An evaluative analysis of the practice of teamwork in Health and Personal Social Services

Abstract

This report describes the practice of teamwork as expressed in case conferences for care of the elderly and evaluates the effectiveness of case conferences in their contribution to care. The study involved the observation of more than two hundred case conferences in sixteen locations throughout the West Midlands, in which one thousand seven hundred and three participants were involved. Related investigation of service outcomes involved an additional ninety six patients who were interviewed in their homes. The pu`pose of the study was to determine whether the practice of teamwork and decision-making in case conferences is a productive and cost effective method of working. Preliminary exploration revealed the extent to which the team approach is part of the organisational culture and which, it is asserted, serves to perpetuate the mythical value of team working. The study has demonstrated an active subscription to the case conference approach, yet has revealed many weaknesses, not least of which is clear evidence that certain team members are inhibited in their contribution. Further, that the decisional process in case conferences has little consequence to care outcome. Where outcomes are examined there is evidence of service inadequacy. This work presents a challenge to professionals to confront their working practices with honesty and with vision, in the quest for the best and most cost effective service to patients.