1. Good communication
Communication primarily referred to intra-team communication and included team members feeling as though they could listen as well as speak out within a team context; and the ability to discuss and resolve difficulties within the team. It was suggested that being part of a large team hinders good communication by limiting the “two-way” communication, and that some peoples' views do not travel “upwards”.
2. Respecting/understanding roles
Importance of respecting and understanding the roles of other team members; that the limitations and boundaries of each role were well understood; and to have an understanding of how the roles have the potential to impact on patients. Practitioners should also be aware of how their own role fits within the team, and differs from that of other team members, and that roles and responsibilities are made explicit.
3. Appropriate skill mix
Skill mix refers to the mix and breadth of staff, personalities, individual attributes, professions and experience. Teams value diversity, and clearly need input from a range of staff who bring complementary experience and attributes to the team. Teams also felt that it was important to have the full complement of staff.
4. Quality and outcomes of care
Ensuring the quality and outcomes of care was identified as an important component of a good team and includes several reflective mechanisms both within and external to the team. Teams emphasized the importance both to have systems for capturing their effectiveness (such as measuring patient outcomes); and to meet their targets. This included suggestions that teams are able to reflect; accept criticism and act on it; have defined outcomes; follow-up patients; provide feedback to other services (for example, on appropriateness of referrals and timeliness and appropriateness of information provided); and celebrate their own successes; and clinicians keeping their skills up to date.
5. Appropriate team processes and resources
This theme includes access to sufficient physical resources (office space, parking, computers); privacy to make confidential phone calls; appropriate and efficient systems and procedures, including induction processes, policies, and paperwork that serves the need of the service whilst avoiding duplication. Workload management, having enough time to do the job, and time management were highlighted by several teams. Finally, the pathway for patients, and the integration of the team with wider services was seen as an important procedural issue.
6. Clear vision
Participants identified the need for a clear vision, role and purpose of the team. This was both to steer the direction of the team, but also required so that teams could establish appropriate referral criteria into the team.
7. Flexibility (of the team and the individuals within it)
The need for flexibility was identified as an individual attribute “ability to cover each other’s roles, but knowing your boundaries”. Individuals also need to be flexible to respond to the constantly changing service environment and patient needs (for instance, flexibility of working hours). Flexibility of the service was also identified, for instance, flexibility in referral criteria.
8. Leadership and management
All teams identified the importance of good leadership, and the characteristics of a good leader are explored elsewhere.
9. Team culture: camaraderie and team support/relationships
The importance of team culture was the largest theme, with 66 items within this theme. Trust, mutual respect, reliability, commitment and support were the most commonly raised themes. But team culture included the importance of informal relationships, camaraderie, fun, and friendship between colleagues.
10. Training and development opportunities
Opportunities for gaining new knowledge, sharing knowledge, continuing professional development, and education.
11. External image of the service
The importance of the external image of the service was raised by half of the teams and included the physical presentation of the staff (that is, whether or not they wear uniforms); the external image portrayed to outside agencies through their external points of contact (for instance phone systems that do not work properly); the external marketing of the service, which is important for managing referrals and the workload of the team.
12. Personal attributes
Several personal attributes were identified as being important to having an excellent team. These included approachability, appropriate delegation, being able to compromise, confidentiality, decisiveness, empathy, good organisation skills, initiative; knowing ones strengths and weaknesses; open to learning; acquiring, demonstrating and sharing new skills and knowledge, patience, personal responsibility, protective, reflexive practice, tolerance
13. Individual rewards and opportunity
Participants identified the importance of the individual returns on team work, which included good financial rewards; opportunities for career development; autonomy; challenge within the role and the opportunity to think outside the box.