The Management Moment: Creating Public Health Management Teams That Work

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The Management Moment

Column Editor: Edward L. Baker

Creating Public Health Management Teams


That Work
Kimberley Freire, Rebecca Davis, Karl Umble, and Anne Menkens
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Coming together is a beginning. together, developing competent teams has become a


Keeping together is progress. priority in health management and leadership training.
Working together is success. Offered by the School of Public Health and the
—Henry Ford Kenan-Flagler Business School at the University of
North Carolina at Chapel Hill, the Management
Public health has always required multidisciplinary Academy for Public Health is a leadership and man-
collaboration. In recent years, the field has redefined agement training program that has worked with teams
how public health professionals should collaborate and of public health managers and community partners for
who should be included. For example, the Institute of almost a decade.7 The Academy’s hallmark is its fo-
Medicine has called on public health leaders to collabo- cus on team and project-based learning. Teams learn
rate with private industry, media, healthcare, academia, skills in managing people, money, and data. To practice
and government.1 The National Institutes of Health’s the skills and develop innovative strategies, each team
“roadmap” states that “research teams of the future” develops a business plan for a health program within
must be multidisciplinary and involve public and pri- its community or state. Nonprofit business experts and
vate alliances to spur innovation and accelerate the academy faculty coach teams through business plan de-
translation of science to practice.2 More broadly, the velopment and implementation.8
global “New Public Management” movement, known Recently, we interviewed representatives from 40
as “reinventing government” in the United States, calls teams who attended the academy during 2003–2005.
for agencies to decentralize and partner to develop cre- We asked them what factors are most important to
ative solutions to health and social problems.2–4 accomplishing team goals, in this case implementing
So, public health managers have to link up with new their business plans. Many of their conclusions echoed
partners. But how can managers actually form collabo- LaFasto and Larson. We have selected the top five
rative teams that improve public health work? themes to present here, along with some suggestions
Frank LaFasto and Carl Larson, who have studied for how you, as a manager, could try to implement their
thousands of teams in a variety of organizations, de- advice.
fine teams as “a special type of collaborative group that
forms to create or change something specific.”5 Teams
are built to act. This makes them different from task
forces or boards that are formed only to advise or sup- Corresponding Author: Kimberley Freire, PhD, MPH, North Carolina Institute For
port an effort. Furthermore, collaborative teams rely on Public Health, Campus Box 8165, Chapel Hill, NC 27599 ([email protected]).
joint decision making and peer leadership and may not qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq
have a single leader with executive authority.5,6 Team Kimberley Freire, MPH, is a doctoral candidate, Department of Health Behavior &
members, therefore, need to be able to work together Health Education, School of Public Health, University of North Carolina at Chapel Hill.
to accomplish specific tasks. Because health programs Rebecca Davis, MPH, is a doctoral candidate, Department of Health Behavior &
can stand or fall depending on how well teams work Health Education, School of Public Health, University of North Carolina at Chapel Hill.
Karl Umble, PhD, MPH, is Program Planner and Evaluator, North Carolina Institute
for Public Health, School of Public Health, University of North Carolina at Chapel Hill.
J Public Health Management Practice, 2008, 14(1), 76–79 Anne Menkens, MA, is Project Director, North Carolina Institute for Public Health,
Copyright C 2008 Wolters Kluwer Health |Lippincott Williams & Wilkins School of Public Health, University of North Carolina at Chapel Hill.

