April 18, 2023

Key Leadership Competencies: Teams Thinking

Clinician Leadership | Leadership Development | Team Development

Reading Time: 6 minutes

As a firm of executive coaches working exclusively with healthcare leaders, we’ve come to realize the competencies required to lead well in our industry are changing. Rapidly.

Take team dynamics, for instance. While it has always been true that healthcare is the product of the integration of multiple disciplines, there is increasing recognition that effective management of the intersection of those disciplines is critical for high performance and true transformation. 

Like the rest of healthcare, team practices have evolved significantly in recent years. Part of that evolution is the emergence of “teams” as a verb — teaming — to describe new ways of thinking about teams. On one hand, we have fixed, structured teams. On the other, we have times when people in your organization need to pair up “on the fly” to solve a problem or seize a timely opportunity. 

Teams Thinking entails mastery over both: leading established teams and dynamic teaming as needs arise. In this post, the fourth installment in our Leadership Competencies series, we invite you to consider ways that Teams Thinking can magnify your impact as a leader. 

Traits of a “Teams Thinking” leader

J. Richard Hackman, a 20th century pioneer in team psychology at Harvard, spent a career studying what makes teams successful. “I have no question that when you have a team, the possibility exists that it will generate magic, producing something extraordinary. But don’t count on it,” he cautioned, noting that research consistently shows teams underperform despite ample resources.

A “Teams Thinking” leader is able to sustain high performance by practicing the following: 

  • Embracing interdependence, intentionally developing trust and respect among teams.
  • Facilitating inclusive, interactive, and collaborative learning.
  • Assembling, developing, and aligning diverse teams equipped with the capabilities necessary to lead the organization.
  • Encouraging teams to explore conflicting points of view as a way to ensure solid decision making and aligned execution.

To get there, it helps to examine both conventional and emerging team concepts.

What exactly is a team?

Before we explore different types of teams, it’s important to define what is meant by the word “team.” In Leadership Team Coaching, author Peter Hawkins defines a team this way:  

“A small number of people with complementary skills who are committed to a shared purpose that can only or best be accomplished together, with a set of shared performance goals and a shared approach for which they hold themselves mutually accountable.”  

This definition focuses on the functional purpose of teams — a coming together to accomplish a shared goal that requires the interdependent cooperation of its members. Watkins goes further to state that the measure of when a group becomes a team is when everyone “shares responsibility for each other’s performance, well being and learning.”  

Using this definition, we can contrast a true “team” from groups of people often referred to as a team but lacking its essential character. Groups of people reporting to the same leader are only a team to the extent they collaborate in work that requires the participation and knitting together of their respective functional capabilities. (As an aside, a lot of leadership “team” member capacity is wasted in their presence at “team” meetings addressing topics about which they have no functional connection.)  

Groups of people who come together in support of a shared goal but who fail to recognize, manage and leverage their interdependence also fall short of the definition of a true team. Too often we see groups come together around a shared goal but its members see their function as optimizing or protecting their individual interests rather than working collaboratively, respectful of the needs of the other members of the group. 

“Team” as a noun: Fixed team models

The traditional view of “teams” as an established group of individuals is a familiar concept. Team members are used to performing together, know each other’s roles, and how to interact. These fixed teams reflect somewhat stable environments where cause-and-effect relationships are relatively predictable. 

In this model, a leader sets a definite direction. That action is often “emotionally demanding because it always involves the exercise of authority, and that inevitably arouses angst and ambivalence — for both the person exercising it and the people on the receiving end,” says Hackman.

In his book, Leading Teams, Hackman offers five essential elements for effective team building:

  1. Teams must be real. People have to know who is on the team and who is not. It’s the leader’s job to make that clear.
  2. Teams need a compelling direction. Members need to know and agree on what they’re supposed to be doing together. Unless a leader articulates a clear direction, there is real risk that different members will pursue different agendas.
  3. Teams need enabling structures. Poorly designed tasks, the wrong number or mix of members, fuzzy or unenforced norms of conduct invariably land teams in trouble.
  4. Teams need a supportive organization. The organizational context — including the reward system, human resource system, and information system — must facilitate teamwork.
  5. Teams need expert coaching. Most executive coaches focus on individual performance, which does not significantly improve teamwork. Teams need coaching as a group in team processes — especially at the beginning, midpoint, and end of a team project.

