Team Rules | Quality 101 | Quality & Innovation | SHM | Society of Hospital Medicine

Establishing Team Rules

At your very first team meeting, it is key to establish the team “rules,” and that everyone explicitly agrees with them. It may even be useful to have all team members formally sign a document agreeing to these rules to communicate and stress their importance. The facilitator is usually given the task of gaining consensus and enforcing the team rules.

Download the team rules task sheet as a starting point. The team should modify the rules as needed and then officially record and acknowledge them.

To some, these rules may appear a bit preachy. However SHM's experience is that breakdowns commonly occur when these basic rules are ignored or violated.

Key Principle

Everyone on the team must be encouraged to speak up, and all views must be respected. Traditional concepts of rank have to go “out the window.” A unit clerk should feel comfortable telling the lead physician,

“I don’t think that will work because of [reason]. Why don’t we consider trying it this way?”

In addition to these rules, it should be made very clear that potential members should notify the leader immediately if they cannot devote the requisite time and effort so that a suitable replacement can be found. Timely minutes as well as a quick turnaround for comments/corrections should be the rule.

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.

Questions or Comments, please email