Facilitating Improvement Teams

Improvement within any given system will require a team approach.  

Improvement Teams

 A team should have adequate support and participation for the project or initiative. 

Key people should include:

  • A team lead to co-ordinate and facilitate the project
  • Process owners who can make changes i.e. members of the team who work within the area and can support testing changes
  • Representative who could be impacted by the project, i.e. families, young people, patients, customers who have experience of the service (service user)
  • Improvement advisor to provide improvement support
  • Support services, if needed i.e. data analysts, finance
  • A sponsor with links to the executive level for leadership support

The team should be guided by a project charter and will agree to take on various roles and responsibilities over the course of the project. There are project management tools to support the team with the project.

Working with Improvement Teams

Once the improvement team is identified, there are some basic concepts to consider which support a team working effectively together. An approach to look at these concepts is through Lencioni’s model where he describes five ‘dysfunctions’ which stop a team reaching its highest performance. Each level is not distinct, they are interrelated and the presence of one of them can prevent the team from being successful. The five ‘dysfunctions’ are:

  • Absence of Trust – this happens when team members are not willing to open up to each other and show their weaknesses and mistakes
  • Fear of conflict – if there is no trust, team members are unwilling to take part in sharing opinions and challenging different ideas
  • Lack of commitment – if there is a fear of conflict, team members don’t share their views and air their opinions, they won’t commit to decisions
  • Avoidance of Accountability -if team members don’t commit to decisions, they are unlikely to hold each other to account
  • Inattention to Results – if team members don’t hold each other to account, this can lead to team members putting individual needs above the collective goals of the team

When one of the dysfunctions is present it leads to the impact shown in the diagram of the model below

Lencioni's 5 dysfunctions of a team displayed as a pyramid

Based on evidence and experience of working with improvement teams there are a range of tried and tested practical approaches that work well in avoiding Lencioni’s dysfunctions. These draw on principles of coaching and facilitation. A list of further reading about facilitation and coaching approaches is provided at the end of this section

  • Agreeing ways of working / ground rules with the team helps ensure all team members feel comfortable to participate. Upholding the agreed ways of working helps build a safe place where trust can develop.
  • Helping the team to understand their individual drivers and motivations and those of other team members helps develop mutual understanding and build relationships. Kahler’s 5 Drivers provides one practical tool to use for this.  
  • Creating a safe space where team members feel able to offer their opinions, be curious & creative and challenge ideas without fear of judgement helps remove fear of conflict. Liberating Structures and the Facilitation Toolkit provide lots of ideas for facilitating discussions.
  • Using coaching skills of active listening, questioning, constructive feedback and reframing can help improvement teams explore options, reach consensus and commit to their agreed decisions
  • The 7 Step Meeting process provides an efficient, structured approach for running improvement team meetings. It involves active participation of all team members and collective agreement about all elements of a meeting including agenda items, timings and actions. It provides a practical way of holding each other to account for fulfilling documented actions and achieving the teams’ improvement goals
Tools to help facilitate Improvement Teams

Liberating Structures

This resource offers an alternative way to approach and design how people work together. It provides a menu of thirty-three Liberating Structures to replace or complement conventional practices

Facilitators Toolkit

Tools, techniques and tips for effective facilitation

Mind Tools

A collection of resources to support effective and inspirational leadership

Collaboration Tools

A list (and links) to techniques, toolkits and resources focussing on effective collaboration, facilitation, design and engagement.

Kahler’s Drivers

Kahler identified five common drivers that motivate us. This tool assists teams to understand how individuals are ‘driven’ and how to develop mutual understanding and build relationships within the team. 

Further reading to help facilitate Improvement Teams

The Five Dysfunctions of a Team, 2002, Patrick Lencioni