Integrated Team Monitoring & Assessment
What is ITMA?
ITMA is a tool to assist those working in and responsible for integrated teamworking – one of the key proposals arising from the 2006 White Paper, Our health, our care, our say. Such teams need to know how well they are working, and they need to be able to improve, but assessing how a team is working is a complex process. The most appropriate action is to undertake regular audits.
The Purpose of ITMA?
The purpose of ITMA is to provide a relatively simple and cost-effective way of assessing the effectiveness of team working. It enables a rapid appraisal of the ‘health’ of a team and identifies areas of difficulty covering both internal functioning and external factors, thereby enabling a focus upon remedial action commensurate with the significance of the problems.
ITMA can do three main things:
- provide material to conduct an assessment on the current effectiveness of team working;
- with repeated use, allow changes in team functioning to be charted over time;
- provide a common framework and vocabulary for team members to develop a jointly owned approach to tackling some of the barriers to effective team working
On its own it will not reveal how problems associated with poor team working in any particular team should be addressed. Where ITMA findings expose weaknesses, tailored interventions will need to be used that reflect local needs and circumstances. The framework is generic and the purpose is to ascertain from team members how far they feel the contents of the framework characterise their own working arrangements. In particular, it will be important to distinguish between the internal functioning of the team (Principles 1-4) from external factors (Principle 5), since responsibility for action will probably involve different people.
The Four Stages of ITMA?
Stage 1: Preparation
It is important at the start of the process that partners agree the reasons for using the tool. Is the process to be mainly developmental, more of a routine audit or part of a more extensive remedial programme? Opening up this initial debate is often an important step in individual partners becoming more honest in their views about the workings of the team.
Stage 2: Gathering Data
At the heart of ITMA is the process of gathering data about the team through answers to a questionnaire. Team members are asked to respond to 30 statements by reflecting on their experiences and selecting from a range of possible responses.
Stage 3: Analysis and Interpretation of Data
The individual scores of team members are brought together to provide a picture of how the whole team is working, and to compare the responses of different types of team member.
Stage 4: Action Planning for Alternative Findings
Finally, an assessment has to be made about what the scores mean about the team, and what action to take in the light of this exercise. This will involve determination of priorities and drawing up action plans to ensure change happens.
Stage 1: Preparation
Stage 1: Preparation
For ITMA to work properly there needs to be clear agreement about the reasons for using it. There are several possibilities:
- to undertake a series of regular 'health checks' as part of a wider programme of service monitoring and review
- to explore and expose problems or to confirm apparent success
- a prospective exercise undertaken by partners just embarking on team working with a view to identification of ‘success’ factors
- a retrospective exercise by partners renewing or revising their joint working arrangements.
Whatever the purpose, it is important that everyone affected has the chance to discuss the reasons for using the tool and what is expected to be achieved. Facilitation of the process is important at two stages in particular:
- in introducing partners to the wider teamworking partnership context and the assessment process, and in helping them become familiar with the tool
- in analysis of findings across the partners, examination of issues arising and action planning
Often this facilitation will be conducted internally by someone from one of the parent agencies. Where this is the case, then it should be made clear to participants that this activity has the strong support of senior managers and policy-makers. Sometimes, and especially where it is expected to be difficult or sensitive, it may be better facilitated externally by agencies or individuals with experience in this area. Another important preliminary step is to be clear about - and to communicate - what will conclude the process in terms of feedback and action planning. Those participating need to be assured not only that taking the trouble to undertake the assessment is worthwhile but that they can be, and should be, frank and honest in their responses.
