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Section III (Chapters 13, 14, 15, 16, and 17) covers the evaluation and improvement of performance by healthcare teams. The previous chapter deals with evaluation of both individual team members and whole teams. This chapter examines training. It is the first of 4 chapters covering action for improvement.

From time to time both team leaders and whole teams need training. Determining what training is needed by a team and the timing of the training is ordinarily the responsibility of the leader, as noted in Chapter 8. The sponsor also has a role in suggesting team training when he or she perceives a need. In addition, the sponsor may suggest training for the leader and sometimes may provide that training directly. And, of course, team leaders often choose to obtain training without being prompted.

In small organizations, for example, small medical groups, training can be provided informally through mentoring or coaching, or it can be purchased from outside sources. In large organizations, there is often a Human Resources Department with a training component, and large organizations also often purchase training from consulting or training firms.

Three years ago, Nathan Mitchell, PharmD, was appointed head pharmacist in a 325-bed hospital in Michigan. Twenty-four other clinical pharmacists as well as 32 pharmacy technicians and other staff reported to him. Since taking the job, Dr. Mitchell had gradually come to believe that he would benefit from training in team leadership. Foremost on his mind was the distress he experienced in coping with occasional conflicts among the other pharmacists. He also wondered how best to structure his large group and whether he might be able to find a better way to make decisions so that the decisions would not be questioned and repeatedly revisited by the other pharmacists. And he hoped he could gain some insights into how to work more effectively with the nurses and physicians with whom he served on various teams in the hospital.

His boss, the Director of Clinical Operations, suggested that he attend a 3-day course in leadership, provided by a highly regarded national organization that trains leaders in many different fields. Dr. Mitchell considered her suggestion but decided that he really wanted leadership training that was specific to health care. He spoke further with his boss, and she suggested additional people who might be able to help him identify training that would be right for him.

What would be the best way for Dr. Mitchell to obtain the training he wanted? Leadership training is commonly conceived as training for people who will be leaders of institutions, for example, Chief Executive Officers and Chief Medical Officers (CMOs). Training for these leaders needs to include content on strategic planning, marketing, healthcare policy, finance, accounting, and other topics that are relevant to leading teams at a senior level in an organization. ...

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