Organizational Restructuring
Interdisciplinary Team-Based Development

Hanover Health District

implemented this best practice in 1996 and ongoing

Qualifying under the Best Practices catalogue:
1 Establish Direction
12 Determine requirements
123 Structure the organization

Best Practice Summary
(how it works, how you measure it)

A business environment of rapid change along with increasingly limited resources necessitated an innovative organizational plan. In 1993 a Leadership Team was formed which lead the organization to development of a common mission statement and a set of shared organizational values. In 1996 the plan for an interdisciplinary team model was announced based on the following set of premises:

. Hanover Health District resources are prioritized to first hire, train and support the public health professionals needed to provide day-to-day quality customer services.

. Those public health professionals who provide direct customer service are in the best position to determine how to deliver that service. Leadership supports innovative team decisions for change, without penalty for failure, when those decisions are based on the organization's mission and shared values.

. "Technical expertise" is a separate concept from "supervision." Team members are encouraged to consult regularly with peers and, as motivated, to develop their own strengths (technical expertise) as determined by the needs of the organization.

. Interdisciplinary teams give the greatest flexibility and maximal "brain power" for ensuring that quality services are delivered both effectively and efficiently in an environment of rapid change.

. Given the limited resources, employees who possess a broad base of knowledge, skills, and abilities are the most useful to the organization.

. Time and workload management are both an employee and team responsibility.

Impact on the Process Organizational Performance (OUTCOMES)

The move toward self-directed interdisciplinary teams has allowed major reductions in management and supervisory positions largely as turnover occurred, thereby minimizing the impact on jobs and salaries. The result has been a substantial financial savings allowing the organization to both remain within its budget and continue delivering necessary services through purchasing needed direct service personnel and equipment. Primary teams organized by service delivery area have resulted in improvements in service delivery processes. The training required for such a transition has altered the organizational culture to one that is customer focused, based on a set of shared values, minimizes "turfism," and accustomed to dealing with change.

Best Practice Qualification

Although other team-based organizations exist, this particular interdisciplinary team model is unique in public health.

For Additional Information

Hanover Health Department
12312 Washington Highway
Ashland, VA 23005

W. Ted Tweel, M.D., M.P.H.
District Director
(804) 365-4348
wtweel@vdh.state.va.us

Steve Fuhrmann, Ed.D., R.N.
Operations Manager
(804) 365-4354
sfuhrmann@vdh.state.va.us

Daniel Warren, M.D., M.P.H.
Peninsula
dwarren@vdh.state.va.us

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