American Association for Physician Leadership

Team Building and Teamwork

How to Assess, Recognize, and Reward Teamwork

Laura Hills, DA

October 8, 2016


Abstract:

Although medical practice managers often know a lot about how to reward individual employee performance, they may not be as well versed in the best strategies for rewarding teamwork. However, the most effective employee recognition and rewards programs focus on both individual and team performance. This article describes strategies that practice managers can use to reward teamwork without lessening their employees’ desire to perform well individually. It describes five possible goals for a team rewards program and 10 practical tips for assessing and rewarding teamwork. This article also identifies three common concerns about rewarding teamwork and strategies for overcoming those concerns. It describes three types of team rewards programs and discusses when to use continuous and intermittent rewards. This article also offers medical practice managers a reliable five-question survey to use with their employees to assess teamwork and suggests a strategy to encourage employees to recognize the teamwork they observe in one another. Finally, this article explores the importance of the medical practice manager’s attitude about team recognition and rewards and suggests what to do when the manager is conflicted about the team rewards he or she must give.




It is human nature to behave in ways that bring us positive recognition, praise, privileges, and riches. As Irvine(1) succinctly puts it, “You do things you get rewarded for.” The rewards that motivate our behavior can be external and clearly stated to us—or they can be internal and no more than the good feeling we get from behaving in certain ways. But no matter the form or origin of our rewards, it is rewards that shape, propel, and reinforce a great deal of our behavior. This is true everywhere in life, including within the medical practice.

The employees you manage will behave, therefore, in the ways that bring them the most and the best rewards. A mistake managers sometimes make is that they say that they want one behavior from their employees yet they reward another. Specifically, they say that they want their employees to demonstrate teamwork, yet they reward only individual performance. Managing employees in this inconsistent way will encourage them to focus mostly or solely on their individual work and may even discourage them from making the needs and performance of the team a priority. According to Schrage,(2) “Organizations that truly want their people to work better together must stop publicly discriminating against teams in favor of individuals.” Schrage adds, “People need to feel that the benefits of being team players measurably outweigh the perceived and real costs of compromise and self-sacrifice.”

Excessive focus on individual performance can actually backfire.

The challenge medical practice managers must face is how to reward teamwork without diminishing their employees’ desire to perform well individually. In fact, excessive focus on individual performance can actually backfire. It can undermine teamwork and create a tense, competitive, or even cutthroat work environment. On the other hand, rewarding teams and not individuals can cause your star employees to become demoralized, especially if they feel like they are carrying the team or there are some obvious slackers who are getting the same rewards that they are. The trick is to recognize both team and individual performance, balancing the two, while encouraging a cooperative culture. Fortunately, there are a number of strategies that can help.

Five Goals for Team Rewards Programs

Before creating and unveiling a team rewards program for your employees, a very important first step is to know what you’re trying to achieve. Geraghty(3) identifies five possible goals:

  1. Attract talented employees. A team recognition and rewards program can entice talented employees to work for your medical practice and set your practice apart from the competition. Therefore, you’ll want to develop a team rewards program that you can publicize in job postings and throughout your recruitment efforts.

  2. Motivate employees to perform optimally. The most effective team recognition and rewards programs focus on motivating desired behaviors. When you develop your program, be sure that recognition and rewards are tied to specific behaviors that you can identify, observe, and measure. At the end of the day, you want to motivate actions that achieve results, not simply effort and good intentions.

  3. Foster personal growth and development. Team rewards can encourage and promote personal growth and professional development. Your team recognition and rewards program should be beneficial in the long run to each member of your team.

  4. Increase employee satisfaction. Team recognition and rewards programs can promote employee engagement, resulting in increased workplace satisfaction. They can motivate your employees to persist in the face of challenges and to come up with creative solutions to their problems. Simply put, they can help them derive more pleasure from their work. When you develop your team recognition and rewards program, focus on what you can do to help your employees increase their job satisfaction.

