Assessing the functional level of rehabilitation teams and facilitating team development.

In the United States, the incidence rate of new or recurrent stroke is approximately 795 000 per year, and stroke prevalence for individuals over the age of 20 years is estimated at 6.5 million.1 Mortality rates in the first 30 days after stroke have decreased because of advances in emergency medicine and acute stroke care. In addition, there is strong evidence that organized postacute, inpatient stroke care delivered within the first 4 weeks by an interdisciplinary healthcare team results in an absolute reduction in the number of deaths.2,3 Despite these positive achievements, stroke continues to represent the leading cause of long-term disability in Americans: An estimated 50 million stroke survivors worldwide currently cope with significant physical, cognitive, and emotional deficits, and 25% to 74% of these survivors require some assistance or are fully dependent on caregivers for activities of daily living (ADLs).4,5 Notwithstanding the substantial progress in acute stroke care over the past 15 years, the focus of stroke medical advances and healthcare resources has been on acute and subacute recovery phases, which has resulted in substantial health disparities in later phases of stroke care. Additionally, healthcare providers (HCPs) are often unaware of not only patients’ potential for improvement during more chronic recovery phases but also common issues that stroke survivors and their caregivers experience. Furthermore, even with evidence that documents neuroplasticity potential regardless of age and time after stroke,6 the mean lifetime cost of ischemic stroke (which accounts for 87% of all strokes) in the United States is an estimated $140 000 (for inpatient, rehabilitation, and follow-up costs), with 70% of first-year stroke costs attributed to acute inpatient hospital care1; therefore, fewer financial resources appear to be dedicated to providing optimal care during the later phases of stroke recovery. Because there remains a …

The rehabilitation team: Staff perceptions of the hospital environment, the interdisciplinary team environment, and interprofessional relations

Background: Teamwork is one of the most fundamental factors in rehabilitation medicine. Although isolated physicians and therapists are working with rehabilitation services in Bangladesh, there is limited data for understanding the effects of a team effort. Objective: To evaluate the effect of rehabilitation team meeting on the patients’ disability in the Department of Physical Medicine and Rehabilitation (PMR) in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Methods: This was a randomized controlled trial conducted in the Department of Physical Medicine and Rehabilitation (PMR) in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2018 to October 2019. Two hundred and thirty nine patients attending the PMR department for comprehensive management of disability (such as disability in mobility, speech, self-care, sphincter control etc.) were purposively selected for the study. Patients were randomly allocated by lottery in two groupsgroup A (received Rehabilitation Team Meeting service) and group B (received conventional Rehabilitation treatment). The meeting comprised physiotherapist, occupational therapist, rehabilitation nurse, speech and language therapists, social worker, nutritionist, psychologists under the team leader guidance by physiatrist. Respondents of both groups were assessed to see the effects of treatment at 6th weeks, 12th weeks and 24th weeks. Among 239 patients, 77 patients in group A and 71 patients in group B had completed 24th week follow up. Outcomes were measured by FIM (Functional independence Measure) scores. Results: The mean age of the patients in group A and B were 42.2 (±17.5) years and 45.7 (±14.6) years respectively. In both groups, majority of the patents were male and came from urban areas. Main cause of disability was stroke while others had traumatic brain injury, spinal cord injury, spinal cord compression, rheumatoid disease and others. At baseline and after 6th week of treatment, there were no significant statistical differences between the two groups (p>0.05) regarding FIM scores. In 12th week, FIM significantly increased in group A (p=0.009) compared to group B which persisted till 24th week (p<0.001). Conclusion: Rehabilitation team meeting significantly reduce disability of the patient. It needs to work continuously to build up the rehabilitation team to improve physical rehabilitation in Bangladesh to ensure total care of the disabled. Bangladesh Med Res Counc Bull 2020; 46(3): 228-232

This study examines the impact of Human Resource Management (HRM) practices on team-building effectiveness within the insurance industry in India. With rising competition and a rapidly evolving business landscape, effective teamwork has become crucial for organizational success, particularly in service sectors like insurance where collaboration enhances client service and operational efficiency. The study identifies key HRM practices - recruitment and selection, training and development, performance appraisal, and compensation- as influential factors in fostering team cohesion, motivation, and effectiveness. Utilizing a Structural Equation Modeling (SEM) approach, the research analyzes data collected from a sample of employees across leading insurance companies in India. The SEM technique allows for a comprehensive assessment of direct and indirect relationships between HRM practices and team-building outcomes, revealing critical paths that significantly contribute to team effectiveness. Results indicate that targeted HRM practices not only improve team performance but also enhance job satisfaction and retention rates within teams. The findings offer practical implications for HR practitioners aiming to optimize team dynamics and strengthen overall organizational performance in the insurance sector. The study concludes by recommending HR strategies that align team-building initiatives with organizational goals to maintain a competitive edge in the industry.

