What enables high performance dispersed teams of health professionals in community settings?: An exploratory study

Ms Annette Zucco1, Professor David Greenfield2, Ms Wendy Geddes1, Mr Ken Hampson1

1South Western Sydney Local Health District, Bankstown, Australia, 2University of Tasmania, Rozelle, Australia

Background: Allied health professionals, at South Western Sydney Local Health District, work in dispersed teams in the community. This arrangement enables services to be delivered across significant distances with continuous physical separation, while requiring individuals to work as a cohesive team. High performance healthcare teams are associated with excellent clinical and patient outcomes, innovation and greater staff satisfaction. This study explores the factors that enable high performance of dispersed allied health teams.

Methods: An exploratory, qualitative study was conducted. Recruitment occurred using non-random purposive sampling from Drug Health, Mental Health and Primary and Community Health services. These services were chosen because they operate from various community locations utilising a dispersed team structure. Semi-structured interviews were conducted with service managers. An inductive thematic analysis was undertaken.

Results: There were 13 study participants, who managed teams with nine to 23 members dispersed across two to ten community sites. Team performance was shaped by three components: dispersed team structure, challenges of managing a dispersed team, and enabling a high performance dispersed team. Geographical distance and the ability to adapt to meet community need were reported as distinct features of a dispersed team. Participants described four management challenges: addressing day-to-day logistics, developing team connection, ensuring clinical care across numerous sites, and ensuring effective operational management. Participants described seven characteristics of high performance teams: communication, leadership, trust, resolving conflict, commitment to team goals, accountability, collective orientation to results, and effort. Two further characteristics important for dispersed health teams were identified: clinical governance, including supervision of clinical practice, and the opportunity for team face-to-face interaction.

Discussion and implications: High performance dispersed teams are built on a foundation of strong relationships. In order to be high performing, dispersed teams need to: deliver a service that meets community need, acknowledge and overcome the challenges of being dispersed, and work together to develop high performance team characteristics.


Annette Zucco is an occupational therapist who has worked in paediatrics for the majority of her career. She is currently Head of Department of Occupational Therapy, Primary and Community Health at South Western Sydney Local Health District. Annette completed a Master of Health Service Management (University of Tasmania) in 2018. She has an interest in developing high performance health care teams.

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