Team Members | Quality 101


The leader of a team is a permanent role for the life of the team. He or she should develop a preliminary plan for each team meeting. The leader is responsible to coordinate and focus the meeting activity on the mission of the team. The leader actively participates as a member by contributing ideas and participating in the team's processes and decisions. The leader is usually responsible for developing the record of the meeting outcomes and actions needed. The team leader requests assistance from a team facilitator when the team is struggling with its ability to work together and use effective team meeting skills.


The most effective teams have a trained team facilitator in a permanent role to meet with them and guide their use of meeting skills and tools. If assigned, the facilitator should be present at most meetings, especially in the early stages of development when the team is learning how work together and how to use the improvement tools. If a permanent facilitator is not assigned to the team, then one should be available to assist the team when they are struggling with team processes or when they need advice or skill training to effectively use problem-solving tools.

The facilitator functions as a team adviser with expertise in the processes and tools that help teams to be effective. The facilitator works with the team leader to make sure that information is gathered to study the issue being addressed, that an improvement plan is developed, and that the meeting record is being completed properly. The facilitator is the team’s liaison with the steering committee for resources and time. The facilitator must exercise personal discipline and not contribute ideas or participate in decisions regarding the process being studied.

The facilitator coaches the team in the use of team meeting skills and tools and gives impartial feedback to the members to improve their communication and meeting process. The involvement of the facilitator normally diminishes as the team members and team leader gain more knowledge and skills about team processes and tools.


Effective teams usually include four to six members, including the team leader. The team may be larger, but the time commitment usually increases and the speed with which the team begins to perform is slower. Team members are normally selected because they represent a part of the cross-functional process that is being improved. Sometimes, a team member from outside of the process is included to give the process “fresh eyes.” All members have a responsibility to participate and share their knowledge with mutual respect for other team members. Team members will also rotate to fulfill the roles or recorder or timekeeper at each meeting.


The recorder is a rotated position selected at the beginning of each team meeting based on the ground rules. The primary role of the recorder is to record content from brainstorming, consensus building, and other tools and processes on a flip-chart or white board that is visible to the team. It is important that the recorder write down what each team member says rather than what they interpret was said. Sometimes it is helpful to select two recorders when a lot of information needs to be logged.

Team members agree up front that they will not criticize the spelling or writing of the recorder. Every team member should be encouraged to fill this role, and be applauded for the patience and listening skills it requires. The recorder is a full participant in the team process while they are recording. Sometimes the team leader and other members need to make sure that the recorder is participating.


The timekeeper is also a rotated position selected at the beginning of each team meeting based on the ground rules. The primary role of the timekeeper is to call out the time remaining on each agenda item at intervals the team determines is appropriate when developing their ground rules. In this way, the timekeeper assists the team in staying on task and managing its time effectively.

FRIDAY, FEBRUARY 6, 2009: Bernie Dana and Dorothy Ray

If you need additional support in leading a quality improvement effort, SHM’s signature programs can guide your team through each phase and provide individual mentoring in areas such as care transitions (Project BOOST®), Glycemic Control (GC), Medication Reconciliation (MARQUIS), Atrial Fibrillation (AFIB) and Venous Thromboembolism (VTE). We also provide resources by clinical topic to help you find exactly what you need.

No matter where you are in the spectrum, SHM can assist you in your efforts. SHM encourages you to join the QI community and view the calendar for up to date information on key events and discussions around the quality and innovation movement.

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