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16 Team Building Case Studies and Training Case Studies

From corporate groups to remote employees and everything in between, the key to a strong business is creating a close-knit team. in this comprehensive case study, we look at how real-world organizations benefited from team building, training, and coaching programs tailored to their exact needs.  .

Updated: December 21, 2021

We’re big believers in the benefits of  team building ,  training and development , and  coaching and consulting  programs. That’s why our passion for helping teams achieve their goals is at the core of everything we do.

At Outback Team Building & Training,  our brand promis e  is  to be  recommended , flexible,  and  fast.  Because we understand that when it comes to building a stronger and more close-knit team, there’s no one-size-fits-all formula. Each of our customers have a unique set of challenges, goals, and definitions of success. 

And they look to us to support them in three key ways:  making their lives easy by taking on the complexities of organizing a team building or training event; acting fast so that they can get their event planned and refocus on all the other tasks they have on their plates, and giving them the confidence that they’ll get an event their team will benefit from – and enjoy.

In this definitive team building case study , we’ll do a deep dive into real-world solutions we provided for our customers.

4 Unique Team Building Events & Training Programs Custom-Tailored for Customer Needs 

1. a custom charity event for the bill & melinda gates foundation  , 2. how principia built a stronger company culture even with its remote employees working hundreds of miles apart , 3. custom change management program for the royal canadian mint, 4. greenfield global uses express team building to boost morale and camaraderie during a challenging project, 5 virtual team building activities to help remote teams reconnect, 1. how myzone used virtual team building to boost employee morale during covid-19, 2. americorps equips 90 temporary staff members for success with midyear virtual group training sessions, 3. how microsoft’s azure team used virtual team building to lift spirits during the covid-19 pandemic, 4. helping the indiana cpa society host a virtual team building activity that even the most “zoom fatigued” guests would love, 5. stemcell brightens up the holiday season for its cross-departmental team with a virtually-hosted team building activity, 3 momentum-driving events for legacy customers, 1. how a satellite employee “garnered the reputation” as her team’s pro event planner, 2. why plentyoffish continues to choose ‘the amazing race’ for their company retreat, 3. how team building helped microsoft employees donate a truckload of food, 4 successful activities executed on extremely tight timelines, 1. finding a last-minute activity over a holiday, 2. from inquiry to custom call in under 30 minutes, 3. a perfect group activity organized in one business day, 4. delivering team building for charity in under one week.

We know that every team has different needs and goals which is why we are adept at being flexible and have mastered the craft of creating custom events for any specifications.  

When the  Seattle, Washington -based head office of the Bill & Melinda Gates Foundation – a world-renowned philanthropic organization – approached us in search of a unique charity event, we knew we needed to deliver something epic. Understanding that their team had effectively done it all when it comes to charity events, it was important for them to be able to get together as a team and give back  in new ways .

Our team decided the best way to do this was to create a brand-new event for the Bill & Melinda Gates Foundation which had never been executed before. We created an entirely new charitable event – Bookworm Builders – for them and their team loved it! It allowed them to give back to their community, collaborate, get creative, and work together for a common goal. Bookworm Builders has since gone on to become a staple activity for tons of other Outback Team Building & Training customers! 

To learn more about how it all came together, read the case study:  A Custom Charity Event for the Bill & Melinda Gates Foundation .

Who said hosting an impactful training program means having your full team in the same place at the same time? Principia refused to let distance prevent them from having a great team, so they contacted us to help them find a solution. Their goals were to find better ways of working together and to create a closer-knit company culture among their 20 employees and contractors living in various parts of the country. 

We worked with Principia to host an  Emotional Intelligence  skill development training event customized to work perfectly for their remote team. The result was a massive positive impact for the company. They found they experienced improved employee alignment with a focus on company culture, as well as more emotionally aware and positive day-to-day interactions. In fact, the team made a 100% unanimous decision to bring back Outback for additional training sessions.

To learn more about this unique situation, read the full case study:  How Principia Built a Stronger Company Culture Even with its Remote Employees Working Hundreds of Miles Apart .

We know that employee training that is tailored to your organization can make the difference between an effective program and a waste of company time. That’s why our team jumped at the opportunity to facilitate a series of custom development sessions to help the Royal Canadian Mint discover the tools they needed to manage a large change within their organization. 

We hosted three custom sessions to help the organization recognize the changes that needed to be made, gain the necessary skills to effectively manage the change, and define a strategy to implement the change: 

• Session One:  The first session was held in November and focused on preparing over 65 employees for change within the company. 
• Session Two:  In December, the Mint’s leadership team participated in a program that provided the skills and mindset required to lead employees through change. 
• Session Three:  The final session in February provided another group of 65 employees with guidance on how to implement the change. 

To learn more, read the full case study:  Custom Change Management Program for the Royal Canadian Mint .

When Greenfield Global gathered a team of its A-Players to undertake a massive, challenging project, they knew it was important to build rapports among colleagues, encourage collaboration, and have some fun together.

So, we helped them host an Express Clue Murder Mystery event where their team used their unique individual strengths and problem-solving approaches in order to collaboratively solve challenges.

To learn more, read the full case study:  Greenfield Global Uses Express Team Building to Boost Morale and Camaraderie During a Challenging Project .

When the COVID-19 pandemic struck, we were proud to be able to continue supporting our customers’ goals with virtual team building activities and group training sessions.

With remote work being mandated as self-quarantine requirements are enforced on a global scale, companies began seeking ways to keep their newly-remote teams engaged and ensure morale remained as high as possible.

And MyZone was no exception. When the company found themselves feeling the effects of low employee morale and engagement, they noticed a decrease in productivity and motivation.

To make matters even more difficult, MyZone’s team works remotely with employees all over the world. This physical distancing makes it challenging for them to build a strong rapport, reinforce team dynamics, and boost morale and engagement.

The company was actively searching for an activity to help bring their employees closer together during this challenging time but kept running into a consistent issue: the majority of the team building activities they could find were meant to be done in person.

They reached out to Outback Team Building and Training and we were able to help them achieve their goals with a Virtual Clue Murder Mystery team building activity.

AmeriCorps members are dedicated to relieving the suffering of those who have been impacted by natural disasters. And to do so, they rely on the support of a team of temporary staff members who work one-year terms with the organization. These staff focus on disseminating emergency preparedness information and even providing immediate assistance to victims of a disaster.

During its annual midyear training period, AmeriCorps gathers its entire team of temporary staff for a week of professional development seminars aimed at both helping them during their term with the company as well as equipping them with skills they can use when they leave AmeriCorps.

But when the COVID-19 pandemic got underway, AmeriCorps was forced to quickly re-evaluate the feasibility of its midyear training sessions.

That’s when they reached out to Outback. Rather than having to cancel their midyear training entirely, we were able to help them achieve their desired results with four virtual group training sessions: Clear Communication ,  Performance Management Fundamentals ,  Emotional Intelligence , and  Practical Time Management .

Find all the details in the full case study: AmeriCorps Equips 90 Temporary Staff Members for Success with Midyear Virtual Training Sessions.

With the COVID-19 pandemic taking a significant toll on the morale of its employees, Microsoft’s Azure team knew they were overdue for an uplifting event.

It was critical for their team building event to help staff reconnect and reengage with one another. But since the team was working remotely, the activity needed to be hosted virtually and still be fun, engaging, and light-hearted.

When they reached out to Outback Team Building and Training, we discussed the team’s goals and quickly identified a Virtual Clue Murder Mystery as the perfect activity to help their team get together online and have some fun together.

For more information, check out the entire case study: How Microsoft’s Azure Team Used Virtual Team Building to Lift Spirits During the COVID-19 Pandemic.

The Indiana CPA Society is the go-to resource for the state’s certified public accountants. The organization supports CPAs with everything from continuing education to networking events and even advocacy or potential legislation issues that could affect them.

But as the time approached for one of INCPAS’ annual Thanksgiving event, the Indiana CPA Society’s Social Committee needed to plan a modified, pandemic-friendly event for a group of people who were burnt out my online meetings and experiencing Zoom fatigue.

So, we helped the team with a Self-Hosted Virtual Code Break team building activity that INCPAS staff loved so much, the organization decided to host a second event for its Young Pros and volunteers.

For INCPAS’ Social Committee, the pressure to put on an event that everyone will enjoy is something that’s always on their mind when planning out activities. And their event lived up to their hopes.

For more information, check out the entire case study: Helping the Indiana CPA Society Host a Virtual Team Building Activity That Even the Most “Zoom Fatigued” Guests Would Love .

When Stemcell was looking for a way to celebrate the holidays, lift its team members’ spirits, and help connect cross-departmental teams during the pandemic, they contacted us to help host the perfect team building activity.

They tasked us with finding an event that would help team members connect, get in the holiday spirit, and learn more about the business from one another during the midst of a stressful and challenging time.

So, we helped them host a festive, virtually-hosted Holiday Hijinks team building activity for employees from across the company.

For more information, check out the entire case study: Stemcell Brightens Up the Holiday Season for its Cross-Departmental Team with a Virtually-Hosted Team Building Activity .

We take pride in being recommended by more than 14,000 corporate groups because it means that we’ve earned their trust through delivering impactful results.

We’ve been in this business for a long time, and we know that not everybody who’s planning a corporate event is a professional event planner. But no matter if it’s their first time planning an event or their tenth, we  love  to help make our customers look good in front of their team. And when an employee at Satellite Healthcare was tasked with planning a team building event for 15 of her colleagues, she reached out to us – and we set out to do just that!

Our customer needed a collaborative activity that would help a diverse group of participants get to know each other, take her little to no time to plan, and would resonate with the entire group.

With that in mind, we helped her facilitate a  Military Support Mission . The event was a huge success and her colleagues loved it. In fact, she has now garnered a reputation as the team member who knows how to put together an awesome team building event.

To learn more, read the case study here:  How a Satellite Employee “Garnered the Reputation” as Her Team’s Pro Event Planner .

In 2013, international dating service POF (formerly known as PlentyOfFish) reached out to us in search of an exciting outdoor team building activity that they could easily put to work at their annual retreat in  Whistler, B.C . An innovative and creative company, they were in search of an activity that could help their 60 staff get to know each other better. They also wanted the event to be hosted so that they could sit back and enjoy the fun.

The solution? We helped them host their first-ever  Amazing Race  team building event.

Our event was so successful that POF has now hosted The Amazing Race at their annual retreat for  five consecutive years .

To learn more, check out our full case study:  Why PlentyOfFish Continues to Choose ‘The Amazing Race’ for Their Company Retreat .

As one of our longest-standing and most frequent collaborators, we know that Microsoft is always in search of new and innovative ways to bring their teams closer together. With a well-known reputation for being avid advocates of corporate social responsibility, Microsoft challenged us with putting together a charitable team building activity that would help their team bond outside the office and would be equal parts fun, interactive, and philanthropic. 

We analyzed which of our six charitable team building activities would be the best fit for their needs, and we landed on the perfect one: End-Hunger Games. In this event, the Microsoft team broke out into small groups, tackled challenges like relay races and target practice, and earned points in the form of non-perishable food items. Then, they used their cans and boxes of food to try and build the most impressive structure possible in a final, collaborative contest. As a result, they were able to donate a truckload of goods to the local food bank.

For more details, check out the comprehensive case study:  How Team Building Helped Microsoft Employees Donate a Truckload of Food .

Time isn’t always a luxury that’s available to our customers when it comes to planning a great team activity which is why we make sure we are fast, agile, and can accommodate any timeline. 

Nothing dampens your enjoyment of a holiday more than having to worry about work – even if it’s something fun like a team building event. But for one T-Mobile employee, this was shaping up to be the case. That’s because, on the day before the holiday weekend, she found out that she needed to organize a last-minute activity for the day after July Fourth. 

So, she reached out to Outback Team Building & Training to see if there was anything we could do to help – in less than three business days. We were happy to be able to help offer her some peace of mind over her holiday weekend by recommending a quick and easy solution: a  Code Break  team building activity. It was ready to go in less than three days, the activity organized was stress-free during her Fourth of July weekend, and, most importantly, all employees had a great experience. 

For more details, check out the full story here:  Finding a Last-Minute Activity Over a Holiday .

At Outback Team Building & Training, we know our customers don’t always have time on their side when it comes to planning and executing an event. Sometimes, they need answers right away so they can get to work on creating an unforgettable experience for their colleagues.

This was exactly the case when Black & McDonald approached us about a learning and development session that would meet the needs of their unique group, and not take too much time to plan. At 10:20 a.m., the organization reached out with an online inquiry. By 10:50 a.m., they had been connected with one of our training facilitators for a more in-depth conversation regarding their objectives.

Three weeks later, a group of 14  Toronto, Ontario -based Black & McDonald employees took part in a half-day tailor-made training program that was built around the objectives of the group, including topics such as emotional intelligence and influence, communication styles, and the value of vulnerability in a leader.

To learn more about how this event was able to come together so quickly, check out the full story:  From Inquiry to Custom Call in Under 30 Minutes .

When Conexus Credit Union contacted us on a Friday afternoon asking if we could facilitate a team building event for six employees the following Monday morning, we said, “Absolutely!” 

