Lucy Gilson

Team Effectiveness 1997-2007: A Review of Recent Advancements and a Glimpse Into the Future

The authors review team research that has been conducted over the past 10 years. They discuss the nature of work teams in context and note the substantive differences underlying different types of teams. They then review representative studies that have appeared in the past decade in the context of an enhanced input-process-outcome framework that has evolved into an inputs-mediators-outcome time-sensitive approach. They note what has been learned along the way and identify fruitful directions for future research. They close with a reconsideration of the typical team research investigation and call for scholars to embrace the complexity that surrounds modern team-based organizational designs as we move forward.

Virtual Teams: What Do We Know and Where Do We Go From Here?:

In this paper, we review the research on virtual teams in an effort to assess the state of the literature. We start with an examination of the definitions of virtual teams used and propose an integrative definition that suggests that all teams may be defined in terms of their extent of virtualness. Next, we review findings related to team inputs, processes, and outcomes, and identify areas of agreement and inconsistency in the literature on virtual teams. Based on this review, we suggest avenues for future research, including methodological and theoretical considerations that are important to advancing our understanding of virtual teams.

Trust and the development of health care as a social institution.

Health systems are inherently relational and so many of the most critical challenges for health systems are relationship and behaviour problems. Yet the disciplinary perspectives that underlie traditional health policy analysis offer only limited and partial insights into human behaviour and relationships. The health sector, therefore, has much to learn from the wider literature on behaviour and the factors that influence it. A central feature of recent debates, particularly, but not only, in relation to social capital, is trust and its role in facilitating collective action, that is co-operation among people to achieve common goals. The particular significance of trust is that it offers an alternative approach to the economic individualism that has driven public policy analysis in recent decades. This paper considers what the debates on trust have to offer health policy analysis by exploring the meaning, bases and outcomes of trust, and its relevance to health systems. It, first, presents a synthesis of theoretical perspectives on the notion of trust. Second, it argues both that trust underpins the co-operation within health systems that is necessary to health production, and that a trust-based health system can make an important contribution to building value in society. Finally, five conclusions are drawn for an approach to health policy analysis that takes trust seriously.

Matching Creativity Requirements and the Work Environment: Effects on Satisfaction and Intentions to Leave

In a survey of 2,200 individuals, the authors examined the degree to which work environments are structured to complement the creative requirements of jobs. Regression analyses indicated that proximal job characteristics were more strongly associated with a combined objective and perceptual measure of job-required creativity than were distal organizational characteristics. Furthermore, higher job satisfaction and lower intentions to leave were found for individuals whose work environments complemented the creative requirements of their jobs.

A Little Creativity Goes a Long Way: An Examination of Teams’ Engagement in Creative Processes

Using surveys and interview data this research examines teams’ engagement in creative processes. Results of cluster analysis indicated that the more creative teams were those that perceived that their tasks required high levels of creativity, were working on jobs with high task interdependence, were high on shared goals, valued participative problem-solving, and had a climate supportive of creativity. In addition, members of the more creative teams spent more time socializing with each other and had moderate amounts of organizational tenure. Implications for management are discussed.

Doing health policy analysis: methodological and conceptual reflections and challenges

The case for undertaking policy analysis has been made by a number of scholars and practitioners. However, there has been much less attention given to how to do policy analysis, what research designs, theories or methods best inform policy analysis. This paper begins by looking at the health policy environment, and some of the challenges to researching this highly complex phenomenon. It focuses on research in middle and low income countries, drawing on some of the frameworks and theories, methodologies and designs that can be used in health policy analysis, giving examples from recent studies. The implications of case studies and of temporality in research design are explored. Attention is drawn to the roles of the policy researcher and the importance of reflexivity and researcher positionality in the research process. The final section explores ways of advancing the field of health policy analysis with recommendations on theory, methodology and researcher reflexivity.

Empowerment and team effectiveness: an empirical test of an integrated model.