  5. Keep talented employees from leaving. When employees love what they do and are recognized and rewarded for their performance, they are less likely to seek employment elsewhere. Make sure that your employees individually consider your team recognition and rewards program to be a plus. Help them to perceive and value it as a benefit of working in your medical practice.

Assessing and Rewarding Teamwork: Ten Tips

Establishing a team rewards program is similar to establishing an individual employee rewards program. Here are 10 tips to help you negotiate those similarities and a few important differences.

  1. Establish clear, observable, and measurable team objectives. Team members must understand and agree on what success looks like, just as they do for their individual performance goals. In addition, you will need a common set of objectives or aspirations so you will have some way of assessing your team’s performance. Gallo(4) suggests bringing everyone together to discuss team goals and metrics. Establish goals that are specific, observable, and measurable. Ask your team: What would it take for us to give ourselves an A? Facilitating this dialogue can be highly motiving and can lay the groundwork for collaboration with a shared vision, Gallo says.

  2. Follow good employee recognition rules. Many of the same rules apply whether you are recognizing an individual or a team. In both instances, you will want to recognize significant accomplishments that are in line with your medical practice’s goals and values. You will want to be specific and timely about what you are rewarding. And you will want to make sure that whatever the recognition or award is will be meaningful to the recipients. None of your employees is going to get excited about a reward that is not personally meaningful. In fact, the wrong recognition and rewards can make employees feel uncomfortable and, sometimes, unappreciated.

  3. Reward both individual and team performance. Although of course you will want to reward teamwork, do not do so at the exclusion of individual rewards. What is the ideal balance of the two types of rewards? According to Mitchell,(5) “There is substantial research that supports the greater importance of individual effort.” Therefore, Mitchell suggests that a well-balanced performance-reward program consists of 75% emphasis on individual behavior and 25% emphasis on team behavior.

  4. Assess team progress regularly. Gallo suggests that managers can pose questions that help the group assess its progress, such as, “How are we performing as a team?” and “What obstacles can we remove?” Ask for answers to these questions in a meeting or anonymously through a survey, Gallo suggests.

  5. Use both monetary and nonmonetary team rewards. There are many nonmonetary rewards at your disposal for both individual and team rewards, even if you cannot change how salaries and bonuses are handled in your medical practice. For example, send members of your team a handwritten note. Write a formal letter of appreciation for the excellent teamwork and place a copy in each employee’s personnel file. Describe the team’s successes during monthly meetings, and thank your staff publicly; or prepare and play a short photo or video montage that highlights your team’s accomplishments.

  6. Organize a team awards event and reward individual teams by name. Schrage suggests that managers can plan awards events that positively impact teamwork conversation and culture. For example, managers can recognize and reward their most dynamic duos and productive trios by name, Schrage says. “Identify and celebrate the ‘fab fours’ and ‘creative quintets’ of innovation or efficiency,” Schrage suggests.

  7. Encourage employees to recognize peers. Topdown recognition is not the only form of reward that matters or that motivates behavior. Also encourage team members to recognize one another. Allow a few minutes at the beginning or end of team meetings for your employees to recognize their fellow team members for their support and outstanding effort. (For an additional idea on encouraging employees to recognize peers, see the sidebar “Create a Team ‘Good’ Book.”)

  8. Reward team-supporting efforts. It is relatively easy to identify and reinforce the employee who is a standout for excellent performance. However, Krotz(6) warns that this strategy taken to an extreme can undermine teamwork. “Don’t talk up teamwork and then empower the player who always goes to the hoop and never passes,” Krotz says. Also be sure to recognize and reward the “player” on your staff who supports his or her teammates by passing the ball, Krotz suggests. Furthermore, when you wish to recognize and reward an individual for exceptional performance, ask him or her to identify who on the team supported the effort and helped to make the success possible.

  9. Time your reward to the appropriate stage of work. Geraghty suggests that rewards have a different impact on the employee’s motivation and subsequent performance during each stage of their work. Specifically, she suggests that rewards can act to motivate the employee to:

    1. Start a new task: In the initial stage of work, rewards serve to promote team “buy in” to start a new task. Rewards increase employee motivation to start a new task by 15%, Geraghty says.

