The research intends to establish how management influences teamwork in the health institutions to promote the provision of quality services. The healthcare services quality depends on the collaboration between many professions in a health institution. The managers have to set effective strategies to enhance the teamwork in the health institutions. The researcher would use questionnaires to collect data directly from the employees, management, and patients. Various factors influence the aspect of teamwork in any health institution. The structure and culture of any organization significantly influence the performance and service delivery of the various health care teams (Bryman & Bell, 2011). Understanding the aspect of teamwork and its relationship with management can help improve delivery of service quality in health institutions (Mitchell, et al., 2012). The researcher would analyze the results for Test-Retest and inter-rater reliability. Thereafter, the researcher would carry out data analysis using the measures of central tendency, correlations, and linear regressions, axial and open coding.
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Management is necessary for the health sector. In hospitals, management aims to deal effectively with workers affairs to enhance teamwork to ensure the provision of quality services (Rosdahl & Kowalski, 2008). In the health sector, there are different professionals that management has to ensure collaboration for efficiency in the provision of services. Consultants, doctors, nurses, pharmacists, and dentists improve the well-being of the patients. Their work is inter-dependent (Vasilache, 2014). It is evident that their service delivery will be hampered if they do not collaborate. The managers must ensure effective communication and motivation of employees to work as a team (Speck, 2006). The research intends to explore the effect of management on the willingness of employees to work as a team and the effect of the teamwork on the delivery of quality services in the health sector in the United Kingdom.
The managers have the responsibility to ensure quality services to the patients (Rosdahl & Kowalski, 2008). The research will determine how well-managed teams contribute to service quality and satisfaction of the patients. The managers have a role to ensure effective collaboration among the workers as well as among outside stakeholders such as other hospitals, other health institutions, governments, and financiers (Rosdahl & Kowalski, 2008). The primary aim is to establish a link between the management, teamwork, and quality health care services. Health professionals should possess management skills relevant to enhance the collaboration of all the stakeholders in a health institution (Reeves et al., 2010). In the teamwork, the efforts of all health workers would be directed towards the provision of quality services to the patients.
Teamwork is an important element in the management of any health institution (Reeves, et al., 2010). The hospital managements are motivated to ensure quality services to employees. Nevertheless, a gap exists between the expected health service and the services that the health institutions provide. A research to enhance the quality of the service is, therefore, necessary.
Teamwork and quality health services
When the employees of the health sectors work in teams, the achievement of the organization's goals and objectives is made easier (Speck, 2006). According to research conducted by the Canadian Health Services Research Foundation (2006), Health institutions that allow for effective teamwork can enhance the quality of patient care. Also, the research suggested that teamwork could result in reduced workload issues that hinder the quality of the services provided. For teamwork to be successful, all the participants need to have clearly defined objectives, efficient communication, protocols, as well as procedures. Besides, all the members need to be actively involved in the achievement of the set objectives (Canadian Health Services Research Foundation, 2006).
Speck (2006) stated that for some years in the UK, a multi-disciplinary teamwork review for all the patients with cancer has been a mandatory requirement. The requirement was established under the Improving Outcomes Guidance that was issued by the National Health Service. The main aim of the requirement was to enhance service delivery in the health institutions in the UK. In that case, the concept of recognizing the input of various medical experts is embraced in the United Kingdom. Speck (2006) states that various medical professionals including surgeons, pathologists, and radiologists among others frequently gather to discuss patient care and treatment plans. The concept ensures that every patient with a new diagnosis of cancer had his or her case discussed at the weekly multidisciplinary meetings. Such a concept gives an assurance to the patient that a group of professionals has discussed their case and treatment. Besides, the discussions benefit the clinicians who attend to patients after the meeting and familiarize with their case. Also, it maintains a connection with the smaller referring health centers.
According to Speck (2006), the collaboration created among the medical experts enhances the quality of service delivery in all the health institutions in the UK. However, there is a concern that some cases that require little discussions may consume much time eventually decreasing the time needed for more issues that are complex. Ben Challacombe, a consultant surgeon, suggests that more time be allocated to the complex issues to improve service delivery (Dar, 2012). Despite the fact, there exist mixed views on the concept of multidisciplinary teamwork; the National Health Service maintains that it will remain in place in the UK. The multidisciplinary teamwork is important for the enhancement of the outcomes of cancer patients as well as service delivery (Dar, 2012).
