohibit, or create conflict—and not just the literal, physical environment, but also the cultural environment. For example, the hospital culture is different from the clinic culture and vice versa. Team members representing both cultures may find it challenging to resolve conflict while in one cultural environment versus the other.
  • Relationship. Problems and issues between people are common. Conflicts can arise when leadership styles differ, reputations contrast, and organization positions are divergent.  
  • Individual. One person may have a deficiency or shortcoming that limits healthy dialogue. Issues range from self-esteem and values to knowledge and experience to IQ and EQ.

In all, conflict is critical for creating high-functioning teams. Lack of conflict hinders the ability to get all information in the pool of shared meaning, and teams that work with incomplete information have limited success in making the best decisions. In addition, when team members don’t feel as though they have been able to share or be understood, it creates tension. Gone unresolved, that tension will ultimately affect commitment to the team’s decisions.

This blog is part one of a two-part article series. Part two focuses on the additional elements needed to create high-functioning teams and how to get your leadership team into high-functioning gear!


Tina Nazier, MBA, CPC
Director, Strategic Alignment
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