Much has been said and written about the importance of teams to the success of organisations and emphasis has been given to the benefits of team‐building activities to achieving both team and organisational effectiveness. Describes attempts to move beyond team building and to link organisational development to team effectiveness in a coherent way. In order to achieve this goal, a team effectiveness audit tool has been devised which is based on individual self‐assessment. The audit tool focuses on six domains considered to be important in effective teams. The self‐report audit tool has now been used by over 140 teams across a range of public‐sector organisations and this has enabled a significant database to be built up. This provides a large normative data set against which individual team performance can be gauged. Focuses on data derived from 37 teams within an integrated acute and community health and social services (HSS) trust. Overall the team effectiveness audit tool has been well received and has proven to be an effective mechanism of linking individual and team performance with organisational‐management objectives.

Inness et al.'s well-designed measurement study 1 provides convincing evidence about key aspects of the Community Balance and Mobility (CB&M) Scale's construct validity and responsiveness to change for a rehabilitationcentre-based sample of adults with traumatic brain injury (TBI). The work is strengthened by the use of a set of comparison measures chosen both to reflect the underlying constructs of interest and to span the International Classification of Functioning, Disability and Health (ICF) areas of ''body function and structures,'' ''activity,'' and ''participation.'' 2 Their study encourages clinicians to think beyond standard measures of balance, such as gait assessments and the Berg Balance Scale (BBS), 3 to achieve a more sensitive clinical assessment of the persistent high-level balance/mobility deficits that individuals with TBI often experience.

Team skills training has been a part of control room crew development for a number of years. Team building has been receiving attention as an effective approach to continued improvement of team performance. Although both team skills and team building are focused on the process of team effectiveness, they are not interchangeable. Team building with a group that has not yet been exposed to team skills is not likely to be successful. Conversely, the fact that a control room crew possesses superior team skills does not necessarily ensure team success. Both team skills training and team building play an important role in the ability of control room crews to become high performance teams. >

The paper is introducing an online communication behavior measurement protocol, developed for medical team work, especially for studying the medical rehabilitation teams on interdisciplinary meetings. The purpose of the research is to analyze the development and usage of shared mental models (SMM) through the communication in medical practice of interdisciplinary rehabilitation teams in order to identify the factors determining the patient safety, and the effectiveness of rehabilitation. The online quantitative rating method uses two parallel raters to count and record the communication utterances of each participant directed to another. The quantitative and interactional data is analyzed, and visualized by AGNA network analysis software. Based on the results (network indices, and communication network diagram) the strong and weak points of communication can be recognized, as the important areas of SMM development. This can be a basis of a development process to enhance team effectiveness, and patient safety.

Management team building: Yes but!

There are limitations of studies on team building from different perspectives. The conclusions of relations between the internal processes, boundary-spanning activities, cohesion and effectiveness are contradictory in those studies. A survey was used to collect relevant data for study of these issues. Path analyses were conducted for hypothesis testing. There are some conclusions as follow: First, inwardfacing boundary management has a significant effect on outward-facing boundary management, which means the mutual supportive and synergic relation between them. Second, inward-facing boundary management has a significant effect on cohesion and effectiveness, and the mediating roles of team cohesion to the relationship between inward-facing boundary management and team effectiveness are supported. Third, the assumption on relationships between outward-facing boundary management, cohesion and effectiveness is supported partially.

