Stress and Performance in Health Care Project Teams

  ABSTRACT

This research presents several practical recommendations to improve the performance of health care projects conducted by health care professionals. It explains the paradoxes inherent to the health care sector that restrain the possibility of increasing project performance and suggests ways to mitigate or resolve them.

The study was conducted with a Canadian sample of 11 projects each comprised of 5 to 8 team members. Data were collected over a period of about 18 months.

   THE PROBLEM

Health care is under transformation, with a mandate to provide the most effective care in the most efficient way. However, health care's growing complexity requires an increasing number of specialized individuals working together in full collaboration. The collision of these two trends is characterized by paradoxes:

Paradox 1: Health care professionals need collaborative skills, but their view of collaboration varies and true collaboration remains elusive.

Paradox 2: Fixing collaborative practices – as most health care projects aim to do – is difficult if true collaboration is elusive in the first place.

Paradox 3: Continuous improvement cannot be successful if it is continuously needed. Once in a while a radical change taking the form of a project must be orchestrated which requires even more collaboration.

Paradox 4: Expertise is necessary in health care project work, but not in a “clinical” way; this makes it difficult for health care professionals to collaborate in ways conducive to project success.

Paradox 5: The success of health care projects relies on resolving the four previous paradoxes.

  THE STUDY

The study was conducted with a Canadian sample of 11 projects each comprised of 5 to 8 team members. Data were collected over a period of about 18 months using both validated questionnaires and face-to-face interviews.

The teams in charge of the eleven projects received special project management training in parallel with their assigned work. The training was short but comprehensive, mainly focused on inter-professional collaboration and project management practices. Four fundamental criteria were emphasized: a focus only on core elements drawn from project management and inter-professional collaboration bodies of knowledge; an emphasis on the teams' current project contingencies; a “just-in-time” delivery of the training with respect to project milestones; and training provided by tandems of project management experts and physicians. Core elements included project management process; uncertainty, planning, and control; the importance of individual, team and stakeholder drivers; and role negotiation and conflict management.

  RECOMMENDATIONS FOR PRACTICE

The authors present several recommendations for practitioners that could improve the success of health care projects.

1. Organizations must build and maintain their capacity to provide the support and infrastructure required for their inter-professional health care project teams.
2. Integrate project management competencies in health care competency profiles.
3. Add project management curriculum to university health sciences programs.
4. Ensure project management teaching is based on the four fundamental criteria and core principles, rather than solely on the use of project management tools and techniques.
5. Integrate project management training for health care workers engaged in continuing education.
6. Ensure that the project management training course includes topics such as:
   • Collaboration
   • Conflict management
   • Stress management and psychological health management
   • Managing priorities and time management practices

  FINAL REMARKS

A transdisciplinary approach is key to resolve the five paradoxes listed above. Forming a health care project team who understands the principles of project management together with the intricacies of inter-professional collaboration is necessary to resolve the five paradoxes.

By sharing experiences and knowledge with respect to project objectives as equal members of the team, project team members create the opportunity for engaging radical solutions and avoid slow continuous improvements.

When people engage in active collaboration, they can embrace the challenges of task interdependency, authority conflicts, trust, and they can acquire the necessary behaviors to achieve project success.

  FULL CITATION

Chiocchio F, Lebel P, Therriault P, et al. Stress and Performance in Health Care Project Teams. Newtown Square: Project Management Institute, Inc., 2012.

From Academia: Summaries of New Research for the Reflective Practitioner | October 2014

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