The team at Conexus Credit Union were looking for an activity that would get the group’s mind going and promote collaboration between colleagues. And we knew just what to recommend:  Code Break Express  – an activity filled with brainteasers, puzzles, and riddles designed to test the group’s mental strength. 

The Express version of Code Break was ideal for Conexus Credit Union’s shorter time frame because our Express activities have fewer challenges and can be completed in an hour or less. They’re self-hosted, so the company’s group organizer was able to easily and efficiently run the activity on their own.

To learn more about how we were able to come together and make this awesome event happen, take a look at our case study:  A Perfect Group Activity Organized in One Business Day .

We’ve been lucky enough to work with Accenture – a company which has appeared on FORTUNE’s list of “World’s Most Admired Companies” for 14 years in a row – on a number of team building activities in the past. 

The organization approached us with a request to facilitate a philanthropic team building activity for 15 employees. The hitch? They needed the event to be planned, organized, and executed within one week. 

Staying true to our brand promise of being fast to act on behalf of our customers, our team got to work planning Accenture’s event. We immediately put to work the experience of our Employee Engagement Consultants, the flexibility of our solutions, and the organization of our event coordinators. And six days later, Accenture’s group was hard at work on a  Charity Bike Buildathon , building bikes for kids in need.

To learn more about how we helped Accenture do some good in a short amount of time, read the full case study:  Delivering Team Building for Charity in Under One Week .

Learn More About Team Building, Training and Development, and Coaching and Consulting Solutions 

For more information about how Outback Team Building & Training can help you host unforgettable team activities to meet your specific goals and needs on virtually any time frame and budget, just reach out to our Employee Engagement Consultants.  

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 From corporate groups to remote employees and everything in between, the key to a strong business is creating a close-knit team. That’s why you need to do team-building sessions as much as you can.

Teams That Changed The World (Team Case Studies)

Written by Victoria Allen

Apr 13, 2018  - Last updated: Aug 30, 2023

During our lifetime there are an abundance of occasions in which we are required to work as part of a team; most notably in the workplace, and because of this, organisations are habitually faced with complex problems, sometimes in higher levels of pressure circumstances.

Team development is more than just running team meetings and ticking of boxes. It involves making hard decisions, and working for the good of others even when the end is not in sight. Great teams cultivate a sense of psychological safety across the organization— from senior executive all the way down to entry-level colleagues.

What it Takes to Build a Top-Performing Team

The proper formation and careful maintenance of a team is crucial to the team's performance and success. Establishing a diverse team with mixed skills and strengths can improve team effectiveness and productivity. They also have a positive effect on the team's dynamics and help everyone achieve key goals individually and together.

Another vital element is communication. By communicating with one another and understanding each other’s communication styles and preferences, a shared culture is created.

Disagreements can be avoided (or easily resolved), with people understanding their individual and group roles in order for each team member to be striving for the same collective goal.

Research lead by Google  has concluded that the best teams included team members who listen to one another and show sensitivity. Studies have also shown that when people work in high performing teams, in contrast to working alone, they are more productive and report greater job satisfaction.

Working in a team results faster innovation, quicker mistake detection and correction, better problem-solving, and greater performance according to research findings.

History is littered with top performing team case studies, and in this article we will look at the three top performing teams that we believe changed the world as we know it.

Before we dive into the case studies, if you're wanting to build a high performing team then you should take a look at QuizBreaker . It's an all-in-one team engagement platform that helps brings teams closer together through a variety of great tools. They offer a 7 day free trial too.

NASA’s Apollo 11

A huge milestone for science and for mankind, NASA’s 1969 Apollo 11 mission is a great demonstration of high-performing teams.

Televised across the world, three astronauts made the revolutionary journey toward the moon and two of the three astronauts stepped foot onto the moon’s surface, creating history.

Whilst Neil Armstrong, Buzz Aldrin and Michael Collins are the well-known faces of this prodigious achievement, they wouldn’t have made it to the history books without the efforts of their supporting team - years of previous research and expertise allowed this mission to take place and succeed.

For two years prior to the operation, mission planners studied the moon’s surface using photographs from satellites and the Surveyor spacecraft, to find the best place for Apollo 11 to land. They needed to consider the geography of the surface, factoring in craters, boulders and cliffs, as well as the best time to land due to the positioning of the sun.

NASA has estimated that more than 400,000 people made the moon landings possible; scientists, engineers and technicians, who had never worked in aerospace before, were given contracts to design a machine capable of transporting humans safely to out of space.

The astronauts visited the laboratories in order to create a human connection to foster a more cohesive team – the workers met the men whose lives were in their hands. In the operations control room, during each flight, there were numerous technicians guiding and supporting those heading into outer space. Essentially, each step of the way, communication was paramount, enabling the team behind NASA’s Apollo 11 to achieve a historical milestone.

The Manhattan Project

The American-led mission to develop the world’s first atomic weapon during WW2 was code-named the Manhattan Project .

It was and still is, thought of as a highly controversial assignment, though it is hard to dispute that it is an excellent example of a top performing senior leadership team.

The task began in 1942 after authorisation from U.S. President Roosevelt. Utilising the minds’ of some of the world’s leading scientists and military personnel, the Manhattan Project started as an attempt to beat the Nazis in a race against time to build a nuclear weapon. However, with hindsight, we now know that the Nazis would not be successful in their attempts to build an atomic bomb.

Involving over 130,000 individuals, spread across 13 locations in the United States of America and Canada, and all sworn to secrecy, this mammoth of a project had a huge risk of exposure and sabotage and therefore communication and coordination would be vital to this mission’s success.

One of the reasons why the Manhattan Project is considered one of the greatest examples of the top performing team case studies is that often, within the realm of research and invention, scientists have a desire to compete against others in order to gain notoriety for their work.

However in this instance, scientists (and other specialists) worked within a team and adopted a group mentality in order to achieve a shared goal.

The Royal Society of London

The Royal Society of London is a classic and old example of a top performing team. Granted a royal charter by King Charles II, the Royal Society of London was the first national scientific institution in the world.

Founded in 1660 and often referred to as “the invisible college”, the society was orchestrated by its team leaders in order to encourage the exchange of scientific and philosophic ideas and theories. The society’s motto “Nullius in verba” is translated as “take nobody’s word for it”. The motto was upheld as a manifest of the members’ drive to verify all statements by the means of scientific facts and experimental research findings.

Notable members over the years have included the legendary Sir Isaac Newton, Charles Darwin, Albert Einstein, and Stephen Hawking.

When the society was formed, during a time dominated by prejudice, war and political unrest, the group prided itself of the fact that it accepted members of all backgrounds.

Papers were exchanged between the scientific scholars, and within the space of just 70 years the science we employ in everyday life today was developed. This includes the sciences of anatomy, astronomy, botany, chemistry, physics and zoology.

The team’s achievements were established on a foundation of trust, support and respect, as well as a collective goal – the advancement of science.

Many of us use Wikipedia on a regular basis and do not stop to think what a great example of teamwork the website portrays.

Volunteer writers and editors contribute by inputting knowledge and facts about the world onto the website in order to create an accessible and easily understood encyclopedic database. Without an army of regular employees, the team worked together to build the biggest database of information of all time.

Wikipedia is one of the most viewed websites in the world and is the result of the cumulative efforts of a vast, and somewhat anonymous, team.

In the world of sports, when thinking about top performing team case studies, one famous team in particular comes to mind.

The New Zealand national rugby union team

The All Blacks , are considered to be one of the greatest performing international teams in history.

Representing a country of just 4.5 million inhabitants, the All Blacks appear to be an untouchable team. They have won the title in 3 World Cups and accomplish a better ratio of wins than other sports teams, making them the foremost sports franchise in history.

In their 125 year long history, the All Blacks have won more than three-quarter of the games they have participated in which is a statistic unsurpassed by any other national sports team. Despite the frequent long periods of time spent away from family whilst touring for matches internationally, the team have a strong determination and drive to achieve a common goal - to win every game and maintain their reputation. All Black team players, including the coach, are seen as equal and as important components in the creation and maintenance of a successful team.

Nature - Birds

There are even examples of effective team performance in nature; think of geese, for example, each winter the flock work together in order to achieve their common goal - reaching their seasonal destination. Communicating by honking at one another, they encourage those who appear to be losing momentum or getting tired.

Or, by flying in a v-shape formation, the geese reduce the drag for those behind them. The same principles could be implemented in an organisational team. Or, by nurturing a team mentality, all members share a common goal and feel supported by one another.

History teaches us that in order for teams to be successful, the conditions must be right. Nurturing management styles, and awareness of others working styles are just some of the contributing factors that aid the creation of a high performance team.

Google’s " Project Aristotle " has highlighted the fact that when individuals join an organisational team, they do not want to leave their individuality and personality at home. People want to be their true selves and feel that they are free to share ideas and thoughts in a psychologically safe environment.

Communication, empathy and mutual understanding all create a productive environment for increased performance and job satisfaction.

By understanding each other’s work styles, strengths and attributes, work stops becoming an act of labour and becomes a collective goal or mission.

No man is an island. Business is a team sport!

About the author

Victoria is a Psychology Masters graduate and works in psychology research/copywriting. She has a background in marketing and has previously worked within the NHS in the Mental Health services. Victoria loves animals and is a self-confessed Pinterest-addict. She is always dreaming of her next travel adventure.

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• Real Life Examples of Successful Teamwork [9 Cases]

Instead of retelling the same old stories about best teamwork practices from companies such as Google, Chevron, or Southwest airlines (which don’t really help when you have a small-to-medium team), we decided to find real-life examples of successful teamwork.

We asked everyday entrepreneurs, CEOs, and HR managers one simple question:

How did you improve teamwork in your organization?

Here are the best 9 examples we came across.

3-step onboarding

Developing teamwork should start as soon as the new employee walks through the door. According to Lauren McAdams , career advisor and hiring manager at ResumeCompanion.com , the most successful method for creating excellent intra-team relations was instilling a sense of teamwork early on in the onboarding process.

”While we do experiment with different team-building measures, there are three that have become common practice:

First, during onboarding, we have new employees shadow an experienced “coach” who is tasked with helping their integration into the team. After the initial phase, we assign the new employees to shadow other people so they get to have more than one “coach”.

Next, when we begin a new project, I personally assign mini-teams to handle those projects. These smaller units are often comprised, in part, of employees who haven't had a chance to work together. This way, new hires get an opportunity to work and develop relationships with everyone they collaborate with.

And finally, leadership rotates on these projects so different people have a chance to test their leadership skills. Also, since project teams always have different people on them, everyone in the company gets to know each other at some point by working together. This level of exposure and collaboration resulted in very strong teamwork at our company.”

Role switching

Some organizations encourage their employees to walk a mile in someone else's shoes. Lee Fisher , an HR manager at Blinds Direct , says that successful teamwork should be based on solidarity, respect, communication, and mutual understanding. With that in mind, his company has been organizing a series of team-building events over the years.

“Our most unconventional event to date was the 'Role Switch'. It was launched across our web and marketing department . In the event, each team member switches roles with a colleague. Usually, team members work together closely but they don’t really understand the complexities of other person’s role.

Spending a day in your colleague’s shoes highlights their efforts, which brings more understanding and respect for one another. The 'Role Switch' was a huge success: it brought the team closer together and made people more considerate of other's workloads and requirements .”

Cross-training

Sharing experience with your peers is important, but recognizing where they can best help you improve is even more important. According to Steven Benson , founder, and CEO of Badger Maps , his company has benefited from one self-initiated cross-training session which resulted in an increase in both teamwork and productivity.

”An example of successful teamwork at our company was when the customer relation department put together an initiative of cross-training and specializing team members for different roles. After deciding who will focus on what, the group sat down and taught one another what they would need to become the expert in their respective area.

Because people were cross-trained, they had a broader set of skills they could use to handle customer interaction - which resulted in fewer hand-offs. This not only enhanced teamwork and productivity, but also improved customer satisfaction. Everyone worked as a team and covered for one another, which made everything move smoothly and quickly."

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Scheduled breaks and self-reflection

Publicly reflecting on achievements increases everyone’s morale. Bryan Koontz , CEO of Guidefitter , considers teamwork to be more than just brainstorming ideas or helping a colleague on a project - it’s about fostering a culture of trust and respect.

“A few ways we cultivate an environment of trust and respect is through meetings, or rather "breaks", that don't necessarily focus on work. By scheduling “break” times in our calendars, we allow our employees to talk, relax, and discuss the ins-and-outs of their days.

We also strengthen our teams through brief weekly meetings with the entire office: each Wednesday morning we huddle up to recap the past week, with each employee sharing one professional and one personal "win". This encourages everyone to pause for self-reflection on their achievements, often serving as motivation to their peers while forging a bond among our team members.”

Team traditions

Members of jelled teams  have a strong sense of identity and often share traditions like getting together for a drink after work. According to Katerina Trajchevska co-founder and CEO of Adeva , establishing team traditions is the foundation upon which teamwork is built.

“Rather than using one particular method for strengthening our team, we focus on creating an environment that fosters team spirit and communication. We organize after hours drinks and hangouts, and develop a culture that encourages everyone to speak up and take part in the big decisions for the company.

Team traditions can do wonders, no matter how trivial they seem: we have a team lunch every Friday, celebrate birthdays and other important dates, and celebrate one of our national holidays together. All of this has contributed to a more cohesive and a close-knit team.”

