Team Assessment Questionnaire

TeamSTEPPS Long-Term Care Instructor Guide

The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.

INSTRUCTIONS:
This assessment is a statistical measurement of your impressions of team behavior as it relates to resident care in your current work setting. Please answer all 55 questions so an overall score may be calculated.

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Facility

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Unit

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Date

Team FoundationStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
1. The team has a clear vision of what it is supposed to do.     
2. The team's activities are guided by a clear Mission Statement.     
3. The team's goals are closely aligned with the goals of the nursing home.     
4. The team has adequate skills and member resources to achieve its goals.     
5. Everyone on the team has a clear and vital role.     
6. The team has adequate meeting time, space, and resources to achieve all objectives.     
7. Team meetings are well attended by all team members.     
8. The team can measure its performance effectively.     
9. The team understands its customer requirements (internal and/or external).     
10. This team is promptly informed of changes in policy or new developments.     
11. The department or unit has clear expectations of this team.     
12. The team receives adequate training to function effectively.     
Team FunctioningStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
13. Team meetings are run efficiently.     
14. Everyone on the team participates at an acceptable level.     
15. This team works well together.     
16. This team works well with other teams/departments in the nursing home.     
17. The goals and objectives of this team will have a positive impact on the nursing home.     
18. The team is on a continuous improvement curve.     
Team PerformanceStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
19. The team uses an effective short- and long-term strategic planning process.     
20. The team meets its (internal and/or external) customer requirements.     
21. The team is productive.     
22. Team functioning doesn't interfere with getting my own job done.     
Team SkillsStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
23. The team members communicate well with one another.     
24. Constructive feedback is given by the team.     
25. Team members are familiar with each other's job responsibilities.     
26. The team uses effective decisionmaking processes and problem-solving skills.     
27. The team monitors and progresses the plan of care.     
28. The team can change or improve the way it goes about working on its tasks.     
Team LeadershipStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
29. My boss/supervisor promotes participation by the team in key decisions.     
30. My boss/supervisor shares responsibilities with team members.     
31. My boss/supervisor is an effective leader.     
32. I share my ideas/suggestions whether or not my boss/supervisor agrees with my input.     
33. My boss/supervisor focuses on building team's technical and interpersonal skills.     
34. My boss/supervisor coaches and supports individual team members.     
35. My boss/supervisor promotes individual problem solving and intelligent risk taking.     
36. My boss/supervisor leads by example.     
Team Climate and AtmosphereStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
37. Team members trust each other.     
38. Morale on this team is high.     
39. Team members support each other.     
40. There are no feelings among team members that might pull this team apart.     
41. The team resolves conflicts soon after they occur.     
42. I feel free to express my opinions.     
43. I have an influence on team decisions.     
44. Team members can openly discuss their own problems and issues.     
45. Team members show consideration for needs and feelings of other team members.     
46. Team members receive recognition for individual performance.     
Team IdentityStrongly AgreeAgreeUndecidedDisagreeStrongly Disagree
47. I know why I am on a team.     
48. I am pleased to be on a team.     
49. The team subscribes to a clear set of values.     
50. This team is fun to work with.     
51. No individual, group or gender dominates team activities.     
52. The team has a positive self-image.     
53. The team recognizes the resident as a critical team member.     
54. The team is a safety net for residents.     
55. I am a member of a team in which the leader promotes teamwork.     

THANK YOU FOR FILLING OUT THIS FORM

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Current as of October 2008
Internet Citation: Team Assessment Questionnaire: TeamSTEPPS Long-Term Care Instructor Guide. October 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/sitetools/tmassess.html