Team Health Audit Questionnaire

Toolkit for Implementing the Chronic Care Model in an Academic Environment

To assess its strengths and weaknesses, hospital teams can use the Team Health Audit to identify barriers to successful team functioning.
 

Team Name: __________________________________________

Audit Date: ____________________________________________

Directions: Rate your level of agreement to the statements below, using a scale of 1-10. Write your rating on the blank line for each statement.

12345678910
Strongly
Disagree
DisagreeNot CertainAgreeStrongly
Agree

In your opinion:

_____     a.   The vision and mission of the team are clear and all members have agreed to work toward them.
_____     b.   Team members understand expectations and boundaries for team activities.
_____     c.   Specific and measurable goals have been defined.
_____     d.   The team purpose aligns with the large organization and with the needs and objectives of team members.
_____     e.   The team leader does a good job.
_____     f.    The contribution I can make to the team is clear to me and my fellow team members.
_____     g.   The knowledge, skills, and experience of our team members is appropriate for our mission.
_____     h.   Team members listen to and understand each other.
_____     i.    Information sharing is very good within the team.    
_____     j.    The team delegates tasks and follows up very well.
_____     k.   Team embers manage disagreements and conflicts constructively.
_____     l.    Plans are made, problems are solved, and decisions are analyzed effectively by the team.
_____     m.  Our team is making good progress toward our goals.
_____     n.   The team's measures are effective in tracking our progress.
_____     o.   Our team invests time in learning how to be a better team.

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Page last reviewed January 2008
Internet Citation: Team Health Audit Questionnaire: Toolkit for Implementing the Chronic Care Model in an Academic Environment. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/chroniccaremodel/chronic2a1.html