Unconventional business meetings

Some companies use their business meetings to improve teamwork within the organization by making them fun and laid-back. James Lloyd-Townshend , CEO of Frank Recruitment Group  believes that bringing teams together in an informal environment improves teamwork, strengthens bonds, and bolsters morale - which is why he decided to spice up the company’s monthly meetings.

”One unusual method we’ve introduced is “First Thursdays”: we start off our monthly business meetings with a business review, promotions, and awards - and then move on to an open bar event.

Apart from “First Thursdays,” we also have “Lunch Club”: another monthly event where employees enjoy an all-expense-paid afternoon to celebrate their success and enjoy fine dining and have fun with their colleagues.

However, the most popular team building method we employ is our incentivised weekends away. Our top-performing consultants get the chance to travel to major cities such as London, New York, and Miami as the rewards for their hard work.”

Peer recommendations

Some companies are building teamwork through peer recognition. Jacob Dayan , a partner, and co-founder of Community Tax said that encouraging employees to be active participants in recognizing their peers has proven to be quite a powerful motivational tool.

”I ask employees to share or report instances when someone on their or another team has been particularly helpful or has gone above and beyond their call of duty. After we thank the contributing employee for their input, we make sure the employee being acknowledged knows the source of information. Having employees “nominate” their peers for recognition has the additional bonus of bringing them closer together and building camaraderie with long-term productivity benefits.”

However, Mr. Dayan is well aware that peer reports and nominations can be driven by personal feelings (positive as well as negative), and can give an unrealistic representation of certain employee's contribution.

”Personal relationships, both close and less so, are an important consideration when pursuing this approach, which is why we do not hand out recognition without validating the worthiness of the employee's contribution. We ask the appropriate manager to review the submission and keep an eye on it over time, just to make sure there are no dubious activities.”

Conflict resolving

Successful teamwork happens when members of a group trust each other, are comfortable expressing themselves, and deal effectively with conflict, according to Laura MacLeod , a licensed social worker specialized in group work, an HR consultant, and a mastermind behind “From the inside out project” .

”Many companies think that team building is about company picnics, happy hours, and other fun events. These things are fine, but they don't address the real issues people face when they have to work together. Going out for a drink with someone you can't get along with will be just as uncomfortable and awkward as trying to finish a project with that person - the only difference is having alcohol as a buffer.”

According to Laura, certain team-building exercises can help individuals overcome both intragroup and personal conflicts .

“Choose simple activities that help build cohesion and trust amongst team members. For example, you can use “Pantomime in a circle” exercise: without using words, pass an imaginary object (a bucket of water or a ball) around the circle; the point of the exercise is for group members to rely on each other to complete the activity.

When it comes to personal misunderstandings, you might want to choose an activity where you are actually allowed to yell at a person. So, pair off people and have them repeat opposing sentences (such as it’s hot/it’s cold) back and forth - going from soft to very loud. This will allow people to get out strong emotions in a non-threatening way, and blow off some steam in the process.”

"Spotless" team-building exercise

Dmitri Kara , a tenancy expert at Fantastic Cleaners , shared with us a team-building exercise his team uses to increase cooperation and efficiency.

”Everybody in the office has to simultaneously perform a 2-to-5-minute cleaning routine (like wipe their desk, keyboard, monitor, shelves). But there’s a catch: the tools are limited. For example, make everybody wipe the dust off their desks at the same time but provide only 2 sprayers and 1 roll of paper towel (if your team has 10 members)-. Scarcity will encourage people to share and help each other.”

Besides providing obvious benefits (like a cleaner working environment), Dmitri says this team building activity boosts organization, improves long-term productivity, and develops a sense of morale, discipline, and shared responsibility. He even shares how the exercise came into being:  

”At first it was not really a dedicated exercise. The first time we did it all together, it was because of a video shoot. But since it felt good, a few days later somebody said, "let's do that again". And that's where the whole thing came to be.”

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Other posts in the series on The Big Book of Team Culture

• Tips To Take Better Meeting Notes
• How To Be a Good Team Leader
• Belbin Team Roles: Theory and Practice
• How To Deal With a Toxic Coworker
• Organizational Culture and Its Impact on Team Performance

What Is Teamwork Actually?

• High Performing Teams: What Are They and How Do I Build One?

Characteristics of a Productive Team

• All Leadership Theories in Under 15 Minutes
• How to Create Organizational Culture
• Group vs Team [Differences, Comparison, Transformation]
• Types of Teams [Advantages and Disadvantages]

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The Secrets of Great Teamwork

• Martine Haas
• Mark Mortensen

Over the years, as teams have grown more diverse, dispersed, digital, and dynamic, collaboration has become more complex. But though teams face new challenges, their success still depends on a core set of fundamentals. As J. Richard Hackman, who began researching teams in the 1970s, discovered, what matters most isn’t the personalities or behavior of the team members; it’s whether a team has a compelling direction, a strong structure, and a supportive context. In their own research, Haas and Mortensen have found that teams need those three “enabling conditions” now more than ever. But their work also revealed that today’s teams are especially prone to two corrosive problems: “us versus them” thinking and incomplete information. Overcoming those pitfalls requires a new enabling condition: a shared mindset.

This article details what team leaders should do to establish the four foundations for success. For instance, to promote a shared mindset, leaders should foster a common identity and common understanding among team members, with techniques such as “structured unstructured time.” The authors also describe how to evaluate a team’s effectiveness, providing an assessment leaders can take to see what’s working and where there’s room for improvement.

Collaboration has become more complex, but success still depends on the fundamentals.

Idea in Brief

The problem.

Teams are more diverse, dispersed, digital, and dynamic than ever before. These qualities make collaboration especially challenging.

The Analysis

Mixing new insights with a focus on the fundamentals of team effectiveness identified by organizational-behavior pioneer J. Richard Hackman, managers should work to establish the conditions that will enable teams to thrive.

The Solution

The right conditions are

• a compelling direction
• a strong structure
• a supportive context, and
• a shared mindset

Weaknesses in these areas make teams vulnerable to problems.

Today’s teams are different from the teams of the past: They’re far more diverse, dispersed, digital, and dynamic (with frequent changes in membership). But while teams face new hurdles, their success still hinges on a core set of fundamentals for group collaboration.

• Martine Haas is the Lauder Chair Professor of Management at the Wharton School and Director of the Lauder Institute for Management & International Studies at the University of Pennsylvania. She holds a PhD from Harvard University. Her research focuses on collaboration and teamwork in global organizations.
• Mark Mortensen is a professor of organizational behavior at INSEAD and for over 20 years has studied and consulted on collaboration and organization design, with a focus on hybrid, virtual, and globally distributed work. Mark publishes regularly in Harvard Business Review , MIT Sloan Management Review , and INSEAD Knowledge, and is a regular fixture in popular press outlets like the BBC, the Economist , the Financial Times , and Fortune .

Partner Center

How Teams Work: Lessons from the Pandemic

When COVID-19 first sent office employees home last year, many managers filled their teams’ calendars with online check-ins, drop-ins, and updates to make up for the loss of spontaneous interactions—often sinking morale and efficiency.

Knowledge workers and managers didn’t know what types of interactions they needed to succeed. When managers understand the building blocks for team work, they can allocate time better and select the right communication tools, whether teams are dispersed or together, a new study from Harvard Business School suggests.

Executives are starting to envision post-COVID collaboration in organizational cultures reshaped by remote work. Research by Leslie Perlow , the Konosuke Matsushita Professor of Leadership at HBS, and colleagues sheds light on the interactions that were lost during the pandemic’s early weeks, and how teams adapted or faltered. The findings also hold practical implications for managers struggling with low engagement and inefficiency amid a lack of face time and continued pandemic stress.

“One of the big insights from our work has been that, just because you went to the meeting doesn’t mean you know what happened,” explains Perlow. “The more senior people assume that the more junior people understood the meeting because they were there.”

In reality, while technology makes it possible to invite more and different people to virtual meetings, the lack of spontaneous “huddle time”—quick post-meeting conversations to process what just happened—can leave some attendees in the dark about nuances and next steps.

The researchers also found that switching from on-site to remote work reduced “bounce time,” a term they use to describe impromptu brainstorming sessions. The disappearance of bounce time stunted innovation and caused content discussions to intrude on meetings scheduled for other purposes.

“Grabbing a marker and sketching ideas together on a whiteboard—that's much more difficult in the virtual environment,” says Ashley Whillans , assistant professor at HBS and co-author of the study Experimenting During the Shift to Virtual Team Work: Learnings from How Teams Adapted Their Activities During the COVID-19 Pandemic , which will appear in the journal Information and Organization .

Perlow, Whillans, and HBS doctoral student Aurora Turek interviewed 51 knowledge workers at a professional services firm from April to June 2020 to chart teams’ interactions as they transitioned to remote work. The name of the firm and its industry are confidential, but its teams routinely traveled together to visit clients prior to the pandemic.

Drawing on past research about collaboration, the study identifies three categories of interpersonal interactions essential to knowledge workers and looks at how teams tried to facilitate them. They include:

• Task interactions , when team members collaborate on activities that directly contribute to output;
• Process interactions, such as the agenda-setting that structures a team’s work by laying out responsibilities and timelines;
• Relationship interactions in which colleagues support each other and share skills.

Task interactions: Harnessing the right technology

At the office, the teams studied would often sit together and discuss content or projects, providing feedback about ideas and early iterations. Like with bounce time interactions, these “content interactions” were usually spontaneous, so the shift to remote work made it difficult to give and receive early input.

In response to these challenges, the teams found that using asynchronous communication tools—specifically, Slack or similar messaging apps—helped compensate for the lack of spontaneity. Moreover, the researchers suggest that this change could permanently improve team collaboration, even when teams reunite in person, by giving individual members more time to think through their responses.

To compensate for lost bounce interactions, the teams used synchronous communication tools, such as WebEx or Zoom, to simulate in-person work conditions and brainstorming.

Even with these tools, it took time for teams to adapt, the study says. The researchers quoted one of their study subjects in the paper as follows:

“In the first project, we didn’t have a virtual team room, and didn’t have a rhythm for working together and organizing our work,” the interviewee said. “In the second project, we had a smoother teaming process because we tried to relax the norms around communication, do more virtual brainstorming, and allow for more personal autonomy over the work.”

Process interactions: Prioritizing quality over quantity

In terms of agenda-setting, Perlow, Whillans, and Turek found that balancing the quantity and quality of process interactions was critical for teams as they adjusted to remote work. In an office, it’s easy to ask a manager or colleague, “When is this due?” or “Who’s working on that?” Without those informal interactions, teams often went too far, scheduling too many meetings to touch base.

“They would have check-ins and check-outs, and then that process time would start to get usurped and there would be other kinds of interactions happening within it,” Whillans says. “Process time started to become content conversations because teams were not getting as much feedback during the day.”

With so many check-ins, burnout became a real concern. Over time, teams discovered that using Slack or minimally disruptive technologies for process questions helped them achieve balance.

Relationship interactions: Connecting through huddles, not yoga

The importance of nurturing social relationships has come sharply into focus during the pandemic, as often isolated coworkers communicate exclusively online. Spontaneous socializing in the office helps build bonds, and “huddle time” offers opportunities to learn from one another.

When these interactions could no longer happen organically, teams started scheduling them. Virtual drinks, team dinners, and yoga sessions became opportunities to learn more about colleagues than was possible in the office, as videoconferencing offered glimpses into people’s home lives.

But as they interviewed employees at the firm they studied, the researchers found that scheduled social time tended to feel forced, and not everyone was interested or able to attend. Still, those who participated found the experiences worthwhile, even if they fell short of past in-person gatherings.

Not all social time is the same, however. “Huddle time” helps workers understand the team’s work and context. For teams that valued these “hallway conversations,” especially after meetings, and made an effort to replicate them online, “the results were striking,” the researchers write.

“The challenge of replicating ‘hallway’ conversations via digital communication led interviewees to realize that these conversations were more than ‘downtime’—it became apparent that these conversations helped the team qualify their thinking,” they write.

Short, scheduled debriefs after client meetings helped team members process what transpired and the work that needed to follow.

Moving forward in a virtual world

By labeling the types of interactions a team needs and tracking the quality of scheduled time, managers can systematically improve collaboration, the researchers write.

“There’s huge inefficiency in so many meetings, and it became even worse in the virtual world,” says Perlow. “So, how can we think about, what are good meetings, and what are less-effective meetings?”

Inevitably, various types of team interactions co-occur or overlap. Perlow says she and her fellow researchers are continuing to examine those intersections and ways that different technologies can improve team collaboration long term.

“When we go back to the new normal,” says Perlow, “now that we better understand that you need these different types of interactions to work well together as a team, can we figure out how to do them more effectively?”

About the Author

Kristen Senz is the growth editor of Harvard Business School Working Knowledge. [Image: Unsplash/Robert Anasch]

What approaches helped your team adjust to remote work?

Share your thoughts in the comments below.

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Case Study #1

Erika pribanic-smith, department of communication, project description.

My goal was to determine if interventions to improve team cohesion through interpersonal communication would result in better team performance as measured by presentation cohesiveness on the final project. I conducted this assessment in a required course for all majors in the Department of Communication. Initial enrollment for the course was 123 students; four withdrew before the semester ended, and nine additional students stopped attending class but did not drop.

