A relentless focus on performance

June 1, 1997
Misconceptions exist about teams and teamwork. Every collection of people who work together in a dental office call themselves a dental team.

The team concept is not a pretty `label` for feeling good about your colleagues.

Joan Forrest Eleazer

Misconceptions exist about teams and teamwork. Every collection of people who work together in a dental office call themselves a dental team.

The term of choice is now team member rather than staff. Staff meetings are dedicated to team building. But what is a team? In your practice, are you a team or a group of people working in the same office?

We use the term, "team," all the time. Most of us have an understanding of what a team is. However, the mind thinks in pictures, and everyone has a uniquely different mental representation of a team.

Maybe your picture is of an athletic team on which you played. Maybe it is a professional or college sports team for which you live and die. Perhaps your visualization of a team conjures up pictures of a Boy Scout troop. A group that you belonged to through school, church, or community involvement may come to mind. Developing a common understanding of what teams are, and are not, can enable the dental team to improve its performance and better serve its patients.

In The Wisdom of Teams (an outstanding reference to develop your knowledge in this area), the authors, Katzenbach and Smith, define a team as, "A small number of people with complementary skills who are committed to a common purpose, performance goals and approach for which they hold themselves mutually accountable."

Let`s evaluate this definition.

Common purpose

When a group works together to develop a purpose that is meaningful to everyone, they develop a direction that focuses their efforts.

Picture a crew rowing. The oars all move in harmony, powering the boat forward. Although the crew members cannot see where they are going, they respond in unison to the directions of the coxswain and move the shell forward toward their goal. They share the common purpose to cross the finish line first. They contribute their all to achieving this purpose.

Developing a shared vision or purpose is a key to developing an effective team. Time must be set aside for team members to explore the questions, "What do we do, and why do we do it?" The answers will serve to begin the formation of the common vision.

Related performance goals

The team is the vehicle (a means to an end, not the end itself) for achieving exceptional performance. The challenge is finding the element that ignites team members to accomplish more than any one individual could achieve.

The purpose of a team is not to make people feel good or get along better. Katzenbach`s research tells us that the most fundamental characteristic that distinguishes real teams from non-teams is a relentless focus on performance.

Very often, I see groups make the mistake of focusing on compatibility as the measure of being a successful team. They lose sight of why they are together in the first place.

Dr. Peter Dawson, director of the Center for Advanced Dental Study, reminds us in his course, "How To Put Your Practice in the Top 10%," that a dentist can practice dentistry on his own. He hires the first staff member in order to free himself to be more productive. He then devotes more of his time to those functions that only he can perform for his patients. Likewise, the doctor hires the second staff person for the same reason, and so on.

For a group to really come together as a team, they must focus first on performance. Focusing on personal chemistry, togetherness, communication, etc., as the primary measure of team effectiveness can derail a team.

Interpersonal skills are an integral factor in a team`s ability to define a common purpose and related performance goals. The abilities to actively listen, resolve conflicts, solve problems, avoid blame, and value differences are skills that are essential for each member to possess or develop.

The point is that the development of these skills is not the end result. It is the application of these skills to achieve performance goals and produce outstanding quality and service that is the desired end-result.

Successful teams develop and commit to a common approach, or guiding principles, for how they will work together. Guiding principles define how staff will treat each other and the patients. They are the critical values that guide relationships between team members and with patients. Guiding principles are promises team members make to one another to behave consistently, according to these guidelines.

The guiding principles should be developed together in the same way the shared purpose is developed. Set aside time to jointly develop your team guidelines.

Think of the subtle difference between, "Doctor holds me accountable" and "We hold ourselves accountable." A group becomes a team when every member makes the shift from the first phase to the second.

Successful team-building brings members from a sense of individual accountability to an acceptance of joint accountability.

Just labeling your staff a team will not make it a team. It requires discipline and effort. The rewards are worth it!

The author is executive director of the Center for Advanced Dental Study in St. Petersburg, Fla., where she teaches courses on Dental Quality Management. She can be reached at (800) 952-2178.

Is it merely `togetherness` or is it teamwork?

This checklist will aid your evaluation.

1. Common Purpose

To evaluate the degree to which your team shares a com-mon purpose, answer these questions:

- Do you have a meaningful purpose to which all members aspire? Is it a team purpose or that of the dentist only?

- Do all staff members understand the purpose and describe it in the same way? Remember, the mind thinks in pictures. "Being the best" is difficult to measure and may mean different things to all involved.

- Do the staff members believe the purpose is important and inspiring?

2. Related Performance Goals

To check your group`s focus on challenging performance objectives, answer these questions:

- Does the team have team goals that are clear and measurable? [If a quantifiable measure does not exist, how will the team know if the goal is achieved? What will be the indicator(s) of accomplishment?]

- Do all the members of the team agree with the goals, understand their importance, and agree on how achievement of the goals will be measured or determined?

- If asked individually, will all the team members describe the goals in the same way?

3. Common Approach

The following are samples of guiding principles from dental-practice and dental-laboratory teams:

- We practice no-fear communication.

- We rely on the initiative and participation of every person.

- We celebrate each other`s success.

- We seek first to understand, then to be understood.

- We keep our commitments.

- We act with integrity, honesty, and a sense of ethics.

- We are accurate and timely.

- We have a sense of urgency in all that we do.

- We continually improve everything we do.

- We are patient-focused. Everything we do provides a service for our patients.

4. Mutual Accountability

To assess your group`s degree of mutual accountability, answer these questions:

- Do all team members feel accountable for all measures of performance?

- Are your team members clear on what they are individually responsible for and what they are jointly responsible for?

- Do your reward and recognition systems acknowledge individual or team effort?

Going from individuals to a team

Extensive research is unwavering in the conclusion that teams outperform individuals. Dentists cannot master the challenges of today alone. The demands of patient service, technological changes, and managed-care threats call out for responsiveness in terms of speed and quality that can only be met by a high-performance team, not a group of individuals. Is your dental staff a team or a group?

To transform your dental group to a team:

- Develop a common purpose. Teams cannot succeed without a shared purpose. Most groups never become a team, because they remain unclear about what they want to accomplish and why they want to accomplish it.

- Agree on performance goals. Most successful teams can trace their success to the development of, working toward, and achievement of performance-oriented goals. Decide as a group on two or three specific, action-oriented, measurable goals that, if achieved, will move your practice forward. Be sure that the group has facts and data that measure its progress.

- Define your guiding principles. Spend the time together to describe how you will work with each other and with your patients to achieve your purpose and attain your goals. At least monthly, evaluate how well each member is functioning within these principles.

- Hold each other mutually accountable for results. To be a truly successful team, the members must go beyond individual bests to achieving the team`s performance goals. Have a weekly dialogue about how well the team worked to achieve its goals together. Recognize and reward behaviors that demonstrate stretching beyond the mindset of "this is my job" to a mindset of going the extra mile to do "whatever it takes" to accomplish our goals.

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