The authors developed a model of team empowerment as an emergent state linking inputs (I) with processes (P) and, thereby, with outcomes (O) in the context of an expanded team IPO framework. Using survey responses from 452 members of 121 empowered service technician teams, along with archival quantitative performance and customer satisfaction criteria, the authors tested the model using structural equation modeling techniques. The model was generally supported, although areas for improvement were evident. Specifically, empowerment partially mediated the influences of various inputs on team processes, whereas team processes fully mediated the influence of empowerment on outcomes. Directions for future research and application are discussed.

Creativity and Standardization: Complementary or Conflicting Drivers of Team Effectiveness?

We examine relationships between creativity, the use of standardized work practices, and effectiveness (measured as both performance and customer satisfaction) among 90 empowered teams of service technicians. Despite the seemingly contradictory natures of creativity and standardized procedures, our results indicate that they can be complementary. Specifically, standardization was found to moderate the relationship between creativity and both team performance and customer satisfaction, although the pattern of results differed for the two measures of effectiveness. We discuss how and when teams can effectively employ both work practices.

The terrain of health policy analysis in low and middle income countries: a review of published literature 1994-2007

This article provides the first ever review of literature analysing the health policy processes of low and middle income countries (LMICs). Based on a systematic search of published literature using two leading international databases, the article maps the terrain of work published between 1994 and 2007, in terms of policy topics, lines of inquiry and geographical base, as well as critically evaluating its strengths and weaknesses. The overall objective of the review is to provide a platform for the further development of this field of work. From an initial set of several thousand articles, only 391 were identified as relevant to the focus of inquiry. Of these, 164 were selected for detailed review because they present empirical analyses of health policy change processes within LMIC settings. Examination of these articles clearly shows that LMIC health policy analysis is still in its infancy. There are only small numbers of such analyses, whilst the diversity of policy areas, topics and analytical issues that have been addressed across a large number of country settings results in a limited depth of coverage within this body of work. In addition, the majority of articles are largely descriptive in nature, limiting understanding of policy change processes within or across countries. Nonetheless, the broad features of experience that can be identified from these articles clearly confirm the importance of integrating concern for politics, process and power into the study of health policy. By generating understanding of the factors influencing the experience and results of policy change, such analysis can inform action to strengthen future policy development and implementation. This article, finally, outlines five key actions needed to strengthen the field of health policy analysis within LMICs, including capacity development and efforts to generate systematic and coherent bodies of work underpinned by both the intent to undertake rigorous analytical work and concern to support policy change.

Removing user fees for primary care in Africa: the need for careful action.

Current calls for the removal of user fees respond to evidence of their regressive impacts and their role in enhancing social exclusion—but removal must be carefully managed because this action may have negative impacts on the wider health system User fees are once again a topic of hot policy debate in Africa. They were introduced relatively recently in many countries (box 1), but the current call is for their removal, particularly at primary care level.2 As analysts who have consistently argued against user fees, we broadly support this call. However, we recognise that this action cannot be introduced overnight and, if weakly implemented, may exacerbate the problems facing African health systems. We outline both why we believe African countries should move away from user fees, and what actions should accompany their removal to ensure that this policy change strengthens rather than undermines healthcare provision. Our suggestions are based on the experience of countries such as South Africa and Uganda that have already removed some or all fees, as well as wider experience of policy change. User fees are the most regressive form of healthcare financing available; they contribute to the unaffordable cost burdens imposed on poor households; and they represent one facet of the social exclusion experienced by these households. Out of pocket payments (which include user fees at public sector facilities) are more regressive than any other method of financing health care, capturing a higher proportion of income among poor households than wealthier ones.3 Thus, simply on the basis of the equity principle that those with the greatest ability to pay should make appropriately larger contributions, out of pocket payments are the least desirable way of financing health services. At primary care level, fees are relatively low. None the less, such fees can encourage inappropriate self treatment …