The guidelines provided by Speck, Dar, and Canadian Health Services Research Foundation revealed that teamwork is necessary for the health care quality services. Nevertheless, they did not consider the factors that motivated the health professions to work towards the provision of quality health care services. They failed to address the fact that hospitals have not yet attained a one hundred percent of the required quality. Is there a gap between the motivators provided by management and the one expected by employees? A research in the health sector would give insights on the matter.
Evolution of the health sector
In the UK, the aspect of teamwork is at the core of every decision maker. Many government forums and reports call for collaboration in the healthcare sector to renew the health care system (Maun et al., 2014). In 2008, the health council of the United Kingdom released reports explaining the importance of improved teamwork in all the health institutions in the UK. Studies conducted in the UK provide that teamwork improve the performance of the healthcare officials as well as promoting quality service delivery (Joint Commission Resources, Inc., 2008). Other research shows that teamwork leads to job satisfaction, patients’ satisfaction eventually reducing morbidity in patients.
Some factors that could have an impact on the teams include the membership and the duration of the existence of the team. Such factors vary across different settings in the health sector. For instance, teams in the ICU, departments exist for a shorter period compared to the teams from other departments. The membership of such teams also depends on the patient complexity and the shifts of work in the hospitals. Also, the teams working within the immediate environment of the hospital tend to have different jobs, features and processes compared to those working in rehabilitation areas. The teams in the rehabilitation areas have a high degree of stability and the members work together over a long period (In Weatherhead & In Todd, 2014)
Salas et al. (2013) found that teamwork was necessary for improved service quality. Teamwork was necessary for the improvements of the services provided to the patients. The health sector is increasingly becoming complex. Nevertheless, each person specializes in the different field (Salas et al,, 2013). Therefore, a manager who will integrate the ideas of all the people must be present.
The evolution of the health care is increasing on the daily basis. Today the health workers have to collaborate with the patients, relatives, in addition to other health professionals (Camar, 2009). Mitchell (2012) noted that the collaboration has become a necessity as a result of the increasing ailments and the types of the diseases. Teamwork was necessary for the situations where the health workers had to deal with urgent matters and situations. With increasing complexity of the collaboration in the health sector, the health professionals are required to have adequate management skills (Mitchell, 2012).
Motivation to provision of quality health care services
Despite the benefits that come with health professionals working as a team, there exist certain organizational factors that affect teamwork in many nations, and the UK is not an exception. According to Vasilache (2014), organizational factors such as the structure and culture have a strong influence on the collaboration and performance of the healthcare teams. Studies show that teams that work in an organizational environment that support teamwork flourish. In the UK, various healthcare settings have varying degrees of complexity of organizational management.
Vasilache (2014) suggests that management, resources, and setting are the three components that can help improve the effectiveness of teamwork in the health institutions. On the part of management, teams require a clearly defined organizational philosophy that motivates the health professionals to collaborate. Besides the organizations provide the required resources and tools to enable the teams achieves their desired goals and objectives. According to a study conducted within the Veterans Health Administration system in the United States, consistent team-based processes results in positive outcomes for the team, patients, and the service delivery at large (Vasilache, 2014). Moreover, the aspect of setting is an important element in the performance of any team. Because of the varying aspects of the institutionalism of teams, various distinctions exist between the settings. Bounded teams have a pertinent understanding of the team membership. They tend to see themselves as a social entity, and other people perceive them to be social entities (Gramatikov, 2010).