Each semester, students self-select into teams of 6-7 students on the first day of class. Students work in these teams throughout the semester on discussion exercises after lecture, team quizzes, and ultimately, a team presentation. In previous semesters, teams that communicated well with each other delivered excellent presentations, but most delivered the dreaded “patchwork project”; team members independently completed their tasks and then cobbled everything together at the last minute without knowing what others on the team were doing. Furthermore, Student Feedback Surveys indicated that a few students loved the team aspect of the course, but many hated it.

Employing team cohesion literature as well as Decision Emergence and Social Penetration theories, I hypothesized that developing stronger interpersonal ties among teammates via self-disclosure would assist in developing team cohesion, which in turn would motivate students to achieve team goals as a unit and keep each other accountable. I encouraged self-disclosure by developing discussion exercises that required students to come up with examples from their own lives for theoretical application. The disclosures grew more personal over the first half of the semester, starting with “Describe a situation in which you were misunderstood” (General Semantics Theory) and progressing to “Describe a situation in which someone shared your secret or you shared someone else’s” (Communication Privacy Management). A second intervention I employed to improve communication involved guided in-class team meetings, in which I assigned specific tasks related to the presentation assignment and provided instruction on the teamwork behaviors that should be exhibited at that stage of the project.

To measure team cohesion, students completed a team cohesion assessment survey (adapted from a Group Communication textbook’s team cohesion index) at four points during the semester: Week 2, Week 6, Week 10, and Week 14; the index consisted of 20 Likert-scale questions and one open-response question (“Is there anything you’d like to add?”). A Toastmasters list of criteria for group presentation cohesiveness was converted into a rubric for analyzing team performance on the final presentation.

Project Evaluation

Overall, the team cohesion assessment revealed a steady decline in team cohesion from the Week 2 survey to the Week 10 survey, then a spike between the Week 10 and Week 14 surveys. However, the literature recommends assessing team cohesion at both the individual level and the group level, and each level of analysis told a slightly different story in this project. The assessment survey included both individual-level and group-level questions, such that most individual-level questions (e.g., “I identify with the team and its members”) had a group-level counterpart (e.g., “Members of the team identify with the team”). The index of questions that gauged individual team members’ level of connection and commitment to the team demonstrated a relatively even measure of cohesion across the first three surveys with a slight bump in the second survey; the individual-level index rose sharply for the fourth survey. However, the index of questions that asked students to assess their fellow team members’ level of connection and commitment to the team sharply declined from Week 2 to Week 6, stayed nearly the same from Week 6 to Week 10, and then sharply rose by Week 14. In each survey, the individual-level index was higher than the group-level index, though the two indices were closer at Weeks 2 and 14 than in Weeks 6 and 10. (See figure below.)

Significantly, the Week 6 survey coincided with a presentation progress report deadline, and the Week 10 survey occurred around the deadline for teams’ presentation outlines. The open-ended responses at Week 10 in particular indicated that tensions were running high on teams in which students perceived their teammates were not doing their parts to complete the work. The Week 14 survey fell in the middle of presentations, and the overwhelming success of the presentations seems to have generated good will among most of the respondents.

Only one out of the 20 teams failed to score 100 percent on the presentation cohesiveness rubric, for an overall average of 96.4 percent (per Blackboard statistics). Nearly all of the presentations had good flow, consistent visuals (design of each PowerPoint slide), and consistent voice. In most cases, each teammate demonstrated knowledge of what each other teammate was doing. The presentations were tight and well-rehearsed. In short, most teams met the criteria for presentation cohesiveness. However, some went well beyond the Toastmasters criteria. Some teams coordinated their wardrobes; a few even coordinated the size and color of their notecards. Overall, with only one exception, the presentations were engaging and informative. Anecdotally speaking, they were the best presentations I have seen in my seven years teaching theory at UTA. A few even drew enthusiastic ovations from their peers.

Therefore, the class achieved the ultimate goal of cohesive team presentations, and despite dips in the middle, team cohesion was higher at the end of the semester than at the start. I do not believe the self-disclosure intervention affected team cohesion as anticipated, however. Reflections submitted the last week of the semester revealed that several students learned communication is a crucial part of effective teamwork, and some students even indicated that getting to know their teammates made a difference. I think much of that communication and bonding occurred outside of class, though. More significantly, because the team cohesion index increased amid successful presentations, team achievement affected team cohesion more than team cohesion affected team performance. I believe improved communication affected presentation cohesiveness directly rather than affecting team cohesion as a mediating factor .

Though a few students stubbornly insist that teamwork is terrible and they do better work on their own, the end-of-semester reflection responses were overwhelmingly positive, demonstrating that students found the teamwork experience this semester to be not only valuable but also enjoyable. Several students indicated they made close friends or at least expanded their campus network, and some said they loved the class because of their teams. (See responses to the teamwork reflection in Appendix A.)

In sum, I believe the project was successful, not only at improving the team presentations but also at improving most of my students’ ability to work in teams and their view of teamwork in an academic setting.

Despite the successes outlined above, some issues arose that limited the development of team cohesion in some teams and specifically hampered the self-disclosure intervention. These are issues I hope to address in future semesters:

• Several students were absent the first class, and a handful missed the whole first week. Therefore, some students were placed into groups that already had formed and were not able to self-select into teams, and a few of those students were vocal about disliking the teams to which I assigned them. Significantly, the one team that consisted entirely of people who first attended on the second day of class had a disastrous presentation, and direct communication with some of the students on that team revealed they never gelled.
• Attendance throughout the semester became an issue for multiple teams. Based on open-ended survey responses, some students who missed a lot of class did not bond with their teammates as much as students who did attend, and those students also missed a lot of the decision-making and task-planning for the presentation, so they were not as involved or invested in the project as other team members.
• Some teams did not fully and properly engage in the self-disclosure exercises. I eventually discovered that some teams skipped the discussion altogether and just had the person who was providing the real-life example write out the discussion report due at the end of class to save time. Therefore, the members of those teams weren’t learning about each other at all; they just treated the exercise as something they had to turn in for a participation grade. Furthermore, although a different person was supposed to provide an example each time so that everyone was disclosing about themselves, some groups had the same person sharing an example every time.
• Attrition occurred on a handful of teams as some students officially dropped the class or simply stopped coming. Two teams suffered severely; both began the semester with seven members, but one presented with three members at the semester’s end, and another ended the term with only two members. Those few teammates certainly bonded, but their view of the team experience was negative.

Future Direction

Given the general success of this project, I will continue emphasizing communication in future semesters. However, to overcome some of the issues I encountered this semester, I will make a few changes.

• I feel self-selection works great for the most part. However, I will shift team selection to the second day of class to reduce the number of students who are absent at the time of selection and do not get to select their own teams.
• I will monitor the self-disclosure exercises more closely to ensure that teams are a) actually discussing and b) distributing the self-disclosure across team members more evenly. Though it will make attendance record-keeping more difficult and eliminate a valuable check on students’ understanding of the concepts, I will consider doing away with the written report so that students are more focused on the discussion and not just submitting something for a grade.
• I will have more in-class team meetings. We only had three this semester, and they were in the last half-hour of quiz days because I knew most students would be present for the quizzes. Some students stated in their open-ended responses that coordinating schedules outside of class was difficult, though, and they wished we had some full class periods designated for team work. Therefore, I will work some full-class work days into the schedule next time. Deadline stress and failure of teammates to contribute seemed to hamper team cohesion more than anything else, but hopefully having more time to work together in person will increase participation in the project and decrease tension. Doing so in class also will give me more opportunity to guide their communication and teamwork behaviors.
• Some students still will skip class and fail to become a true part of the team or contribute meaningfully to the project. Therefore, I will do more to monitor and alleviate those situations earlier in the semester. Some teams exercised their ability to “fire” team members after the outline, but others didn’t realize or remember that was an option and complained that they presented with teammates who hadn’t contributed to the research and writing. Furthermore, teams only exercised the firing option after the outline was due; none did so earlier in the semester. I believe completing a large component of the project with dead weight increased tension and decreased team cohesion. I will make sure at every checkpoint that students remember they can remove teammates who are not participating in the project, and I will increase the number of peer evaluations students complete to facilitate this process. After they present, students complete a peer evaluation that evaluates each teammates’ cooperation, timeliness of contribution, preparation (research, writing, selecting/producing visuals), and presentation performance. I considered implementing a modified version of that evaluation at each checkpoint but decided against it because I didn’t want students to confuse the peer evaluations with the team cohesion assessments or become overwhelmed with paperwork. I will discontinue the team cohesion assessments, though, and have students complete peer evaluations more frequently instead. These will alert me to issues earlier while encouraging students to think critically about their teammates’ contributions throughout the process and take action as needed. Hopefully issues coming to light sooner will enable me to combine teams that may end up with few members well before the presentation.

Reflection: What is the most important thing you learned about teamwork this semester? (unedited responses)

Be flexible when working with everyone’s schedules

Being ahead of the curve.

being flexible and allowing others to contribute

Coming together in person can make a lot of things a lot simpler as opposed to doing it all online

Communication is the key for a successful team environment.

Communication so the team can adjust to fit everyones’ needs.

Don’t let negativity ruin a good presentation.

Everybody has to work together toward the team’s goals. One person can’t carry the team effectively and if one or more people don’t do their work it make the rest of the team’s jobs much harder and more frustrating. With that said, when people do actually participate it helps to bond those members together and make a better, cohesive, end project.

How to collaborate

How to communicate & get things done on time by planning as a team.

How without fail, working as a team is awful.

I didn’t learn it because I already knew it, but the most important thing I already know is that I work better alone and I still really don’t like group work with random people.

I know now to be here the first day of class, so I can pick my own group members considering I have to pay over a thousand dollars a class.

I learned how to better understand people’s opinions and what they had to say about the issues we were talking about.

I learned that a lot of the time someone on the team will not put in as much effort and will just float along in which the other members will have to carry the extra weight.

I learned that if everyone is on the same page and at least somewhat dedicated to the end goal, the group work will be successful and maybe even enjoyable, which contradicted my previous ideas of group work.

I learned that if you set up expectations for how you want your team to work, it will be more successful.

I learned that most people are not willing to work on teams no matter how old they are or the level of education they have.

I learned that working on big teams is difficult and its important to find meeting times.

I learned that you cannot expect the same amount of effort from each team member, but that oftentimes other members of the team will step up and fill the gaps made. The best strategy for success is to work well with those who demonstrate a willingness to give their time and effort to making the project the best it can be.

If you don’t get to know the people you are in a group with, it makes it hard to work with them.

It definitely takes a lot of work to make your team effective. You must always put in effort to try to restructure your schedule so everyone can meet. You also have to trust and depend on one another.

It is tough to have all team members focus on a task and be organized, especially when we each have much more going on in our lives, but as long as we all communicate well the job can definitely be done. Communication is key, for sure.

Leaders shape the future, and every team needs a strong leader to succeed.

Learning to speak up and state my own opinion even when I’m not entirely confident. Communication and openness is key in order to fully thrive in a group project. I enjoyed my group and the time we spent working together. I consider them my friends.

making new friends 🙂

Making sacrifices to achieve the big picture the team set out to attain.

Most people do things last minuet and you can’t make anyone do anything on your time frame.

Not everyone is going to do their part, but what counts is that the other members have the integrity to step up and cover the people who are slacking.

Organization is important

Planning and communication are key

Sometimes, you gotta pick it up and be leader.

Start the team project ahead of time and not wait until last minute because then you might get some team members that do not contribute.

Teams hold me down and block me from my shine  I learned I don’t work well well with others. But the assignment was cool. Groups make my head hurt

that communication is very important

That everyone needs to do their part to make the team run smoothly. Also, communication is key.

That google docs saves lives. It is very easy for everyone to be working on the same slides at once and that automatically save once you stop typing so nothing gets lost.

That some people are disrespectful. I also learned that others are extremely respectful. Projects definitely can’t be pushed back to the last minute. I also learned that understanding concepts after a lesson were much easier to understand working in a group because we were able to apply them to things we knew in real life.

That time is a key concept in getting things done in the time allotted, giving us the opportunity to finish our work thoroughly to where we have time to go over it a second time.

That time managing is essential to being prepared.

That we all have busy lives and we all work differently but we all trusted each other and that we would get all of our parts done, not micro manage each other and it would all workout.

The important thing I learn is that communication is one of the most important things to make a team successful. We kicked a few people out of our team because they did not execute their role as agreed. Once they were notified they were kicked out they were offended because the rest of the team did not understand their personal life situations, nonetheless, they never spoke about the problems they had at all to maybe find an alternate way as a team to complete each task as we had agreed to. We could not help them at the end nor feel empathic because they were not communicating with us how they said they were. Everyone was open about their situations they had going on outside of class, either school related, work or even personal but those people never did. They would agree to everything and say they would do it but at the end they did not and we did not feel compassionate about it because they never once did communicate anything about the possible encounters they could have or had been facing.

The longer we worked together the more stuff we had in common and accomplished our goals.

The most important thing I learned about being on a team is that unplanned circumstances happen and you have to be ready for them.

The most important thing I learned about working in a team is that sometimes, you can’t count on everyone to keep their word.