Stage 2: Collecting Data
Stage 2: Gathering Data
This is the main part of the exercise. In this section you will find 30 statements about team working grouped around four principles. In relation to each statement you are being asked to do three things:
- answer the question realistically: make a judgement about how you think the team actually is, not how you would like it to be;
- give your opinion as an individual: this is about what you think, rather than trying to reflect what the team thinks;
- make your comments: next to each score box there is room for comment in an expanding box, and the more you use this box the better ITMA will be an accurate tool
In each section you are asked to respond to a number of statements about the integrated team. All you have to do is decide your opinion on these statements by choosing one of four options, each of which carries a score which we would like you to insert in the appropriate box:
- Strongly Agree [SA] – Score 4
- Agree [A] – Score 3
- Disagree [D] – Score 2
- Strongly Disagree [SD] – Score 1
Principle 1 - Clear Purpose & Mission
Score 4 |
Score 3 |
Score 2 |
Score 1 |
The reasons for the team’s creation and function are understood and appreciated |
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There is wide support within the team for the team’s mission |
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The team is working towards clear aims and objectives |
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Team members are clear about the new policy agenda and the importance of integrated teams |
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Team members appreciate that by working together they can achieve more than by working separately |
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Team members receive adequate training and development for working together |
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Please briefly suggest ways in which you think performance on this principle could be improved:
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Total Score
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Principle 2 - Securing Ownership & Trust
Score 4 |
Score 3 |
Score 2 |
Score 1 |
There is a strong commitment across the team to making integration work |
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Team members feel that their contributions are equally respected and valued |
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Team members know they can rely on each other |
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Team members ask each other for help and support and receive it |
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Team members meet together sufficiently often to share information and views about service delivery |
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Team members mix together socially as well as professionally |
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Please briefly suggest ways in which you think performance on this principle could be improved:
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Total Score
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Principle 3 - Robust Working Arrangements
Score 4 |
Score 3 |
Score 2 |
Score 1 |
The roles and responsibilities of each team member are well understood |
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Effective arrangements for management and leadership of the integrated team are in place |
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Arrangements for accessing the team by users and fellow professionals are clear and understood |
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Team members are willing to work on tasks not normally seen as within their professional remit |
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All team members use the same electronic system for recording and sharing data |
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The team has the right membership to achieve its objectives |
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Please briefly suggest ways in which you think performance on this principle could be improved:
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Total Score
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Principle 4 - Learning & Review
Score 4 |
Score 3 |
Score 2 |
Score 1 |
Regular team meetings are held for peer support and sharing of good practice, and to monitor activity and performance |
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The team knows when it is working successfully and records its achievements |
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There are clear and effective arrangements for separate professional supervision and support where this is needed |
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The team encourages members to use their own learning and development skills in order to support each other |
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The team has clear ideas on how it can further improve performance |
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There are clear and effective arrangements for involving users and carers in the review process |
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Please briefly suggest ways in which you think performance on this principle could be improved:
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Total Score
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Principle 5 - External Links & Support
Score 4 |
Score 3 |
Score 2 |
Score 1 |
Parent agencies support the team and value what it is trying to achieve |
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The team is adequately resourced and supported to achieve its objectives |
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Partner agencies have laid down a clear and realistic timetable for the team to achieve its aims and objectives |
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The functioning of the team is not affected by organisational restructuring within the partner agencies |
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External performance management requirements are consistent with the aims and objectives of the team |
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The team is confident about its continuing existence and is able to make plans for the future |
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Please briefly suggest ways in which you think performance on this principle could be improved:
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Total Score
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Stage 3: Analysis & Interpretation of Data
Having filled in the scores for each section of ITMA Readiness Tool, you now need to interpret the meaning of the scores for each section, as well as the aggregate score. This is detailed in the boxes below.
Principle 1: Clear Purpose & Mission
A: 21-24 |
The reasons for the team’s creation and function are understood and appreciated |
B: 16-20 |
There is wide support within the team for the team’s mission |
C: 11-15 |
The team is working towards clear aims and objectives |
D: 10 or less |
Team members are clear about the new policy agenda and the importance of integrated teams |
Principle 2: Securing Ownership & Trust
SCORE |
INTERPRETATION |
A: 21-24 |
There is a strong commitment across the team to making integration work |
B: 16-20 |
Team members feel that their contributions are equally respected and valued |
C: 11-15 |
Team members know they can rely on each other |
D: 10 or less |
Team members ask each other for help and support and receive it |
Principle 3: Robust Working Arrangements
SCORE |
INTERPRETATION |
A: 21-24 |
The roles and responsibilities of each team member are well understood |
B: 16-20 |
Effective arrangements for management and leadership of the integrated team are in place |
C: 11-15 |
Arrangements for accessing the team by users and fellow professionals are clear and understood |
D: 10 or less |
Team members are willing to work on tasks not normally seen as within their professional remit |
Principle 4: Learning & Review
SCORE |
INTERPRETATION |
A: 21-24 |
Regular team meetings are held for peer support and sharing of good practice, and to monitor activity and performance |
B: 16-20 |
The team knows when it is working successfully and records its achievements |
C: 11-15 |
There are clear and effective arrangements for separate professional supervision and support where this is needed |
D: 10 or less |
The team encourages members to use their own learning and development skills in order to support each other |
Principle 5: External Links & Support
SCORE |
INTERPRETATION |
A: 21-24 |
Parent agencies support the team and value what it is trying to achieve |
B: 16-20 |
The team is adequately resourced and supported to achieve its objectives |
C: 11-15 |
Partner agencies have laid down a clear and realistic timetable for the team to achieve its aims and objectives |
D: 10 or less |
The functioning of the team is not affected by organisational restructuring within the partner agencies |
Aggregation of Data
A final step in data interpretation is to form an overall view on the significance of the aggregate ITMA scores in order to decide what further steps – if any – to take. The first step here is to complete the aggregate scoring box below, and compare these with the following table on how these scores should be interpreted.