The healthcare system contains the factors that influence the collaboration process and encourage effective working of the teams. The aim of moving successful teamwork forward in the UK is to make health outcomes better through a well-integrated healthcare system. The aspect of teamwork is the foundation upon which the decision makers trust that the health care system reforms will be successful. Nevertheless, Salas (2013) suggests that the success of a team requires a defined understanding of the factors that facilitate effective teamwork as well as the obstacles to effective teamwork. With a clear understanding of such important factors, it is evident that service delivery in all the heath institutions will be highly enhanced (Edwards & Webster, 2012). Patients will receive improved medical care, and the cases of deaths and dissatisfaction will shrink (Edwards & Webster, 2012). According to evidence provided by Reeves et al. (2010) the UK has progressed in transforming the main healthcare delivery system to ensure that sustainability and accessibility of the health institutions are enhanced. Following the success of the team-based approach to service delivery in many health institutions in the UK, many nations have decided to adopt the aspect of teamwork in the health centers (Joint Commission Resources, Inc., 2008). Therefore, the importance of teamwork in any health institution is not debatable. It is clear that for efficient service delivery, health professionals need to work as a team.
The selection of the relevant research methodology is significant for the attainment of the research objectives. The research objectives dictate the research the adopted research design. Both qualitative and quantitative data will be collected. Therefore, the research methodologies adopted will facilitate the collection of both qualitative and quantitative data.
Philosophy of research
The research intended to generate the knowledge relevant knowledge in the field of management and health. It is crucial to examine the philosophy of research that describes how to generate the knowledge. It is vital to understand ontology, the epistemology, and the application of the two in the research. The epistemology concerns the search for the knowledge and the consideration of whether it is true (Taylor, et al., 2006). Its interest is to differentiate the factual knowledge and the opinions. The research intends to unravel the influence of management on the willingness of the workers to work as a team in the service delivery (Blaikie, 2010). Much is known about the influence of management on employee's motivation (Vasilache, 2014). The research needs to acquire facts on the management of health workers in the hospitals in the United Kingdom. Ontology specializes in the knowledge of the existence. While researching the way something existed, answers automatically arise on the actual knowledge (Taylor et al., 2006, p.320). The research intends to unravel the influence of management on the willingness of the workers to work as a team in the service delivery (Blaikie, 2010). The research will utilize the epistemology in the research. The research will generate accurate information.
Research aim, questions, and objectives
The research aims at the establishment of the relationship between the management, teamwork and the delivery of quality services. The following questions are linked to the research and outline its aim.
- How does effective management influence the teamwork among the health workers?
- What are the expectations of workers from the management so that they can willingly work as a team in the provision of quality health care services?
- How can managers promote the teamwork in health institutions?
- What is the link between the teamwork and the provision of the quality health care services?
- Are there any other factors that influence teamwork other than management?
- With the research questions stated above, the objectives of the research are stated below.
- To determine the relationship between the management, teamwork and provision of quality health care services.
- To understand how the managers can motivate workers.
- Establish whether there are other factors that influence employees’ willingness to work as a team other than the one provided by the management
The research will adopt both the qualitative and quantitative research approaches. The quantitative research will adopt survey design while the qualitative research will utilize the observational design. The quantitative research use numbers to describe various measurement variables in an attempt to answer the research questions (Gramatikov, 2010). The researcher will use a quantitative approach to investigate management actions that enhance employee’s willingness to participate in a team.
Research design and methodology
First, the research will adopt the survey design a type of descriptive research design. The methods in the descriptive studies investigate the facts about a certain phenomenon without affecting the behavior of the participants (Zikmund, 2013). Unlike, the experimental design it provides the facts in their natural setting. The correlation studies involve a comparison of two phenomena, which is not relevant to the current study (Zikmund, 2013). The descriptive research design allows the use of the questionnaires and observations as methods of collecting data.
Mainly, the survey research will utilize the questionnaires sent to the management, health employees, and the patients visiting George Eliot Hospital. The researcher will send questionnaires to the respondents through the email. Management and the health workers have the relevant knowledge to respond to the questionnaire. The questionnaires on management will ask the questions on the actions the management has undertaken to promote teamwork (Karwowski, 2006). Employees will answer the factors that increase their willingness to work as a team, the one provided by management comparable to their expectations. Workers are also professional, and the response rate is expected to be high. The patient's questionnaires will be made simple for easy understanding. They would be frequently encouraged to return the questionnaires. The questionnaires will help reach many respondents while keeping the cost of collecting data at a considerable level (Mc Nabb, 2015).
