Abstract

Dynamic change continues to characterize the health care delivery environment in the early 1990's. Within such an environment, institutional care providers in particular must develop and implement new and effective strategies if they are to remain viable entities. ;This case study reported on the development of a chartered cross-functional quality improvement team within a single hospital of a three-hospital system in the mid-western United States. In addition to the case study, the Myers-Briggs Type Indicator was used with team members to clarify personality type and individual interviews with team members served to extend, enrich, and deepen insights into the behavior of the team. The team was charged to find opportunities for improvement regarding computer equipment utilization within the hospital. The team met for over a one-year period and was disbanded prior to achieving their goals. ;Interviews of the team members, administration of the Myers-Briggs Type Indicator, and critical incident field notes from facilitators were utilized to gather data. A social system analysis of the case study was performed to report on the dynamics of the team, to gain insight of the team's emergent system, and to understand possible outcomes based upon that emergent system, including productivity, satisfaction, and development. ;Given this case study, the results of the Myers-Briggs Type Indicator, and the results of the interviews, several findings surfaced. All members of the team demonstrated a preference for Judgment on their Myers-Briggs Type Indicator. This illustrated a strong sense of closure and low tolerance for openness to new ideas from team members. Members of the team tended to form alliances and factions, some of which supported the work of the team, some of which distracted from the work of the team. The team lacked cohesion, conformity, and communication. The facilitators were inhibited from doing team building by the existing administrative structure. ;Based upon these findings, recommendations were offered. Among them were recommendations to: establish team norms during the initial stage of team development; provide an assessment of the team's readiness to participate as cross functional team members, and if necessary, to provide team and or quality improvement process training at the beginning of the team's formation in team building utilizing group process; have facilitator roles defined so as to empower the facilitators to hold the team accountable for following the facilitators' recommendations; and have coaches and facilitators who are in agreement with the direction the team should follow. ;The reader should be cautious in any generalizing of the findings due to structural limitations inherent with case study research design. Because this is a single sample and not compared with any other teams, this team may not be typical of any other team