The most important thing I learned about working with a team this semester was planning and working around difficult schedules, improvising to get the job done.

The most important thing I learned from working in a team, was mostly time management and working together to achieve the same goal. Our theory had a lot to do with how our team functioned so it was nice to incorporate the two together.

The most important thing I learned on this team is that its best to not be last minute about things but to be ahead of things.

The most important thing I learned this semester about working in a team is how busy schedules can impact your plans. This led to working even harder in finding the best solution, where sometimes it meant dividing up who meets up on one day and who the other, with some meeting both days. Figuring out schedules can be the most daunting task but it can easily have a solution if you begin making a plan.

The work gets done when everyone is involved!

Things move better when you work together

This has been one of my favorite classes yet and I am thrilled to have gotten to meet every member in my group. I personally believe we will all never forget each other.

This semester i learned that even in a college setting where everyone is here to learn and get a good grade you may still encounter other that don’t play well. Sometimes it takes someone to be the bigger person and groom the team to just understand that we are all here just to get the job done.

To be more assertive in all aspects of my life.

To listen more than anything because there are so many things to learn and value about one another. We all come different places but somehow we all ended up in the same group! I love my team!!

To make sure that I am available to the team and to organize my time around the team’s schedule so as to make sure we get everything done.

to properly plan and create timetables for the group assignment.

We’re all different and unique, but yet we all think as one, all have the same mindset in order to reach our goal for this semester.

When everyone puts out and carries their own responsibilities like they should, the team can take ideas and form them into what we need, be it for an assignment or anything else.

Working in a big team is difficult but if at least most of the members coordinate to work towards the same goal then the team can create a fantastic piece of work.

Working in a team requires a lot of organization and patience. Now that we are in college, we all have different schedules and sometimes is hard to contact each member of the group however it’s not impossible. I have seen many people with busy schedules and still made the effort to contribute to the team. I have learn that we must be willing to work hard, have patience, and organization in order to have a strong contributing team. I am glad this class requires to grade our members because in that way I can show the great or minimal effort that each member did on the project.

You have to be willingly to sacrifice your schedule in order to work effectively with a team.

You need to be patient with people, but you can’t be a pushover.

Teamwork: An Open Access Practical Guide - Instructor Companion Copyright © 2020 by Andrew M. Clark and Justin T. Dellinger is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Session 2. Teamwork and Communication in Health Care

Chapter 6. Case-Based Learning

At a glance, instructor’s guide.

Overview for instructors. The purpose of this didactic session is to introduce students to the concepts of interprofessional education and collaborative practice. Instructors will use two case studies to highlight the specific teamwork and communication skills individuals need to work effectively on an interprofessional health care team. Each case study uses little to no medical or dental terminology to embed oral health. As a result, this session is ideal for pre-licensure health sciences students with no clinical training.

Materials provided in this toolkit.

• Pre- and Post-Session Assessment Questionnaire
• Instructor’s Copy, Case Study: Jill
• Instructor’s Copy, Case Study: Mr. Jones
• Case Study: Jill
• Case Study: Mr. Jones

Instructor Preparation.

• Download slides 30–34 and the accompanying speaker notes from Smiles for Life Course 1: The Relationship of Oral to Systemic Health

Note: You must register as an educator before you can download individual slides and speaker notes. Slide numbers viewed through the web interface for Smiles for Life differ from the numbers on the downloaded slides. Slide numbers in this toolkit correspond to slides in the third edition of Smiles for Life in their downloaded format.

• Ask a faculty member from each of the participating programs to locate or draft a short description of the roles and responsibilities for his or her respective profession. Compile these descriptions into one Word document and make it available to your students through email, your preferred learning management system, or your website.
• Pre-Session Assignment: Teamwork and Communication in Health Care

Note : The survey portion of the Pre- and Post-Session Assessment Questionnaire is taken from the TeamSTEPPS ® Teamwork Attitudes Questionnaire , which looks at five core components of teamwork. TeamSTEPPS was developed jointly by the Department of Defense and the Agency for Healthcare Research and Quality to improve the quality and safety of patient care. To learn more about the system, which includes a full curriculum and other resources, visit TeamSTEPPS .

• Complete the Pre- and Post-Session Assignment: Teamwork and Communication in Health Care .
• Review the roles and responsibilities document provided by the instructor.
• Pre-assessment (2–5 minutes)
• Introduction (5 minutes)
• Discussion of the pre-session assignment (10 minutes)
• Smiles for Life Course 1: The Relationship of Oral to Systemic Health PowerPoint slides 30–34 (10 minutes)
• Case study for Jill (10 minutes)
• Case study for Mr. Jones (10 minutes)
• Wrap-up (5 minutes)
• Post-assessment (2–5 minutes)

Instructor’s Notes

This session will take approximately one hour, depending on the number of participants.

Pre-assessment (2–5 minutes). Ask students to complete the pre-session portion of the Pre- and Post-Session Assessment Questionnaire as they arrive.

Introduction (5 minutes). Review the learning objectives and purpose of the session. Ask students to identify themselves by hand as you note the professions represented in class. Then, ask a student volunteer from each profession to read the roles and responsibilities for his or her profession aloud.

Discussion of pre-session assignment (10 minutes). The purpose of this assignment is to provide students with a real-world example of substandard health care delivery.

Ask student volunteers to share their answers to the questions in the Pre-Session Assignment: Teamwork and Communication in Health Care . Use the following notes to enhance discussion for each question.

• The purpose of this question is to prompt students to think about their personal experiences with teamwork. Allow a few students to share their answers.
• The purpose of this question is to prompt students to identify specific examples of effective or ineffective teamwork.
• This question should prompt students to reflect on the consequences of poor health care delivery (i.e., what happens when teamwork, collaboration, and good communication are absent).
• This question asks students to contemplate what went wrong with Deamonte’s health care delivery.

If necessary, guide students toward an understanding of the ways better communication and teamwork could have resulted in the more timely care needed to save Deamonte’s life.

Smiles for Life Course 1: The Relationship of Oral to Systemic Health PowerPoint slides 30–34 (10 minutes). This portion of Smiles for Life Course 1: The Relationship of Oral to Systemic Health introduces the concepts of interprofessional education and collaborative practice. Take time to read the definition of each and point out that the purpose of this didactic session is to prepare students for collaborative practice.

Case study for Jill (10 minutes). Break students into interprofessional teams of five or six. If possible, place one student from each profession on each team.

Instruct students to read Jill’s case study silently, then answer the questions as a team. One student should take notes and be prepared to discuss the team’s answers.

Use the following notes to enhance discussion generated by the questions.

• Yes. Although Jill’s school nurse could have taken action earlier, the dentist, physician, and school nurse communicated in a positive manner that reflects collaborative practice.
• Yes. All U.S. states and territories have laws that mandate the reporting of suspected abuse by specified individuals. These typically include physicians, nurses, and other health professionals. The need to be alert to nonmedical issues also highlights a potentially overlooked aspect of patient-centered care delivery. All health care providers should be concerned about a patient’s overall health and wellbeing, including those conditions whose treatment extends beyond the provider’s training.
• Jill’s health care team exhibited effective communication, mutual respect, and concern for comprehensive care.
• The physician addressed Jill’s oral health concerns and provided a dental referral. This illustrates patient-centered, comprehensive care.
• The dentist followed up with Jill’s physician and also consulted with her school nurse. This illustrates effective communication and collaboration.
• Participate in interprofessional education opportunities such as this one.
• Learn about the roles and responsibilities of other health care providers.
• Contact local health care providers once in practice to facilitate collaboration.

Case study for Mr. Jones (10 minutes).

Option 1 Ask students to form new teams with at least one person from each profession present on each team. Teams should designate one person to take notes and report on team findings. After the students have formed teams, direct them to read the case study for Mr. Jones silently, then answer the questions as a team.

Option 2 Ask students to remain with their present teams but designate a new person to take notes and report findings. Direct students to read the case study for Mr. Jones silently, then answer the questions as a team.

• The primary care provider (PCP) prescribed oral medication—a poor choice for patients with difficulty swallowing—and failed to refer Mr. Jones to a dentist for further evaluation.
• The speech language pathologist (SLP) did not perform an adequate oral examination, even after noticing Mr. Jones’s bad breath and food accumulation.
• The pharmacist filled the prescription for oral antibiotics in pill form without questioning the patient’s ability to swallow, even though the pharmacist recognized his facial paralysis and difficulty speaking.
• Mr. Jones’s health care team members did not communicate or collaborate with one another regarding his health care delivery.
• The PCP could have spoken to the SLP over the phone and explained that he prescribed Mr. Jones antibiotics and pain medication for an infected tooth. This may have prompted the SLP to point out the need for liquid antibiotics to ensure patient compliance. It may also have prompted the SLP to follow up with Mr. Jones regarding his oral condition at his appointment.
• Even without a call from the PCP, the SLP could have performed a comprehensive oral examination as part of Mr. Jones’s appointment and noted the infected tooth, which should have prompted an immediate dental referral.
• The pharmacist could have questioned Mr. Jones about his facial paralysis and ability to swallow. This would have prompted a change in prescription from pill to liquid form, enabling Mr. Jones to take the oral antibiotics more easily.
• Yes, the PCP could have referred Mr. Jones to a dental provider when the oral antibiotics were prescribed.
• Yes, cost and unnecessary pain and stress for the patient.

Wrap-up (5 minutes).

To facilitate a wrap-up discussion, ask students the following questions.

• Did working with students from other professions highlight aspects of health care delivery that you had not considered before?
• How will you apply what you learned today about teamwork and communication in health care to your education and in practice?

To close the session, summarize the following points for your students.

• Patient-centered health care requires all health care providers to communicate and collaborate effectively.
• A lack of communication and teamwork has been shown to negatively impact patient health outcomes.
• Patient health and safety is at risk when health care providers do not work together.

Post-assessment (2–5 minutes). Ask students to complete the post-session portion of the Pre- and Post-Session Assessment Questionnaire before they leave. Impress upon them the value of their feedback in helping you hone the session for future students.

< Previous Page: Session 1. Team-Based Care

First Published: 10/2015 Last updated: 03/2016

Next Page: Chapter 6 Resources >

College Educator Workshops & Conferences

Student Success, Retention & Engagement | On Course

Case Study: Team Work

Students in Mrs. Rickshaw’s Student Success class are required to do a half hour team presentation on a topic of their choice. Mrs. Rickshaw randomly assigns students to teams. Students have approximately four weeks to research and prepare, including two hours of class time. Marks are given based on an instructor evaluation of the presentation combined with a peer evaluation by their team members.

Jane, Robert, Danny, Sharon and Liz were assigned to Team 3. During their first team meeting they introduced themselves and began to decide on a topic.  After 45 minutes, they were still trying to settle on a topic. They finally settled on Money Management, however the instructor informed them that another team had already chosen that topic but Conflict Management was still available. During the last 15 minutes of class time, Robert tried to convince the group that they should present a role-play of conflict. Sharon wanted to do research and give a more detailed, informational presentation. Jane was excited by the role-play idea and suggested they make a video presentation of their own play-acting. Danny fell asleep some time before the topic was chosen and Liz sat quietly listening to the arguments of her teammates.  At the end of the class no work division had occurred but the team agreed to meet in a study area at 4:15 on the following Monday.

After waiting for Danny until 4:30, the team decided to start without him. Jane announced she had to leave in twenty minutes because she had to pick up her child at the day care by 5:00. Robert was ready to start script writing but Sharon wanted to discuss the content of their presentation and assign research – thinking they could write the script once they were knowledgeable. Liz just listened quietly.  An argument ensued, and Jane had to leave before a decision was reached. The next meeting was to be held during their class time the next week.

Before the next meeting, Robert convinced Jane that a role-play was the way to go, and together they put together a draft script, working hard to make the skit funny and entertaining. Robert confronted Danny and warned him to attend the class meeting or he wouldn’t get a part in the play.  In the meantime, Sharon picked up six books from the library and printed four articles from the Internet. She prepared an outline detailing various aspects of conflict management. Liz just worried about her role in the whole project.

At the class meeting, all team members were present. Robert informed the group that he and Jane had decided to do a skit, and they had a script all ready. Then he began to assign parts to his teammates. Sharon was incensed and insisted the script was short on content and demanded that they re-build the script around her outline. Robert said he wanted no part in a boring presentation.

Danny did not show up to the remaining team meetings. Liz agreed to do a small part in the play. Jane promised to gather props and costumes. Sharon stubbornly insisted on preparing an informational presentation. She would have liked to have this integrated into the role-play but Robert would not agree to change his script. They planned a practice of the role-play during their math class on the morning of October 16, the day of their presentation.

On the morning of October 16, Danny did not come to school and Liz forgot to bring the props. The practice ended up being more of an argument session. Danny showed up just before Student Success was to start and said “You mean it’s today?!” Liz was very nervous and felt very sick. She wasn’t sure she could do her part. The presentation began with Sharon reading her lengthy introduction and then the skit began. The skit was five minutes in length. The whole presentation left the other class members confused and it ran twelve minutes instead of the required thirty.

Questions for Discussion:

1. In your team, each member is to choose one of the characters in the case study. Complete the evaluation on the reverse of this sheet for your own character first and then for the other members of the team. This form will be given to you to evaluate your teammates when your own presentation is completed.

