Key indicators of nursing care team performance: insights from the front line

Self-directed nursing care teams (NCTs), comprised of a registered nurse (RN) team leader and two or more non-licensed caregivers, are a key feature of patient-focused care reengineering. In well-functioning teams: (1) role overlap routinely occurs; (2) team members express satisfaction with interpersonal communication; and (3) team members express the belief that their shared purpose--and that of the health care organization--is the patient. Focus groups of team members in two case study hospitals expressed generalized dissatisfaction with performance on all three key imperatives of well-functioning teams, but also generally agreed that team delivery of bedside nursing care can work if properly managed. Based on study findings, recommendations for process improvement are made.