76
Creating Public Health Management Teams That Work ❘ 77

● Team Members Must Commit to he or she is experiencing that are not being expressed.
a Common Goal Strong social ties also help; we will put forth a lot of
effort to help our colleagues when we are also friends
The first task of the team is to articulate and agree on in the journey. So team leaders should build the bonds
what they are trying to achieve. As one manager put among team members—over meals or coffee, through
it, “You all need to know where you’re going and what going to a ball game—to forge stronger commitment.
you’re doing.” Articulating a common goal is as much If you make your team more of a caring “family,” it
about the process as it is the end point. Some respon- will be easier to address conflicts or misunderstand-
dents explained that reaching a common goal meant ings when they emerge. Strong teams must trust one
that all team members had input and “bought in” to another’s commitment and intentions, as well as one
their overall business plan concept. another’s wisdom and skills.
How can you keep the team goal-oriented? There is
nothing like writing things down to get them moving
forward. Get your team members to hash out exactly ● Teams Should Build on Their Members’
what their expectations are, identify and agree on the Strengths
primary goals, write them down, and all sign the doc-
ument. In our office, we print out the list and make it Management Academy strengthens management and
into a poster, laminated, and mounted on the wall of leadership skills. As managers’ skills grow, our research
our meeting room. At the end of the time frame for shows, so does their confidence. Some team members,
the project, we put stars next to the goals that have however, are good at managing people, while others are
been met, add new ones, or carry over those that need more comfortable—and effective—with money or data.
further work. Logic models are another excellent tool “Don’t try to make creative people into accountants,”
for building consensus and mutual understanding of one participant told us, a sentiment echoed by many.
where the team is trying to achieve—and how progress Identify team members’ strengths and “nonstrengths,”
can be measured.9 identify leaders, and set people up to succeed at their
assigned tasks.
How can you identify and build on strengths? Many in-
● Team Members Must Commit to Doing dividual development instruments help identify indi-
viduals’ strengths and preferences with regard to work
the Work style, personality traits that affect work, and strengths
to build on. Team-building experts often work such in-
When team members “buy in” to the project goal, they
struments into their activities, for the benefit of both
are likely more motivated to execute project tasks than
the manager’s and individuals’ own understanding of
when they concede to a majority or unilateral deci-
their strengths and weaknesses. Use your team mem-
sion. As one respondent explained, “All people on
bers’ annual evaluations to talk about what they like
the team need to be passionate about the plan, other-
best to do, what you perceive they are best at, and think
wise you’ll run out of steam halfway through.” This
about ways you can help them be more effective at all
seems particularly important for teams with few mem-
of their tasks. If you do not use the instruments, start off
bers and those operating without a solid organiza-
team projects with an open discussion of who is good
tional structure to provide support and team replace-
at what, how each member likes to work, and how the
ments. Good teams quickly identify members who are
team will function. That can help the team get off on
not able or willing to see tasks through: the “weak-
the right foot. Many teams find “team charters” to be a
est links” can drag on team members’ motivation and
great tool.10
progress toward their goal. But when they see all mem-
bers contributing, they draw on the energy and stay
focused.
How can you build commitment? Think about draw- ● Team leaders Must Facilitate Effective
ing many people into your decision-making process, Communication
so you are not just dumping work on people’s desks.
Once a project is under way, find out who needs and Collaborative leadership is driven by consensus instead
wants more direction from you, and step in to help. of executive decision making. That means communica-
On the other hand, give more freedom to those who tion is essential. Some of our participants believe that
want to work more independently. If you identify a the team leaders’ major role is to facilitate communi-
weak link, work with that person to identify how he or cation so that the team can reach agreement on ac-
she can contribute to the program, or what problems tions. Team leaders should seek input from all team
78 ❘ Journal of Public Health Management and Practice

