Team Roles and Leadership

The concept of different roles held by members of a geriatric interdisciplinary team (GIT) is an essential and very complex element of effective team function. GITs are typically situated in a health care setting. One might assume that a physician team member would be expected to serve as the single team leader by virtue of historical and medicolegal precedents. Another view is that leadership is only associated with certain personality traits. However, team approaches to geriatric care require shared responsibility for the team process and outcome. Membership and leadership roles are inseparable and involve an emphasis on role functions rather than on a particular discipline or a set of personality traits.

Success involves the effective utilization of a team’s total resources. Although one or more individuals may have a formal designation as a group leader, the effective use of resources means that all members serve important leadership functions.

In order to progress, team members need to share responsibility for informal and formal leadership.

In true interdisciplinary teams the functions of leadership and membership are viewed as synonymous. Because all team members have an investment in seeing the team achieve its goals and objectives, each member has the responsibility to help the team progress.

The functions of leadership have been identified as including:

Helping the group decide on its purposes and goals.
Helping the group focus on its own process of work together so that it may become more effective rather than becoming trapped by faulty ways of problem solving and decision-making.
Helping the group become aware of its own resources and how best to use them.
Helping the group evaluate its progress and development.
Helping the group to be open to new and different ideas without becoming immobilized by conflict.
Helping the group learn from its failures and frustrations as well as from its success.

Consider the many leadership tasks associated with effective functioning of a geriatric ambulatory care program offering both consultative service and primary care in several environments. In one such program called GERICARE, the service requires team members of different disciplines to confer in team care planning meetings and to assign coverage for both regular and emergency patient calls. Like most programs, GERICARE has a designated formal leader, Dr. L, the clinic physician with the most expertise. However, Dr. L relies on colleagues of many other disciplines to help the team progress in its duties and maintain itself. There are a variety of administrative tasks requiring leadership (e.g., development of clinic policies and procedures, mobilization of resources for clinic operations, arrangement of schedules) as well as clinical care tasks needing leadership (e.g., establishing priorities for patient-specific care plans, coordinating family conferences).