Training teams and leaders to reduce resuscitation errors and improve patient outcome

The emerging work on understanding open source software has questioned what leads to effectiveness in OSS development teams in the absence of formal controls, and it has pointed to the importance of ideology. This paper develops a framework of the OSS community ideology (including specific norms, beliefs, and values) and a theoretical model to show how adherence to components of the ideology impacts effectiveness in OSS teams. The model is based on the idea that the tenets of the OSS ideology motivate behaviors that enhance cognitive trust and communication quality and encourage identification with the project team, which enhances affective trust. Trust and communication in turn impact OSS team effectiveness. The research considers two kinds of effectiveness in OSS teams: the attraction and retention of developer input and the generation of project outputs. Hypotheses regarding antecedents to each are developed. Hypotheses are tested using survey and objective data on OSS projects. Results support the main thesis that OSS team members' adherence to the tenets of the OSS community ideology impacts OSS team effectiveness and reveal that different components impact effectiveness in different ways. Of particular interest is the finding that adherence to some ideological components was beneficial to the effectiveness of the team in terms of attracting and retaining input, but detrimental to the output of the team. Theoretical and practical implications are discussed.

Purpose This study aims to examine the relationship between concrescent conversation environment (CCE), psychological safety and team effectiveness. Although CCE has been known to influence team outcomes, little is known about how it influences them. Integrating the social constructionist and social psychology perspectives, this study argues that CCE ignites a climate of psychological safety resulting in “joint-action” necessary for positive team outcomes. Design/methodology/approach Survey data were collected from 301 team members from US firms operating in different industries. Data were analyzed using SmartPLS. Findings The study establishes CCE as an antecedent to psychological safety and demonstrates that psychological safety mediates the relationship between CCE and team effectiveness. Research limitations/implications This is one of the initial studies to show how verbal behaviors socially construct team dynamics in the shape of psychological safety to influence team outcomes. In doing so, the authors advance the theory pertaining to the role of social exchanges in team processes and outcomes. Practical implications The results provide insights on how managers can improve team outcomes by influencing the conversational environment of the team to elicit feelings of psychological safety. The results also suggest that managers must focus on relational outcomes as well, along with performance outcomes. Originality/value From a social constructionist perspective, team development is built upon the verbal behaviors of the members as they pursue tasks. However, the extant group dynamics literature undervalues conversations’ role in team processes and outcomes. This is the first study that examines the link between a team's conversational environment, psychological safety and team outcomes.

Labour flexibility is an important issue in the design and development of teams. By means of an analytical study this paper investigates the impact of cross-training on team performance. Four cross-training policies are distinguished and compared according to their effects on important performance measures, such as the load of the bottleneck worker and the number of newly used qualifications seen in various situations. These measures indicate a team's effectiveness and efficiency. Furthermore, they are related to psychological, social and organizational aspects of team functioning. A task assignment heuristic serves as a tool for comparing the cross-training policies. This is applied in an experimental study in which the team situation varies with respect to the cross-training policy, the level of absenteeism, and the variation in the mix of orders. It is shown that a worker-oriented cross-training policy, which attempts to spread multi-functionality evenly among employees, performs well. This policy offers the opportunity to shift work among employees to keep the load of the bottleneck worker low. The required coordination effort for allocating workers to tasks is also relatively low. In line with previous research, this study shows a diminishing positive effect of expanding the level of labour flexibility. The coordination effort required to apply additional flexibility appears to increase linearly with the amount of additional cross-training. The diminishing positive effect and the linearly increasing coordination effort suggest that managers should critically consider the level of labour flexibility in worker teams.

In the past, team coordination dynamics have been explored using nonlinear dynamical systems (NDS) methods, but the relationship between team coordination dynamics and team performance for all-human teams was assumed to be linear. The current study examines team coordination dynamics with an extended version of the NDS methods and assumes that its relationship with team performance for human-autonomy teams (HAT) is nonlinear. In this study, three team conditions are compared with the goals of better understanding how team coordination dynamics differ between all-human teams and HAT and how these dynamics relate to team performance and team situation awareness. Each condition was determined based on manipulation of the .pilot role: in the first condition (synthetic) the pilot role was played by a synthetic agent, in the second condition (control) it was a randomly assigned participant, and in the third condition (experimenter) it was an expert who used a role specific coordination script. NDS indices revealed that synthetic teams were rigid, followed by experimenter teams, who were metastable, and control teams, who were unstable. Experimenter teams demonstrated better team effectiveness (i.e., better team performance and team situation awareness) than control and synthetic teams. Team coordination stability is related to team performance and team situation awareness in anonlinear manner with optimal performance and situation awareness associated with metastability coupled with flexibility. This result means that future development of synthetic teams should address these coordination dynamics, specifically, rigidity in coordination.