Drs. Russo and Boer began by outlining the differences between high-performing and dysfunctional teams. High-performing teams are not afraid of face-to-face communication, authentically give and receive appreciation, invest time in getting to know one another, and have more strategic meetings. These behaviors are associated with high performance—superior and on-time results with higher team engagement and less turnover.
In contrast, dysfunctional teams are characterized by poor communication and attitude, authoritarian leadership, unproductive meetings, interpersonal conflict, and artificial harmony. These team dynamics do not just affect team members, they spill outside the team and can affect patient care.
The speakers highlighted Patrick Lencioni’s book “The 5 Dysfunctions of a Team” as a valuable resource for identifying and addressing dysfunctional team dynamics. The five dysfunctions discussed include:
- Absence of trust—to combat lack of trust, leaders need to take the first step by demonstrating authentic vulnerability.
- Fear of conflict—trust allows healthy conflict, but at times fear can get in the way of engaging in difficult discussions. Handled well and not avoided, conflict can be constructive and a catalyst for growth.
- Lack of commitment—team members who feel ignored can disengage. Paying attention to psychological safety and wellness is critical and intentional steps must be taken daily.
- Avoidance of accountability—without accountability, teams can lack focus and allow for low standards of quality. Improvement as a team requires accountability by all members including the difficult task of holding each other accountable.
- Inattention to results—regularly providing team and individual metrics will help members remain focused and encourage putting team needs first. The team must understand how success is measured.
Recognizing these warning signs of dysfunctional teams can be useful for getting in front of the issue quickly; like a change in vital signs in the development of systemic inflammatory response syndrome, these can be signs of things to come. Once recognized, assessing the urgency and team readiness for change can help you prioritize your next steps. Cultivating your own toolkit for addressing dysfunction when it arises may require different strategies depending on the dysfunction present. Unhealthy conflict may require the use of facilitated discussion or mediation whereas team disengagement will be more effectively addressed through team self-reflection and attention to wellness and belonging. Leaning into discomfort, focusing on clear outcomes, monitoring for success, promoting diversity, and creating a culture of self-reflection, feedback, and belonging will broadly promote healthy team dynamics and support the development of a high-performing team.
- Dysfunction in teams can be easily recognized once you learn the signs. To fix a problem, you must recognize it first.
- Strategies for dysfunctional teams can vary based on the dysfunction present.
- Building your own toolkit for change can help manage dysfunction in your team when it presents itself.
Dr. Makowski is an internist and the division chief of acute care medicine at Corewell Health West in Grand Rapids, Mich. She is core clinical faculty of Michigan State University College of Human Medicine internal medicine residency and the medical director of Grand Rapids Street Medicine, both in Grand Rapids, Mich.