members and encourage dialogue among members, who work well on teams, will help programs flourish.
especially when problems or conflicts arise. In fact, sev- Those kinds of people are also likely to stay longer
eral participants expressed that “healthy conflict can be in your shop. In your dealings with the community,
a dialogue,” and managing conflict through productive local business people and other healthcare profession-
discussions was key to progressing in plan implemen- als try to forge connections with people who will bring
tation. With respect to leaders and communication, one a different perspective to your teams. You may have to
manager explained: educate people as to what public health is and does,
how public health affects many other realms of soci-
The leader needs to have the skill to manage the team. . . ety, and why they should care about (and become part-
to encourage [the person who is introverted] to give
ideas and concepts and make sure that the person that ners with) public health practice. In sum, finding people
tends to dominate the conversation is held to a with different perspectives and interests can help your
minimum—in a kind and tactful manner so that one team, as long as the interests are not extremely diver-
person does not dominate the entire plan. gent, and as long as they know how to work well on a
team.
Communication is important to bringing together
As organizations move toward a new management
people with different personalities, work styles, and
style that emphasizes collaboration and innovation,
perspectives to work toward a common goal.
competent teamwork is very important. In our study,
How can you facilitate better communication? Do not
managers shared their advice on what managers and
be afraid to bring up or deal openly with conflicts
supervisors should consider when developing teams
or other difficult issues. Without pointing fingers or
within their organizations, as well as when they link
putting any one on the spot, try to air things that seem
across professional fields and sectors. Focusing on team
to be holding up work. Leaders may need to apolo-
goal development, emphasizing project buy-in while
gize for oversights or mistakes—and thereby to set the
clearly defining individual tasks and goals, identify-
tone for humility and problem-solving on the team. Be
ing and using individual strengths, and allowing for
sure also to communicate when things are going well:
teams to be made up of members with variable skill sets
hold up good examples of teamwork and accomplish-
while building on common interests or backgrounds
ments, give “awards” that show you are recognizing
are all key components to successful team develop-
the hard work the team is putting in. At the end of a
ment. We recognize, and our own research shows, that
period of hard work, our team often has a meeting in
a large part of what makes a team successful is ex-
which specific accomplishments are named and kudos
ternal to the team: the organizations, communities,
are generously given—supplemented with gourmet ice
and other outside interests have substantial influence
cream bars!
on what teams can accomplish. A good start, how-
ever, is to build a team that has the best potential to
work.
● Balance Team Member Diversity and
Common Interests
REFERENCES
Team diversity is important to accomplishing project
1. Institute of Medicine. The Future of the Public’s Health in
goals. Many participants talked about how different the 21st Century. Washington, DC: National Academy Press;
skills, perspectives, and interests made their team 2003.
stronger. In particular, teams need expertise in fi- 2. Office of Portfolio Analysis and Strategic Initiatives, National
nance and data management, program development, Institutes of Health. National Institutes of Health roadmap.
and community outreach. Some participants, however, http://nihroadmap.nih.gov/ Accessed August 29, 2007.
found that common interests with teammates helped 3. Kettl D. The Global Public Management Revolution: A Report on
build their relationships. For example, one team con- the Transformation of Governance. Washington, DC: The Brook-
sisted of epidemiologists from different health districts. ings Institution; 2000.
This team found their common backgrounds helped 4. Osborne D, Gaebler T. Reinventing Government: How the En-
them discuss project issues and empathize with their trepreneurial Spirit Is Transforming the Public Sector. New York:
Penguin; 1992.
teammates.
5. Lafasto F, Larson C. When Teams Work Best: 6,000 Team Mem-
How can you build diverse teams that work well? If bers and Leaders Tell What It Takes to Succeed. Thousand Oaks,
you have a role in hiring process in your organiza- CA: Sage; 2001.
tion, you may be able to build your staff with the 6. Crislip D, Larson C. Collaborative Leadership: How Citizens and
teams in mind. Hire people with good team skills, in Civic Leaders Can Make a Difference. San Francisco, CA: Jossey-
addition to technical competence. Hiring people who Bass; 1994.
“fit” with the values of the team and organization, and 7. Orton S, Umble KE, Rosen B, McIver J, Menkens AJ.
Creating Public Health Management Teams That Work ❘ 79

Management Academy for Public Health: program design 9. Program Development and Evaluation, University of
and critical success factors. J Public Health Manag Pract. Wisconsin - Extension. Logic model. http://www.uwex.
2006;12(5):409–418. This issue is devoted to the Management edu/ces/pdande/evaluation/evallogicmodel.html. Acce-
Academy for Public Health. ssed September 18, 2007.
8. Orton S, Menkens A, Porter J. Sustaining Success: Creating 10. Team Charters: getting your teams off to a great start.
Your Public Health Business Plan. Boston, MA: Jones & Bartlett. http://www.mindtools.com/pages/article/newTMM 95.
In press. htm. Accessed September 19, 2007.

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