    2. Persist: In this middle stage of a task, rewards serve as “motivational maintenance,” Geraghty says. They help teams persevere in the face of distractions, challenges, and competing work tasks. Rewards increase employees’ motivation to persist on a task by 27%, Geraghty says.

    3. Work smarter: In this stage of a task, rewards serve to increase the quality of the performance on the task. They contribute to the team investing more effort, to thinking of creative approaches to solve problems, and to devising new strategies to be more effective and efficient. Rewards increase working smarter by 26%, Geraghty says.

  10. Keep it simple. Ideally, a team rewards program will have two to four measures, not 12 to 14. According to Bares,(7) “Tying employees’ compensation to a performance indicator they do not understand or do not believe they can achieve will only produce frustration.” As Bares suggests, when it comes to team reward programs, “Less is more.”

References

  1. Irvine D. A workplace truism to remember: you get what you reward. EREMedia. November 5, 2012; www.eremedia.com/tlnt/a-workplace-truism-to-remember-you-get-what-you-reward/ . Accessed May 23, 2016.

  2. Schrage M. Reward your best teams, not just star players. Harvard Business Review. June 30, 2015; https://hbr.org/2015/06/reward-your-best-teams-not-just-star-players . Accessed May 24, 2016.

  3. Geraghty S. The basics of a successful employee rewards program. Talkdesk. March 29, 2013; www.talkdesk.com/blog/the-basics-of-a-successful-employee-rewards-program/ . Accessed May 31, 2016.

  4. Gallo A. How to reward your stellar team. Harvard Business Review. August 1, 2013; https://hbr.org/2013/08/how-to-reward-your-stellar-tea/ . Accessed May 24, 2016.

  5. Mitchell B. Individual vs. team rewards. Snowfly. http://snowfly.com/wp-content/uploads/pdf/Teams_V_indiv_Incentives_feb2013.pdf. Accessed May 24, 2016.

  6. Krotz JL. Reward employees for teamwork. Groco. www.groco.com/readingroom/bus_rewardteamwork.aspx . Accessed May 31, 2016.

  7. Bares A. Rewarding teamwork. Upsize. www.upsizemag.com/business-builders/rewarding-teamwork . Accessed May 26, 2016.

Overcoming Three Common Concerns About Rewarding Teamwork

Even though rewarding team performance will help medical practice managers achieve their goals for their practices, Mitchell(1) suggests that the strategy raises three valid concerns:

Reduced Individual Effort

Team reward programs that reward only overall group performance can be counterproductive. They may encourage some team members to reduce their efforts because they don’t think their contributions are noticed or matter. This phenomenon, known as “social loafing,” was first documented in a study by Williams and Karau(2) in 1995.

What to do: The most effective way to prevent or counteract social loafing is to design performance reward strategies that reward individual team members as well as the team as a whole. As Mitchell warns, “Despite enthusiasm for teams, the individual still wants to be recognized.” He recommends that managers develop programs that reward both individual and team performance. (See item #2 under “Assessing and Rewarding Teamwork: Ten Tips” in this article for Mitchell’s suggested balance.)

Competition

Another potential problem with team performance programs is competition between teams. According to Mitchell, “Constant competition between teams can deflect employee efforts away from achieving organizational goals and redirect them toward sabotaging other teams. This is not a healthy organizational environment.”

What to do: If you build competition into your team rewards program, do so only in controlled, short-term intervals, Mitchell suggests. Long-term competitive programs can be “dangerous,” he warns.

Underreporting

Another potential problem with team performance programs is the possibility of hiding or underreporting accidents and errors. This occurs in programs that reward teams for going long periods of time without mishaps. On the surface, this seems like a good strategy. However, Mitchell warns that such programs may encourage teams to hide or underreport accidents and errors.

What to do: When it comes to safety, don’t reward your team for avoiding errors and accidents. It is more effective to identify and reward non-accident and non-error behaviors such as education, safety checks, cross-checking, and meeting attendance, Mitchell says.