2. In your character groups, discuss the strengths and weaknesses displayed by your character. Make a list of at least three suggestions that could have improved that character’s input to the team project. Return to your home team and summarize the discussion for each character.

In your home team, discuss your own personal strengths and weaknesses as you perceive them regarding your contribution to the team project. As a team, write a list of guidelines for the team to follow.

 EVALUATION

Evaluate your character’s teamwork using the assessment below.  This is the same form you will use later to actually evaluate your team members for this class.

         Give a mark from 0 to 5 for each element on the checklist.

              Poor      Fair       Average     Good       Excellent

                  1         2                3             4                 5

          Give a mark of zero if the person did not participate.

                                     Jane       

• Communication
• Participation
• Give and Take
• Organization
• Preparation

Elements of Teamwork Checklist

COMMUNICATION

• Excellent:   Free, open expression of ideas and feelings at all appropriate times with no fear of embarrassment or reprisal.
• Poor:  Stifled, close to the vest, guarded.  Lets the other person start the communication.

PARTICIPATION

• Excellent:   Full contribution, reaches out to lend a hand, readily available.
• Poor:  Lack of initiative to help the other person? Not around when needed, begrudging contribution.

GIVE AND TAKE

• Excellent:   Open to compromise, flexible? Recognition that it is sometimes better to give in than be “Right.”
• Poor:  Stubbornly dug in on own viewpoint, uncompromising, always right, never wrong.
• Excellent:   Promotes team actions and decisions, recognizes he/she needs the team, and lets each member know where they stand. Team members support his/her suggestions.
• Poor:  No leadership initiated. Reacts rather than acts.  Poor or reluctant support of ideas.

ORGANIZATION

• Excellent:   Knows their responsibilities.  Provides structure to accomplish team goals.
• Poor:  Unclear of responsibilities or doesn’t care about responsibilities.

PREPARATION

• Excellent:   Did their homework.  Research was thorough, especially as it affects other team members.
• Poor:  Team progress was held up because of participant’s lack of preparation.  Consistently dropped the ball.
• Excellent:   Lives by the ground rules and procedures.  Functions smoothly, works with the team.
• Poor:  Absence of order, operates on their own rules, progresses from crisis to crisis.
• Excellent:   Members have confidence in participant and can rely on performance.
• Poor:  Mediocre “Class C” player not interested in becoming “Class A.”
• Excellent:   Participant rallies to the goals.  Goals clearly defined in his/her mind.
• Poor:  Lack of awareness of, or resistance to, team goals.
• Excellent:   An attitude of action and momentum, makes suggestions of steps forward.
• Poor:  Dead in the water ? “Everything is a drag” attitude.

–Joanne Fortuin, Northern Albert Institute of Technology, Alberta, Canada

Since first attending one of the summer retreats in 1997, I’ve held nine On Course workshops for our college, and I plan to offer more.

I’m a better instructor because of On Course.

This workshop should be required for all faculty, staff, and administrators.

The On Course Workshop was the most productive learning experience I have had in years.

My first day back I plunged into using On Course materials and methods with my students, and they LOVED it!! And I LOVED it! Thank you so much on behalf of myself and all of my present and future students!

This workshop has taken a hardened, crusty educator and softened her once again to be committed and energized to become the best person and teacher she can be.

I told my Dean that if I took every workshop and conference I had ever attended and rolled them into one, it would not equal what I learned and gained from your workshop.

Our college needs to offer this workshop for all faculty, full and part-time.

You have created a workshop that, in my 25 years of professional development, is by far the best experience I’ve ever had.

I am going back to campus more empowered and energized.

Product news

Case Study: How Teamwork Projects Changed the Entire Trajectory of Convince & Convert

We love hearing how marketing teams all over the world use Teamwork Projects to become more efficient, organized, and productive. That’s why we interviewed Jay Baer, President of  Convince & Convert , to learn about how he and the company use Teamwork Projects to manage their workload. Jay has been helping hundreds of companies put their best strategies forward for over 20 years and was named the most-retweeted digital marketer, according to Leadtail and PunchTab. Speaking about his work, Jay told us, “It’s constantly changing and evolving. You never master something like digital marketing, you just try to hang on for the ride!” The key to Convince & Convert’s success is that the company works with their clients to help them develop skills and strategy; they train companies to fish for themselves (metaphorically speaking), which benefits everyone.

On top of that, the  Convince & Convert blog is ranked as the world’s #1 content marketing resource  by the Content Marketing Institute. Aside from their great work and compelling thought leadership, we’re also fans because they’ve been Teamwork.com customers for about five years now – but we’ll let Jay tell you about that experience himself.

What low-tech approach to tasks do you love?

Jay Baer:  Most of the time I use Teamwork Projects to keep track of what I’m doing and when, but I’m still a big user of sticky notes for simple things I need to remember. Sometimes, it looks like my desk was attacked by them.

What are your biggest time management demands?

Jay Baer:  I travel about 50% of the time. So when I’m on the road, it’s a challenge to schedule telephone calls, Webinars, and meetings. And then when I’m off the road, I have about 10 calls per day. So it’s a balance between keeping my schedule open on days when I’m traveling and giving presentations, and keeping my schedule packed on days when I’m not traveling.

Why did you choose Teamwork Projects to help run your business?

Jay Baer:  We had used a previous product from a competitor, but I did a platform review and found Teamwork Projects to be a much better fit for us, especially with the way it handles task assignments and process steps.

In what department or way do you use Teamwork Projects?

Jay Baer:  Every department. We are a boutique consultancy that provides social media strategy, content  marketing strategy , and digital marketing strategy to some of the largest companies in the world. We also have a fast-growing media division that produces many blogs, podcasts, email products, books, ebooks, virtual training and more. Teamwork Projects is the nerve center for the entire operation. We literally could not operate the business without Teamwork Projects.

What you like about Teamwork Projects? What are your favorite features?

Jay Baer:  The notifications are terrific, and I love the balance between notebooks, discussions, links, files, etc. It’s all very relevant and easy to understand. But the key feature for me – and why we switched to Teamwork Projects originally – is the ability to use task templates and have them work backwards from a completion date. Because for us, we often know the finish date first and work backwards from there. Teamwork Projects supports this, and many/most other systems do not. For example, I have a presentation at the United Nations in Rome soon. My team and I knew the date of that presentation three months ago. That’s our starting point. We create a project in Teamwork Projects with a completion date that matches the presentation date. Then, using our task template for that kind of project, Teamwork Projects automatically schedules and assigns all the tasks working backwards from that date. The day before, we send the meeting planner my biography via email. Seven days before we send them our audio-visual requirements, etc. etc. We have similar systems for our blog, our podcasts, our emails, and even our consulting services.

Would you recommend it to other businesses?

Jay Baer:  Absolutely. I recommend Teamwork Projects all the time, especially to people who know they need something different or who have outgrown the functionality of what they used to use.

If you could sum up your feelings about and happiness for Teamwork Projects in three sentences, what would you say?

Jay Baer:  Teamwork Projects consistently exceeds my expectations. It has totally changed the way our business works, and I can’t fathom how we used to get by without it! We’re delighted that Teamwork Projects has had such a pivotal role to play in Convince & Convert’s work. We recently partnered with Jay and his team to learn about the 7 Secret Ingredients of Great B2B Marketing Teams, as gleaned from his own experience and interviews with top industry leaders. Find out what they are by downloading our ebook.

Jordan is a Product Marketing Manager at Teamwork.com. After starting out as a copywriter at a digital marketing agency, he's spent the past decade at SaaS companies bringing new features to market.

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Interventions to improve team effectiveness within health care: a systematic review of the past decade

Martina buljac-samardzic.

1 Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands

Kirti D. Doekhie

2 Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands

Jeroen D. H. van Wijngaarden

3 Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands

Associated Data

Not applicable

A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved. An updated overview is therefore required, and it will focus on all possible team interventions without restrictions to a type of intervention, setting, or research design.

To review the literature from the past decade on interventions with the goal of improving team effectiveness within healthcare organizations and identify the “evidence base” levels of the research.

Seven major databases were systematically searched for relevant articles published between 2008 and July 2018. Of the original search yield of 6025 studies, 297 studies met the inclusion criteria according to three independent authors and were subsequently included for analysis. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence.

Three types of interventions were distinguished: (1) Training , which is sub-divided into training that is based on predefined principles (i.e. CRM: crew resource management and TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety), on a specific method (i.e. simulation), or on general team training. (2) Tools covers tools that structure (i.e. SBAR: Situation, Background, Assessment, and Recommendation, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger (through monitoring and feedback) teamwork. (3) Organizational (re)design is about (re)designing structures to stimulate team processes and team functioning . (4) A programme is a combination of the previous types. The majority of studies evaluated a training focused on the (acute) hospital care setting. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements.

Over the last decade, the number of studies on team interventions has increased exponentially. At the same time, research tends to focus on certain interventions, settings, and/or outcomes. Principle-based training (i.e. CRM and TeamSTEPPS) and simulation-based training seem to provide the greatest opportunities for reaching the improvement goals in team functioning.

Introduction

Teamwork is essential for providing care and is therefore prominent in healthcare organizations. A lack of teamwork is often identified as a primary point of vulnerability for quality and safety of care [ 1 , 2 ]. Improving teamwork has therefore received top priority. There is a strong belief that effectiveness of healthcare teams can be improved by team interventions, as a wide range of studies have shown a positive effect of team interventions on performance outcomes (e.g. effectiveness, patient safety, efficiency) within diverse healthcare setting (e.g. operating theatre, intensive care unit, or nursing homes) [ 3 – 7 ].

In light of the promising effects of team interventions on team performance and care delivery, many scholars and practitioners evaluated numerous interventions. A decade ago (2008), we conducted a systematic review with the aim of providing an overview of interventions to improve team effectiveness [ 8 ]. This review showed a high variety of team interventions in terms of type of intervention (i.e. simulation training, crew resource management (CRM) training, interprofessional training, general team training, practical tools, and organizational interventions), type of teams (e.g. multi-, mono-, and interdisciplinary), type of healthcare setting (e.g. hospital, elderly care, mental health, and primary care), and quality of evidence [ 8 ]. From 2008 onward, the literature on team interventions rapidly evolved, which is evident from the number of literature reviews focusing on specific types of interventions. For example, in 2016, Hughes et al. [ 3 ] published a meta-analysis demonstrating that team training is associated with teamwork and organizational performance and has a strong potential for improving patient outcomes and patient health. In 2016, Murphy et al. [ 4 ] published a systematic review, which showed that simulation-based team training is an effective method to train a specific type of team (i.e. resuscitation teams) in the management of crisis scenarios and has the potential to improve team performance. In 2014, O’Dea et al. [ 9 ] showed with their meta-analysis that CRM training (a type of team intervention) has a strong effect on knowledge and behaviour in acute care settings (as a specific healthcare setting). In addition to the aforementioned reviews, a dozen additional literature reviews that focus on the relationship between (a specific type of) team interventions and team performance could be mentioned [ 7 , 10 – 19 ]. In sum, the extensive empirical evidence shows that team performance can be improved through diverse team interventions.

However, each of the previously mentioned literature reviews had a narrow scope, only partly answering the much broader question of how to improve team effectiveness within healthcare organizations. Some of these reviews focus on a specific team intervention, while others on a specific area of health care. For example, Tan et al. [ 7 ] presented an overview on team simulation in the operating theatre and O’Dea et al. [ 9 ] focused on CRM intervention in acute care. Other reviews only include studies with a certain design. For instance, Fung et al. [ 13 ] included only randomized controlled trials, quasi-randomized controlled trials, controlled before-after studies, or interrupted time series. Since the publication of our systematic review in 2010 [ 8 ], there has been no updated overview of the wide range of team interventions without restrictions regarding the type of team intervention, healthcare setting, type of team, or research design. Based on the number and variety of literature reviews conducted in recent years, we can state that knowledge on how to improve team effectiveness (and related outcomes) has progressed quickly, but at the same time is quite scattered. An updated systematic review covering the past decade is therefore relevant.

The purpose of this study is to answer two research questions: (1) What types of interventions to improve team effectiveness (or related outcomes) in health care have been researched empirically, for which setting, and for which outcomes (in the last decade)? (2) To what extent are these findings evidence based?

Methodology

Search strategy.

The search strategy was developed with the assistance of a research librarian from a medical library who specializes in designing systematic reviews. The search combined keywords from four areas: (1) team (e.g. team, teamwork), (2) health care (e.g. health care, nurse, medical, doctor, paramedic), (3) interventions (e.g. programme, intervention, training, tool, checklist, team building), (4) improving team functioning (e.g. outcome, performance, function) OR a specific performance outcome (e.g. communication, competence, skill, efficiency, productivity, effectiveness, innovation, satisfaction, well-being, knowledge, attitude). This is similar to the search terms in the initial systematic review [ 8 ]. The search was conducted in the following databases: EMBASE, MEDLINE Ovid, Web of Science, Cochrane Library, PsycINFO, CINAHL EBSCO, and Google Scholar. The EMBASE version of the detailed strategy was used as the basis for the other search strategies and is provided as additional material (see Additional file 1 ). The searches were restricted to articles published in English in peer-reviewed journals between 2008 and July 2018. This resulted in 5763 articles. In addition, 262 articles were identified through the systematic reviews published in the last decade [ 3 , 4 , 7 , 9 – 28 ]. In total, 6025 articles were screened.