As coaches, we work with leaders and their established teams in ways that recognize the art and science of leadership, which we define as the exercise of influence to co-create coordinated movement by a group of people toward a shared goal. That influence flows through relationships, just as electricity flows through a wire. The network of relationships on a team, and the angst and ambivalence involved in leading teams, can produce productive tension to allow conflict to produce deeply shared commitment and ownership of results.

In all, the best teams are rooted in trust: Team members feel safe enough to lean into debates and disagreements in pursuit of the best path forward, and then commit to owning results together.

“Teaming” as a verb: Temporary, dynamic teams

Team as a noun will always be a central part of leadership. At the same time, we know that growing complexities in healthcare are changing how teams form and operate. 

Amy Edmundson, another business professor at Harvard, took her colleague’s concept and added a new dimension: “Teaming” as a verb, which she describes as actively building on-the-go teams that may change at any moment. 

Consider, for example, an emergency services facility where teams change for every case or patient. Or forming a cross-functional project team to solve a unique problem. “How do you create synergy when you lack the advantages offered by the frequent drilling and practice sessions of static performance teams?” — Edmundson ponders. 

This way of thinking about teams corresponds with the growing speed, instability and uncertainty of our times, she explains:

Teaming is about identifying collaborators and quickly getting up to speed on what they know so you can work together to get things done. This more flexible teamwork (in contrast to stable teams) is on the rise in many industries because the work — be it patient care, product development, customized software, or strategic decision-making — increasingly presents complicated interdependencies that have to be managed on the fly.

The time between an issue arising and when it must be resolved is shrinking fast. Stepping back to select, build, and prepare the ideal team to handle fast-moving issues is not always practical….. Today’s leaders must therefore build a culture where teaming is expected and begins to feel natural. This starts with helping everyone to become curious, passionate, and empathic.”

Building your Teams Thinking muscle

As you seek to build proficiency as a Teams Thinking leader, recognize that all teams go through a normal, predictable and (thankfully) manageable process of development. Leaders proficient in Teams Thinking understand and cultivate the essential characteristics of high performing teams to accelerate the process of team formation. 

Below are six areas we focus on in our coaching practice to help our clients develop “muscle” in this competency:

▷ Become skillful in cultivating trust.

Trust is the foundation of any effective team, and you’d do well to deepen your understanding of it. Lead team members through an intentional process to build trust. Recognize that trust requires belief in the character and competence of teammates. Start by creating opportunities for team members to learn more about each other — their sense of purpose, values, experience and expertise, behavioral patterns and mindsets. When disagreements occur (and they will) trust enables team members to assume those differences are differences in ideas, not purpose or values.

▷ Establish and administer team norms.  

As in any relationship, it is important to continuously nurture team chemistry. One way to do that is to develop a set of team norms which define the behavioral commitments of the team members to one another, and to periodically assess how well the team is adhering to those commitments.

▷  Build skill at constructive conflict and collaborative decision making. 

High performing teams cultivate vigorous dialogue and welcome diverse opinions. They are also skillful at processing those differences in a way that enables them to come to closure and commitment from team members, even when they fail to reach a natural consensus. They understand how to communicate their differences in ways that invite dialogue rather than provoking debate, seeking to deeply understand what underlies their differences.

▷  Define efficient systems and skills to communicate and stay connected.

With the pace at which most teams move these days, communication skills and methods are critical to keep team members informed and aligned. Skillful communication helps prevent gaps between intentions and perceptions, which can break down trust.


Yes, elevating and sustaining team performance is a challenge, particularly in an industry so filled with uncertainty and ambiguity as healthcare. It’s also your best chance to drive long-term wins in ways that are truly meaningful and beneficial to the many audiences you serve.

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About the author

Eric P. Norwood, LFACHE, PCC

Eric P. Norwood, LFACHE, PCC is a trusted, experienced advisor to C-Suite leaders, helping them improve their performance individually and corporately. He is a catalyst for change for his clients.

Robert "Bob" Porter, JD, MBA, PCC

Robert "Bob" Porter, JD, MBA, PCC is an accomplished organizational leader with over 30 years’ experience in health system leadership. Bob has extensive experience in working with senior leadership executives in complex organizational settings, with a proven track record for engaging diverse stakeholders in the redesign of organizational systems and processes to achieve breakthrough improvement in performance.

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