References

  1. Mitchell B. Individual vs. team rewards: the 75/25 rule. Snowfly. http://snowfly.com/wp-content/uploads/pdf/Teams_V_indiv_Incentives_feb2013.pdf. Accessed May 23, 2016.

  2. Williams K, Karau S. Social loafing and social compensation: the effects of expectations of coworker performance. J Pers Soc Psychol. 1991;61:570-581.

Types of Team Rewards

Team rewards programs can take various forms, ranging from cash rewards and public acknowledgment to prizes and group celebrations. The timing and frequency of rewards can also vary. But regardless of the strategy you choose, there will be three goals for your team reward program: to acknowledge the role of teams within your medical practice; to reward team performance; and to keep your employees motivated and committed to teamwork. Here are three types of team reward programs that can accomplish these goals:

  • Financial incentives: Performance-based bonuses and profit- or gain-sharing group incentives were traditionally based on large work units in large organizations. However, these strategies can be applied to smaller teams in the medical practice where members earn payouts for meeting team goals. This approach can boost cooperation and productivity and help teams stay focused on shared goals.

  • Recognition: Both formal and informal recognition can reinforce the value of teamwork. Public recognition can occur at a formal event and be commemorated with a plaque or certificate, or posted on your medical practice’s website. It can also take the form of a more informal “thank you” from your practice’s leadership, or even a well-timed, heartfelt email.

  • Teambuilding events: Group teambuilding workshops and retreats can help set a tone of collaboration and trust, reenergize a team, and boost morale. Team celebrations such as a thank-you lunch or bowling party can mark smaller achievements. Offering prizes for team accomplishments or top contributors can also help maintain productivity and keep employees engaged. As well, training programs and expanded decision-making authority are other ways to reward a team and increase its efficiency.

Source: American Psychological Association Center for Organizational Excellence. Making teamwork rewarding. Good Company. July 16, 2008; www.apaexcellence.org/resources/goodcompany/newsletter/article/48. Accessed May 31, 2016.

Recognize and Reward Teams Sincerely, or Not at All

The effectiveness of your team recognition and rewards program will rely heavily on your own attitude about it. According to Klubnik,(1) “The giver’s attitude about the process is important because it influences the nonverbal messages that accompany the recognition.” The best team recognition will be given by a medical practice manager or other individual who considers the reward to be deserved and a win/win proposition for the employees and the practice, Klubnik suggests. Both the giver and the receiver should gain as a result of the process, she says.

Without this mindset, team recognition and reward giving will probably be “less than successful,” Klubnik warns. The giver will be frustrated because he or she doesn’t feel right about giving the reward. And the receiver will become dissatisfied, Klubnik says, because of the nonverbal messages received during the giving process.

What should you do if you can’t recognize and reward your team sincerely? First, own your feelings. You’re entitled to feel as you do. Next, don’t give recognition and rewards through clenched teeth. Hold off until you can feel better about things. Then figure out what’s causing you to feel as you do. If the problem is that you’re just not comfortable giving praise, work on that. “The good news is that the giving process is a learned skill,” Klubnik says. However, if the problem is with the rewards program itself, change it so it feels right to you. Whatever you do, don’t give recognition and rewards that seem undeserved to you. It will come off as false. And you’ll be disappointed in the results.

Reference

  1. Klubnik J. Rewarding and Recognizing Employees: Ideas for Individuals, Teams, and Managers. New York: McGraw Hill, 1996.

Choose the Best Team Reward Schedule

Considering when to reward teams is critical to ensure that the reward system has the largest possible impact on behavioral change. According to Geraghty,(1) “The schedule of reinforcement can actually be more influential on behavioral change than the magnitude of the reinforcement.” There are two types of reinforcement schedules, Geraghty says: continuous reinforcement and intermittent reinforcement.

Continuous reinforcement occurs when every target behavior is rewarded. An example of this is paying a bonus every time an employee reaches a performance target. This type of reinforcement schedule is very effective in quickly shaping employee behavior when starting an unfamiliar task, Geraghty suggests.

