The Impact of Leadership and Teamwork on Nursing Practice Effectiveness

Abstract

This article outlines the findings of a group interview study with health care managers, building on outsider observation of team processes. Efforts made to lead nursing teams effectively and the implications of those efforts for opportunities to improve the design of nursing teams are discussed. Interviewees described a range of approaches to leading nursing teams, encompassing patient care, administrative duties and “looking out” for team members. Leaders’ efforts focused on establishing and maintaining shared goals in the team and facilitating communication through individual conversations and team-based handover. They also sought to support teamwork by “shepherding” team members or by delegating to available people with relevant skills. Leadership is outlined in terms of situational awareness, communication, adapting to novel or unexpected situations, supporting team members and using crossover effects. Two broader observations on the design of nursing teams suggest that the boundaries of nursing teams can differ from their formal definitions and that designing teamwork interventions must take into account necessary trade-offs in specific work contexts