In 1992, as part of a differently focused study, I observed social workers in action in multidisciplinary health teams in New Zealand. In one of these teams there was a considerable amount of bonhomie, laughter, and joking (occasionally against the patients). In a relatively strict order of speaking, the various health professionals reported back on their work with each patient, and decisions were made about discharge. This team was considered a good one to be on because people got along well and there were lots of jokes, which mitigated the overall stress of the work. There were, nonetheless, occasions when...

When human service agencies bring professionals from different disciplines together in teams, their organizational objectives typically emphasize achieving better coordinated and collaborative work to improve the quality of care offered to clients (Perkins and Tryssenaar 1994; Whorley 1996) and, through this process, to contribute to organizational efficiency and effectiveness.¹ Indeed, such teams are mandatory in some countries in some service domains, such as child abuse (Gilgun 1988) and assessment services for older people (Solomon and Mellor 1992). Teamwork rhetoric thus emphasizes the possibilities of a more integrated (if not holistic) professional approach to clients’ needs. The work of one professional...

The conditions for the production of effective teamwork are not restricted to ensuring adequate professional training and the production of competent professionals. These are germane factors, although the notion of training is a highly complex one, raising issues of degree, intensity, focus, and appropriateness. What attention to such factors excludes, though, is the importance of the organizational environment in which teamwork is practiced. All teamwork is produced within an organization. My argument is that rather than relying on generalized rhetoric about the value of teamwork, organizations concerned with the production of effective teamwork are necessarily attentive to the conditions under...

A key objective of this text is to take a familiar mode of service delivery in health care (teamwork) and, “by sailing in a new direction,” map the contours of an alternative paradigm, offering a different account, a different conceptual land (sea) scape in which to locate “teamwork.” Journeying, however, requires a map, and it is for this reason that the trope of “journeying/mapping” permeates the text. However, exploring new conceptual territories is not without its own hazards. Mapping describes both a time-consuming and uncertain process (producing the map recording the passage to an unknown destination) and a powerful act...

The major rationale for teamwork is that teams produce more effective work; at the same time there is a substantial absence of discussion based on close analysis of transcripts of team reviews about the shape and features of this supposedly effective work. The analysis produced here is not intended to result in a prescriptive list of conditions or factors against which the effectiveness of teams can be universally and authoritatively measured. Teamwork is a dynamic outcome of the intersection of professional and organizational discourses and objectives, the range of disciplines represented in a team, the organizational settings in which members...

This chapter begins with a discussion of the accounts of effective practices identified by team members, and it draws attention to the general absence of agreement on these practices, an issue that has considerable significance for the production of effective work. The second part of the chapter, “Difference Patterns and Increasing Subtlety of Vision in Team Practices,” moves, however, in a somewhat different direction. Basing the discussion on an analysis of the transcripts of a small number of team members, and employing Donna Haraway’s (1997b) concept of “diffraction,” I intend here to foreground how, within knowledge-based teamwork, close attention to...

The team meeting is the occasion where members formally meet to exchange information and knowledge about clients, and discuss and confirm ongoing plans for their care. Because much of the team literature has focused on team dynamics, there has been comparatively little attention in the past to examining how teams go about their work by analyzing transcripts of team reviews or discussions (but see Gubrium 1980). More recently, however, a number of authors have produced discussions of teamwork that draw on such evidence. For example, Roberta Sands (1993) discusses the ways in which an interdisciplinary team allocated tasks and negotiated...

Narrative is the most common method for ordering and refocusing experience (White 1981). In describing narrative as inseparable from human experience, Peter Brooks wrote: “Our lives are ceaselessly intertwined with narrative, with the stories that we tell, all of which are reworked in that story of our own lives. . . . We are immersed in narrative” (quoted in McCloskey 1990:7). Within their professional worlds human service workers attend to the narratives of others and create/author their own as part of their everyday work (Pithouse 1987). In this domain, representing a client narratively allows service workers to present and redefine...

The active involvement of clients, family, and significant others in decisions about clients’ health care implies a realignment of power relations away from the more established model of care, which defined patients as passive and grateful for services received (Gilleard and Higgs 1998). In Aotearoa/New Zealand and elsewhere (Lewis and Glennerster 1996) such changes reflect an increasing focus on a “consumer” ethos located within politically dense discourses of holistic care, professional and organizational accountability to consumers/clients, client choice, and the empowerment of clients and families in the processes of care (Shipley and Upton 1992; Ministry of Health 1994), efficiency, and...

The primary objective of this book has been to disrupt dominant representations of interprofessional teamwork and contribute to a new mapping of team practices more appropriate to the changing organizational settings, with their emphasis on professional accountability and effectiveness, in which teams work. The value of this text is that it locates the concept “teamwork” in postmodern theory and attends closely to the practice implications of that theorizing. The preceding chapters have foregrounded those elements of teamwork that have consistently been overlooked in conventional representations of that work, elements that are critical to the achievement of more effective team practices....