In intermittent reinforcement, rewards don’t follow every target behavior response. This type of reinforcement will result in higher frequencies of the desired behavior. It is effective in maintaining the desired behavior after it has become a habit. Geraghty identifies four types of intermittent reinforcement schedules and describes how each has a different impact on team behavior:

  1. Fixed ratio: A fixed ratio reinforcement schedule occurs when a fixed number of behavioral responses occur before giving the reward. For example, a fixed ratio bonus is one that is tied to a fixed number of calls made or appointments scheduled. This type of reinforcement will increase performance.

  2. Variable ratio: A variable ratio reinforcement schedule occurs when a random number of behavioral responses occur before the reward is given. An example of this is when you give gift cards randomly to employees who have achieved goals. This type of reinforcement will result in an increase in desired behavior and the behavior will be more resistant to extinction or weakening, Geraghty says.

  3. Fixed interval: A fixed interval reinforcement schedule occurs when the first behavioral response after a specific period of time has elapsed is followed with a reward. For example, a fixed interval reward is a bonus that is paid on a regular basis. This type of reinforcement will produce an inconsistent performance pattern among employees. Geraghty does not generally recommend it.

  4. Variable interval: A variable interval reinforcement schedule occurs when the first behavioral response after random periods of time have elapsed is rewarded. An example of this would be when a practice manager gives praise randomly to excellent teams. This type of reinforcement schedule will result in an increase in desired behavior, and that behavior will be resistant to extinction and weakening.

Continuous reinforcement is very effective in quickly shaping employee behavior until it becomes a habit. However, once the behavior has become a habit, variable ratio and variable interval schedules of reinforcement are the most effective, Geraghty suggests. Using these schedules of reinforcement will result in the most significant behavior change in employees. In addition, this change is most resistant to weakening, Geraghty says.

Reference

  1. Geraghty S. The basics of a successful employee rewards program. Talkdesk. March 29, 2013; www.talkdesk.com/blog/the-basics-of-a-successful-employee-rewards-program/ . Accessed May 31, 2016.

Assessing Teamwork: A Reliable Five-Question Survey

What are some practical and effective questions that you can you ask your employees to help you assess their teamwork? According to Lurie, Schultz, and Lamanna,(1) the following five-item questionnaire can be completed in three minutes or less and has been shown to have acceptable internal consistency. These questions can yield reliable estimates of your employees’ underlying views of team effectiveness.

Ideally, every member of the team would strongly agree with each of the five statements. If your survey results are less than ideal, probe deeper to learn from your employees what you can do to improve things.

Reference

  1. Lurie SJ, Schultz SH, Lamanna G. Assessing teamwork: a reliable five-question survey. Family Medicine. 2011;43:731-734. www.stfm.org/fmhub/fm2011/November/Stephen731.pdf . Accessed May 31, 2016.

Create a Team “Good” Book

Bell(1) suggests a simple yet effective way to help your employees recognize and reward one another for their teamwork:

  1. Buy a notebook or journal and introduce it to your staff as its team “good” book. Keep it in a place that is accessible to your employees.

  2. Encourage your employees to write in your good book to recognize team members for their contributions and accomplishments, especially those that are work-related.

  3. Read the week’s new good book entries aloud at your regular team meetings.

Explains Bell, “Knights of old recorded good deeds in books for posterity.” A good book will empower your employees to recognize one another in the same way. It will help you foster a practice culture of recognition and gratitude, Bell suggests.

Reference

  1. Bell A. 33 amazing employee recognition ideas you need to be using. SnackNation. August 21, 2015; www.snacknation.com/blog/employee-recognition-ideas/ . Accessed May 31, 2016.

Laura Hills, DA

Practice leadership coach, consultant, author, seminar speaker, and President of Blue Pencil Institute, an organization that provides educational programs, learning products, and professionalism coaching to help professionals accelerate their careers, become more effective and productive, and find greater fulfillment and reward in their work; Baltimore, Maryland; email: lhills@bluepencilinstitute.com; website: www.bluepencilinstitute.com ; Twitter: @DrLauraHills.

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