The research will make observations on the way the services are provided in the health institutions and compare with expectations on the responses obtained from the management, employees, and patients. The observations should be accurate since the researcher collects the correct facts without relying on other people. The observer can view the human behavior in actions and even collect data from those who cannot adequately express themselves (Jupp & Sapsford, 2006). The researcher would seek consent from the management of the hospital to carry our observations and send questionnaires to both the patients and the employees.
Strengths and Limitations of data collection methods
Questionnaires have the capability of collecting a large amount of data at a lower cost than other methods like interviews, experimentsa, and observations. Questionnaires are also not limited by geographical distance, and they will be sent to many patients. Moreover, the questionnaires facilitate effective maintenance of the anonymity of the people who participated in the research (Krishnaswamy & Satyaprasad, 2012).
Nevertheless, the questionnaires experience a high rate of non-response. The expected sample becomes smaller and smaller, and accuracy of the results and the inferences obtained are affected. To overcome the limitation, the respondents would be reminded to send back the questionnaires. In observation, the researcher can reveal the facts the respondents could not disclose in the questionnaires (Thornbill, Lewis & Saunders, 2015). Moreover, the data obtained through observations is more valid. However, the respondents may change their behavior in the presence of the researcher. Also, the observation method is costly and time-consuming.
Data validity and reliability
In determining the quality of the data, it is relevant to examine the validity and reliability of the data collected from the health workers, management, and the patients. Reliability refers to the probability of getting similar results when the same measurements are made on different occasions (Krishnaswamy & Satyaprasad, 2012). The test-retest and the inter-rater reliability will be used to examine the data collected. The reliability is not adequate to prove the adequacy of the data. There is a requirement to scrutinize the validity of the data (Joint Commissions Resources, 2008). The validity determines whether the research is measuring the correct facts of interest. In the research, three types of validity that include the construct, content validity, and predictive validity would be evaluated.
Ethical and practical issues
It is necessary to ensure that the research carried out has considered all the ethical considerations. It is vital to consider that ethics is observed when dealing with the respondents. First, the respondent would be informed that the participation in the research is voluntary (Thorbill et al., 2015). Second, the information gained from the clients would not be disclosed to anybody. Third, the researcher would inform the respondents how they will benefit by participating in the research. The researcher sent to the field would be trained effectively to make certain that they have dealt with the respondents professionally. Besides, it would be necessary to seek permission from the managements of the hospitals before questionnaires to its employees and the hospitals.
Results, Analysis, Discussion
It is difficult, to understand the raw data without organizing it in a methodical way. The methods used to represent the data would include frequency distributions, graphs, pie charts, lines graphs, and polygons. Besides various methods would be used in the analysis of the data. First, the measures of the central tendency would be calculated (Bryman, & Bell, 2011). The measures would include the calculation of mean, median, and mode. Second, calculation of the correlations would be necessary. Lastly, the researcher would draw graphs and the calculation of linear regressions. The axial and open coding are the methods that will be used in the analysis of the qualitative data.
The research intends to determine the effect of management on the willingness of the health workers to work as a team to enhance the quality of the services provided. It is necessary for the collaboration between the internal and external stakeholders. The qualitative and quantitative research approaches will be used in the research. In the research, the survey questionnaires would be sent to the management, employees, and the patients at George Eliot Hospital. Also, the data would test the reliability and validity. The researcher would record, analyze and discuss the desired objectives.
The proper management is necessary to ensure employees are working as a team in the effort to deliver quality health care services. The health sector is made up of different professionals whom their services must be integrated to ensure the needs of all the patients are met. It is necessary to establish whether the motivating factors that managers give is adequate to enhance and maintain the teamwork among the health workers.
The following recommendations are made
- The research on the relationship between the management, teamwork, and quality of service should be carried out as planned.
- The research should be conducted to the management, employees, and patients and the relationship between the results obtained established.
- The researcher makes certain that after collection of the data through the questionnaires, he visits the hospitals for the observational research.