Inclusion and exclusion criteria

This systematic review aims to capture the full spectrum of studies that empirically demonstrate how healthcare organizations could improve team effectiveness. Therefore, the following studies were excluded:

• Studies outside the healthcare setting were excluded. Dental care was excluded. We did not restrict the review to any other healthcare setting.
• Studies without (unique) empirical data were excluded, such as literature reviews and editorial letters. Studies were included regardless of their study design as long as empirical data was presented. Book chapters were excluded, as they are not published in peer-reviewed journals.
• Studies were excluded that present empirical data but without an outcome measure related to team functioning and team effectiveness. For example, a study that evaluates a team training without showing its effect on team functioning (or care provision) was excluded because it does not provide evidence on how this team training affects team functioning.
• Studies were excluded that did not include a team intervention or that included an intervention that did not primarily focus on improving team processes, which is likely to enhance team effectiveness (or other related outcomes). An example of an excluded study is a training that aims to improve technical skills such as reanimation skills within a team and sequentially improves communication (without aiming to improve communication). It is not realistic that healthcare organizations will implement this training in order to improve team communication. Interventions in order to improve collaboration between teams from different organizations were also eliminated.
• Studies with students as the main target group. An example of an excluded study is a curriculum on teamwork for medical students as a part of the medical training, which has an effect on collaboration. This is outside the scope of our review, which focuses on how healthcare organizations are able to improve team effectiveness.

In addition, how teams were defined was not a selection criterion. Given the variety of teams in the healthcare field, we found it acceptable if studies claim that the setting consists of healthcare teams.

Selection process

Figure ​ Figure1 1 summarizes the search and screening process according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. A four-stage process was followed to select potential articles. We started with 6025 articles. First, each title and abstract was subjected to elimination based on the aforementioned inclusion and exclusion criteria. Two reviewers reviewed the title/abstracts independently. Disagreement between the reviewers was settled by a third reviewer. In case of doubt, it was referred to the next stage. The first stage reduced the number of hits to 639. Second, the full text articles were assessed for eligibility according to the same set of elimination criteria. After the full texts were read by two reviewers, 343 articles were excluded. In total, 297 articles were included in this review. Fourth, the included articles are summarized in Table ​ Table1. 1 . Each article is described using the following structure:

Type of intervention

• Setting: the setting where the intervention is introduced is described in accordance with the article, without further categorization
• Outcomes: the effect of the intervention
• A. High: future research is highly unlikely to change the confidence in the estimated effect of the intervention.
• B. Moderate: future research is likely to have an important impact on the confidence in the estimated effect of the intervention and may change it.
• C. Low: future research is very likely to have an important impact on the confidence in the estimated effect of the intervention and is likely to change it.
• D. Very low: any estimated effect of the intervention is very uncertain.

PRISMA flowchart

Summary of results

Studies can also be upgraded or downgraded based on additional criteria. For example, a study is downgraded by one category in the event there are important inconsistencies. Detailed information is provided as additional material (see Additional file 2 ).

Organization of results

The categorization of our final set of 297 articles is the result of three iterations. First, 50 summarized articles were categorized using the initial categorization: team training (subcategories: CRM-based training, simulation training, interprofessional training, and team training), tools, and organizational intervention [ 8 ]. Based on this first iteration, the main three categories (i.e. training, tools, and organizational interventions) remained unchanged but the subcategorization was further developed. Training, related to the subcategory “CRM-based training”, “TeamSTEPPS” was added as a subcategory. The other subcategories (i.e. simulation training, interprofessional training, and team training) remained the same. Tools, the first draft of subcategories, entailed Situation, Background, Assessment, and Recommendation (SBAR), checklists, (de)briefing, and task tools. Two subcategories of organizational intervention (i.e. programme and (re)design) were created, which was also in line with the content of this category in the original literature review. Second, 50 additional articles were categorized to test and refine the subcategories. Based on this second iteration, the subcategories were clustered, restructured and renamed, but the initial three main categorizations remained unaffected. The five subcategories of training were clustered into principle-based training, method-based training, and general team training. The tools subcategories were clustered into structuring, facilitating, and triggering tools, which also required two new subcategories: rounds and technology. Third, the remaining 197 articles were categorized to test the refined categorization. In addition, the latter categorization was peer reviewed. The third iteration resulted in three alterations. First, we created two main categories based on the two subcategories “organizational (re)design” and “programme” (of the third main categorization). Consequently, we rephrased “programme-based training” into “principle-based training”. Second, the subcategories “educational intervention” and “general team training” were merged into “general team training”. Consequently, we rephrased “simulation training” into “simulation-based training”. Third, we repositioned the subcategories “(de)briefing” and “rounds” as structuring tools instead of facilitating tools. Consequently, we merged the subcategories “(de)briefing” and “checklists” into “(de)briefing checklists”. Thereby, the subcategory “technology” became redundant.

Four main categories are distinguished: training, tools, organizational (re)design, and programme. The first category, training , is divided in training that is based on specific principles and a combination of methods (i.e. CRM and Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)), a specific training method (i.e. training with simulation as a core element), or general team training, which refers to broad team training in which a clear underlying principle or specific method is not specified. The second category, tools , are instruments that are introduced to improve teamwork by structuring (i.e. SBAR (Situation, Background, Assessment, and Recommendation), (de)briefing checklists, and rounds), facilitating (through communication technology), or triggering (through monitoring and feedback) team interaction. Structuring tools partly standardize the process of team interaction. Facilitating tools provide better opportunities for team interaction. Triggering tools provide information to incentivize team interaction. The third category, organizational (re)design , refers to (re)designing structures (through implementing pathways, redesigning schedules, introducing or redesigning roles and responsibilities) that will lead to improved team processes and functioning. The fourth category, a programme , refers to a combination of the previous types of interventions (i.e. training, tools, and/or redesign). Table ​ Table2 2 presents the (sub)categorization, number of studies, and a short description of each (sub)category.

Categorization of results

Overall findings

The majority of studies evaluated a training. Simulation-based training is the most frequently researched type of team training.

Most of the articles researched an acute hospital setting. Examples of acute hospital settings are the emergency department, operating theatre, intensive care, acute elderly care, and surgical unit. Less attention was paid to primary care settings, nursing homes, elderly care, or long-term care in general.

Interventions focused especially on improving non-technical skills, which refer to cognitive and social skills such as team working, communication, situational awareness, leadership, decision making, and task management [ 21 ]. Most studies relied on subjective measures to indicate an improvement in team functioning, with only a few studies (also) using objective measures. The Safety Attitude Questionnaire (SAQ) and the Non-Technical Skills (NOTECHS) tool are frequently used instruments to measure perceived team functioning.

Quality of evidence

A bulk of the studies had a low level of evidence. A pre- and post-study is a frequently used design. In recent years, an increasing number of studies have used an action research approach, which often creates more insight into the processes of implementing and tailoring an intervention than the more frequently used designs (e.g. Random Control Trial and pre-post surveys). However, these valuable insights are not fully appreciated within the GRADE scale.

The findings per category will be discussed in greater detail in the following paragraphs.

CRM and TeamSTEPPS are well-known principle-based trainings that aim to improve teamwork and patient safety in a hospital setting. Both types of training are based on similar principles. CRM is often referred to as a training intervention that mainly covers non-technical skills such as situational awareness, decision making, teamwork, leadership, coping with stress, and managing fatigue. A typical CRM training consists of a combination of information-based methods (e.g. lectures), demonstration-based methods (e.g. videos), and practice-based methods (e.g. simulation, role playing) [ 9 ]. However, CRM has a management concept at its core that aims to maximize the use of all available resources (i.e. equipment, time, procedures, and people) [ 324 ]. CRM aims to prevent and manage errors through avoiding errors, trapping errors before they are committed, and mitigating the consequences of errors that are not trapped [ 325 ]. Approximately a third of CRM-based trainings include the development, redesign or implementation of learned CRM techniques/tools (e.g. briefing, debriefing, checklists) and could therefore also be categorized in this review under programme [ 39 , 40 , 42 , 51 , 56 , 58 , 59 , 61 , 62 ].

The studies show a high variety in the content of CRM training and in the results measured. The majority of the studies claim an improvement in a number of non-technical skills that were measured, but some also show that not all non-technical skills measured were improved [ 43 , 47 , 66 ]. Moreover, the skills that did or did not improve differed between the studies. A few studies also looked at outcome measures (e.g. clinical outcomes, error rates) and showed mixed results [ 49 , 52 , 53 ]. Notable is the increasing attention toward nursing CRM, which is an adaptation of CRM to nursing units [ 66 , 67 ]. Most studies delivered a low to moderate quality level of evidence. Although most studies measured the effect of CRM over a longer period of time, most time periods were limited to one or two evaluations within a year. Savage et al. [ 58 ] and Ricci et al. [ 56 ] note the importance of using a longer time period.

As a result of experienced shortcomings of CRM, Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has evolved (since 2006). TeamSTEPPS is a systematic approach designed by the Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense (DoD) to enhance teamwork skills that are essential to the delivery of quality and safe care. Some refer to TeamSTEPPS as “CRM and more”. TeamSTEPPS provides an approach on preparing, implementing, and sustaining team training. It is provided as a flexible training kit and facilitates in developing a tailored plan. It promotes competencies, strategies, and the use of standardized tools on five domains of teamwork: team structure, leadership, communication, situational monitoring, and mutual support. In addition, TeamSTEPPS focuses on change management, coaching, measurement, and implementation. Notable is that even though the TeamSTEPSS training is most likely to differ across settings as it needs to be tailored to the situational context, articles provide limited information on the training content. All studies report improvements in some non-technical skills (e.g. teamwork, communication, safety culture). Combining non-technical skills with outcome measures (e.g. errors, throughput time) seemed more common in this category. Half of the studies delivered a moderate to high quality of evidence.

Simulation-based training uses a specific method as its core, namely, simulation, which refers to “a technique to replace or amplify real-patient experiences with guided experiences, artificially contrived, that evokes or replicates substantial aspects of the real world in a fully interactive manner” [ 326 ]. The simulated scenarios that are used can have different forms (e.g. in situ simulation, in centre simulation, human actors, mannequin patients) and are built around a clinical scenario (e.g. resuscitation, bypass, trauma patients) aiming to improve technical and/or non-technical skills (e.g. interprofessional collaboration, communication). We only identified studies in a hospital setting, which were mostly focussed on an emergency setting. All studies reported improvements in some non-technical skills (e.g. teamwork behaviour, communication, shared mental model, clarity in roles and responsibilities). In addition, some studies report non-significant changes in non-technical skills [ 98 , 137 , 140 , 155 ]. Some studies also looked at technical skills (e.g. time spend) and presented mixed results [ 63 , 112 , 152 , 159 ]. Sixty-nine studies focused on simulation-based training, of which 16 studies delivered a moderate to high quality of evidence.

General team training does not focus on one specific training principle or method. It often contains multiple educational forms such as didactic lectures, interactive sessions, and online modules. General team training focuses on a broad target group and entails for example team building training, coaching training, and communication skills training. Due to the broad scope of this category, high variation in outcomes is noted, although many positive outcomes were found. Most studies have a low to very low level of evidence.

Tools are instruments that could be implemented relatively independently in order to structure , facilitate or trigger teamwork.

Structuring tools

Teamwork can be structured by using the structured communication technique SBAR (Situation, Background, Assessment, and Recommendation), (de)briefing checklists, and rounds.

SBAR is often studied in combination with strategies to facilitate implementation, such as didactic sessions, training, information material, and modifying SBAR material (e.g. cards) [ 202 , 204 , 206 – 208 , 211 ]. In addition, this subcategory entails communication techniques similar or based on SBAR [ 203 , 205 , 209 , 210 , 212 ]. One study focused on nursing homes, while the remaining studies were performed in a hospital setting. Most studies found improvements in communication; however, a few found mixed results [ 208 , 209 ]. Only (very) low-level evidence studies were identified.

Briefings and debriefings create an opportunity for professionals to systematically communicate and discuss (potential) issues before or after delivering care to a patient, based on a structured format of elements/topics or a checklist with open and/or closed-end questions. Studies on (de)briefing checklists often evaluate the implementation of the World Health Organization surgical safety checklist (SSC), a modified SSC, SSC-based checklist, or a safety checklist in addition to the SSC. The SSC consists of a set of questions with structured answers that should be asked and answered before induction of anaesthesia, before skin incision, and before the patient leaves the operating theatre. In addition, several studies presented checklists aiming to better manage critical events [ 221 , 223 , 233 ]. Only one study on SSC was conducted outside the surgery department/operating theatre (i.e. cardiac catheterization laboratory [ 222 ]). However, similar tools can also be effective in settings outside the hospital, as shown by two studies that focused on the long-term care setting [ 249 , 260 ]. Overall, included studies show that (de)briefing checklists help improve a variety of non-technical skills (e.g. communication, teamwork, safety climate) and objective outcome measures (e.g. reduced complications, errors, unexpected delays, morbidity). At the same time, some studies show mixed results or are more critical of its (sustainable) effect [ 215 , 222 , 231 , 242 ]. Whyte et al. [ 262 ] pointed out the complexity of this intervention by presenting five paradoxical findings: team briefings could mask knowledge gaps, disrupt positive communication, reinforce professional divisions, create tension, and perpetuate a problematic culture. The quality of evidence varied from high to very low (e.g. Whyte et al. [ 262 ]), and approximately one third presented a high or moderate quality of evidence. Debriefings can also be used as part of a training, aiming to provide feedback on trained skills. Consequently, some articles focused on the most suitable type of debriefing in a training setting (e.g. video-based, self-led, instructor-led) [ 245 , 246 , 253 , 263 ] or debriefing as reflection method to enhance performance [ 258 , 261 ].