ITMA PRINCIPLE |
MAXIMUM SCORE |
ACTUAL SCORE |
Principle 1: Clear Purpose & Mission |
24 |
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Principle 2: Securing Ownership & Trust |
24 |
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Principle 3: Robust Working Arrangements |
24 |
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Principle 4: Learning & Review |
24 |
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Principle 5: External Links & Support |
24 |
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TOTAL SCORE |
Maximum = 120 |
Actual = |
Interpretation of Aggregate ITMA Score
SCORE |
INTERPRETATION |
105 + |
A highly integrated team that represents a model of good practice |
80-104 |
A team that is developing well but is in need of some further support |
55-79 |
A partially developed team that needs significant improvement |
54 or less |
A fragmented team that shows no real prospect of improvement |
The Dartboard Presentation
The final scores and their interpretation can be accessed pictorially on an integration dartboard, along with a summary analysis of team functioning.
Put the total score for each principle in the appropriate segment below and shade that segment
The profile shows overall performance across all five principles. The nearer the shading is to the centre of the diagram then the healthier is the assessment of team performance. It is possible for a team to be doing relatively well on some aspects and less well on others.
Stage 4: Action Planing for Alternative Findings
The principal aim of ITMA is to enable generic assessment of teamworking. It cannot offer detailed prescriptions for addressing the problems identified in any particular relationship. How team weaknesses or problems are tackled – or how strengths are reinforced and replicated – must depend upon local circumstances and is likely to require specialist organisational development expertise. What is clear generally, however, is that whatever the findings, the assessment process must be seen to conclude with a plan for action. Three broad alternative scenarios are outlined below.
ACTION PLANNING FOR ALTERNATIVE FINDINGS
4a | 4b | 4c |
Assessment suggests the team is working well; members only need to consider how often to build in a regular review | Assessment suggests the team is working well in some respects, but there are concerns about others. Members need to decide how to address these areas of concern | Assessment highlights significant areas of concern that require urgent attention and a detailed plan of action |
Taking the first case (4a) if the findings show a broad consensus about the general strength and 'health' of team working, the action planning may need to consist of little more than agreeing how and when to undertake the next assessment. This could be a repeat exercise with the same individuals, or it could also entail assessments at different levels in the partner organisations. There might also be an agreement that no further formal assessment takes place unless there are important changes within the team or the context within which it operates. Whatever the apparent success of current team working, it will be worthwhile acknowledging that even the healthiest should have regular health checks.
In the case of the second broad scenario (4b) where some problems or weaknesses are identified, the action planning will focus on these areas. Where there is little sensitivity about the issues raised – whether individual or organisational – more detailed analysis of what underlies the assessment findings may well be conducted internally and informally. Where there is greater sensitivity, external facilitation may be preferable. Such exercises should help to provide:
- structured information about people's perceptions throughout the team and the contributing partners;
- opportunities to compare and contrast the views of different team members, thereby providing an opportunity to plan remedial action;
- a process which in itself opens up a debate that introduces more openness and transparency about partners' views on team working.
In the case of the third scenario (4c) action planning will need to embrace extensive and possibly urgent remedial action. This may involve a thorough re–examination of the team, from aims and objectives through structures and processes to working practices. Indeed, if the problems are serious enough it may require that the team is dissolved and re-formed. Whatever the outcome, it is strongly recommended that skilled and trusted external facilitators are used for scenarios 4b and 4c.
Once again, the benefits of using this assessment tool ought to be a clear indication of the nature and scale of problems, of where action is needed most and where it is required most urgently. And although it is a primarily diagnostic tool, the framework also provides a general prescriptive account of how team working can be strengthened. It is for those involved in particular team relationships to apply these general principles to their local circumstances.
Getting Further Help
In those cases where further help is needed, it will usually be best to bring in external support and facilitation. It is not appropriate in this tool to recommend any specific consultancies, though the tool has been devised by Professor Bob Hudson who can be emailed at bob@bobhudsonconsulting.com. Other sources of general support and information are:
The design task for ITMA has been undertaken by Densen Digital Experiences: www.densen.co.uk.