Rounds can be described as structured interdisciplinary meetings around a patient. Rounds were solely researched in hospital settings. Five studies found improvements in non-technical skills, one study in technical skills, and one study reported outcomes but found no improvement. Three studies presented a moderate level of evidence, and the others presented a (very) low level.

Facilitating tools

Teamwork can be facilitated through technology. Technology, such as telecommunication, facilitates teamwork as it creates the opportunity to involve and interact with professionals from a distance [ 271 – 273 ]. Technology also creates opportunities to exchange information through information platforms [ 276 , 277 ]. Most studies found positive results for teamwork. Studies were performed in a hospital setting and presented a level of evidence varying from moderate to very low.

Triggering tools

Teamwork could be triggered by tools that monitor and visualize information, such as (score) cards and dashboards [ 278 , 279 , 281 , 283 , 284 ]. The gathered information does not echo team performance but creates incentives for reflecting on and improving teamwork. Team processes (e.g. trust, reflection) are also triggered by sharing experiences, such as clinical cases and stories, thoughts of the day [ 280 , 282 ]. All seven studies showed improvements in non-technical skills and had a very low level of evidence.

Organizational (re)design

In contrast with the previous two categories, organizational (re)design is about changing organizational structures. Interventions can be focused on several elements within a healthcare organization, such as the payment system [ 292 ] and the physical environment [ 299 ], but are most frequently aimed at standardization of processes in pathways [ 286 , 288 ] and changing roles and responsibilities [ 287 , 289 , 298 ], sometimes by forming dedicated teams or localizing professionals to a certain unit or patient [ 290 , 291 , 295 , 300 ]. Most studies found some improvements of non-technical skills; however, a few found mixed results. Only four studies had a moderate level of evidence, and the others had a (very) low level.

A programme most frequently consists of a so-called Human Resource Management bundle that combines learning and educational sessions (e.g. simulation training, congress, colloquium), often multiple tools (e.g. rounds, SBAR), and/or structural intervention (e.g. meetings, standardization). Moreover, a programme frequently takes the organizational context into account: developing an improvement plan and making choices tailored to the local situation. A specific example is the “Comprehensive Unit-Based Safety Program” (CUSP) that combines training (i.e. science of safety training educational curriculum, identify safety hazards, learn from defects) with the implementation of tools (e.g. team-based goal sheet), and structural intervention (i.e. senior executive partnership, including nurses on rounds, forming an interdisciplinary team) [ 309 , 319 , 322 ]. Another example is the medical team training (MTT) programme that consists of three stages: (1) preparation and follow-up, (2) learning session, (3) implementation and follow-up. MTT combines training, implementation of tools (briefings, debriefing, and other projects), and follow-up coaching [ 5 , 304 , 305 , 316 ]. MMT programmes are typically based on CRM principles, but they distinguish themselves from the first category by extending their programme with other types of interventions. Most studies focus on the hospital setting, with the exception of the few studies performed in the primary care, mental health care, and healthcare system. Due to the wide range of programmes, the outcomes were diverse but mostly positive. The quality of evidence varied from high to very low.

Conclusion and discussion

This systematic literature review shows that studies on improving team functioning in health care focus on four types of interventions: training, tools, organizational (re)design, and programmes. Training is divided into principle-based training (subcategories: CRM-based training and TeamSTEPPS), method-based training (simulation-based training), and general team training. Tools are instruments that could be implemented relatively independently in order to structure (subcategories: SBAR, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger teamwork (through information provision and monitoring). Organizational (re)design focuses on intervening in structures, which will consequently improve team functioning. Programmes refer to a combination of different types of interventions.

Training is the most frequently researched intervention and is most likely to be effective. The majority of the studies focused on the (acute) hospital care setting, looking at several interventions (e.g. CRM, TeamSTEPPS, simulation, SBAR, (de)briefing checklist). Long-term care settings received less attention. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements; objective outcome measures also received attention (e.g. errors, throughput time). Looking at the quantity and quality of evidence, principle-based training (i.e. CRM and TeamSTEPPS), simulation-based training, and (de)briefing checklist seem to provide the biggest chance of reaching the desired improvements in team functioning. In addition, programmes, in which different interventions are combined, show promising results for enhancing team functioning. The category programmes not only exemplify this trend, but are also seen in principle-based training.

Because this review is an update of our review conducted in 2008 (and published in 2010) [ 8 ], the question of how the literature evolved in the last decade arises. This current review shows that in the past 10 years significantly more research has focused on team interventions in comparison to the previous period. However, the main focus is on a few specific interventions (i.e. CRM, simulation, (de)briefing checklist). Nevertheless, an increasing number of studies are evaluating programmes in which several types of interventions are combined.

• Training : There has been a sharp increase in research studying team training (from 32 to 173 studies). However, the majority of these studies still look at similar instruments, namely, CRM-based and simulation-based training. TeamSTEPPS is a standardized training that has received considerable attention in the past decade. There is now a relatively strong evidence for the effectiveness of these interventions, but mostly for the (acute) hospital setting.
• Tools : There is also a substantial increase (from 8 to 84 studies) in studies on tools. Again, many of these studies were in the same setting (acute hospital care) and focused on two specific tools, namely, the SBAR and (de)briefing checklist. Although the level of evidence for the whole category tools is ambiguous, there is relatively strong evidence for the effectiveness of the (de)briefing checklist. Studies on tools that facilitate teamwork ascended the past decade. There is limited evidence that suggests these may enhance teamwork. The dominant setting was again hospital care, though triggering tools were also studied in other settings such as acute elderly care and clinical primary care. Moreover, most studies had a (very) low quality of evidence, which is an improvement compared to the previous review that solely presented (very) low level of evidence.
• Organizational (re)design : More attention is paid to organizational (re)design (from 8 to 16 studies). Although the number of studies on this subject has increased, there still remains unclarity about its effects because of the variation in interventions and the mixed nature of the results.
• Programmes : There seems to be new focus on a programmatic approach in which training, tools, and/or organizational (re)design are combined, often focused around the topic patient safety. The previous review identified only one such study; this research found 24 studies, not including the CRM studies for which some also use a more programmatic approach. There seems to be stronger evidence that this approach of combining interventions may be effective in improving teamwork.

Limitations

The main limitation of this review is that we cannot claim that we have found every single study per subcategory. This would have required per subcategory an additional systematic review or an umbrella review, using additional keywords. As we identified a variety of literature reviews, future research should focus on umbrella reviews in addition to new systematic literature reviews. Note that we did find more studies per subcategory, but they did not meet our inclusion criteria. For example, we excluded multiple studies evaluating surgical checklists that did not measure its effect on team functioning but only on reported errors or morbidity. Although this review presents all relevant categories to improve team functioning in healthcare organizations, those categories are limited to team literature and are not based on related research fields such as integrated care and network medicine. Another limitation is that we excluded grey literature by only focusing on articles written in English that present empirical data and were published in peer-reviewed journals. Consequently, we might have excluded studies that present negative or non-significant effects of team interventions, and such an exclusion is also known as publication bias. In addition, the combination of the publication bias and the exclusion of grey literature has probably resulted in a main focus on standardized interventions and a limited range of alternative approaches, which does not necessarily reflect practice.

Implication for future research

This review shows the major increase in the last decade in the number of studies on how to improve team functioning in healthcare organizations. At the same time, it shows that this research tends to focus around certain interventions, settings, and outcomes. This helped to provide more evidence but also left four major gaps in the current literature. First, less evidence is available about interventions to improve team functioning outside the hospital setting (e.g. primary care, youth care, mental health care, care for disabled people). With the worldwide trend to provide more care at home, this is an important gap. Thereby, team characteristics across healthcare settings vary significantly, which challenges the generalizability [ 327 ]. Second, little is known about the long-term effects of the implemented interventions. We call for more research that monitors the effects over a longer period of time and provides insights into factors that influence their sustainability. Third, studies often provide too little information about the context. To truly understand why a team intervention affects performance and to be able to replicate the effect (by researchers and practitioners), detailed information is required related to the implementation process of the intervention and the context. Fourth, the total picture of relevant outcomes is missing. We encourage research that includes less frequently used outcomes such as well-being of professionals and focuses on identifying possible deadly combinations between outcomes.

Supplementary information

Acknowledgements.

We would like to thank Wichor Bramer, Librarian at the Erasmus Medical Center Rotterdam, The Netherlands, for his support in conducting the search for this systematic review.

Abbreviations

Authors’ contributions.

MBS, KDD, and JDHW reviewed titles, abstracts, and full texts for the systematic review. MBS initiated the first draft of the manuscript and revised the manuscript on the basis of input of KDD and JDHW. MBS, KDD, and JDHW together categorized the results. All authors read and approved the final manuscript.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Availability of data and materials

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Martina Buljac-Samardzic, Email: LN.RUE.MPHSE@CAJLUB .

Kirti D. Doekhie, Email: LN.RUE.MPHSE@EIHKEOD .

Jeroen D. H. van Wijngaarden, Email: LN.RUE.MPHSE@NEDRAAGNJIWNAV .

Supplementary information accompanies this paper at 10.1186/s12960-019-0411-3.

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Watch the on-demand webinar and uncover practical tips on reliable Revenue Forecasting.

Comprehensive Work Management Software

Manage projects, finances, and resources in a single system. Built for consultancies , agencies, and other professional service businesses to gain visibility, boost profitability and standardize operations.

Based on 1,000+ reviews on

Control your entire business from one place

Manage your entire project lifecycle in a single system. Estimate scope, plan projects, track results, and issue invoices. By having sales, delivery, and financials combined, you’ll get a complete overview of your projects and performance in real time.

Plan and forecast your resources

Know when to bring in more work and spot resource shortages before they happen. Make proactive decisions on outsourcing or hiring. Balance your team’s workloads – no more burnout for some while others sit idle.

Make sure you’re profitable

Completing your projects is important, but what truly matters is whether your company is making money. Understand which clients, projects, services or teams are profitable and which are eating into your margins. Know when to charge more or cut costs.

Boost cross-team collaboration

Have all your teams working in the same system to break down silos. Keep all project-related info at everybody’s fingertips and promote visibility across teams, from sales to delivery to accounting. Save hours by eliminating the need for manual status updates and handover meetings.

A single source of truth for your business

Run your consultancy, agency or any other professional services business on one seamlessly integrated platform.

Deliver projects from quote to cash

Create proposals and estimate projects

Manage customer accounts and track pipeline

Plan and forecast work for optimal utilization

Track and manage recurring client work

Track billable and non-billable time in detail

Automate billing and collect payments

Track expenses to keep costs under control

Gain insights on progress, results and outlook

The onboarding process with Scoro was seamless, thanks to the dedicated support and intuitive online resources. It made the transition smooth and allowed new team members to adapt quickly without extensive training.

The support the Scoro team provides to the initial discovery and sales process through onboarding and when you're using the platform is excellent. Every person we've dealt with at Scoro is extremely friendly and knowledgeable.

Replace your existing tech stack.

Shuffling between countless spreadsheets? Stuck in an export-import loop? Stop wasting time, money, and energy on tools that just don’t talk to each other. Scoro covers it all in a single system.

Projects, resources, finances and reporting in one system.

• Contact management
• Project management tools
• Time tracking
• Resource planning
• Invoices & receipts

Don't just take our word for it! Create a free trial and experience Scoro in action.

When I read that Scoro did end-to-end work management, I thought, how could you possibly do that well across the whole piece, but it does really work. It’s the absolute beauty of Scoro.

Connect your favorite apps and tools.

Have some other vital tools you wish to sync with Scoro? Integrate what you need and harness the power of consolidated data in Scoro.

Customer success stories

Scoro has really become the backbone of our company. It has enabled us to pursue higher quality in every single thing we do. From sales and finances to project management and accountability.

Monica Fernandez, COO

We feel that we finally have a tool that enables us to grow – and that will scale as we add more people to the team.

Tyler Webb-Harding, Operations Director

We looked at many tools, so I can confidently say that there’s no other platform as thoughtfully and logically designed as Scoro.

Harv Nagra, Group Director of Operations

We looked at several tools, including Monday.com, Basecamp, and Asana, but none could offer the breadth of features that Scoro has.

Attila Probáld, CEO

Scoro has ensured my team is not overworked, resources are used optimally, and less time is wasted on project management confusion.

Anna-Kaisa Reed, Art Director and Design Team Manager

See how Scoro can help deliver projects and improve your profitability.

Start a free trial

Tour the product and try Scoro for free for 14 days, no credit card required.

Get started today!

Get a 14-day free trial and see how Scoro can work for your business.