The Management Moment
Column Editor: Edward L. Baker
Creating Public Health Management Teams
That Work
Kimberley Freire, Rebecca Davis, Karl Umble, and Anne Menkens
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Coming together is a beginning.
Keeping together is progress.
Working together is success.
—Henry Ford
Public health has always required multidisciplinary
collaboration. In recent years, the field has redefined
how public health professionals should collaborate and
who should be included. For example, the Institute of
Medicine has called on public health leaders to collabo-
rate with private industry, media, healthcare, academia,
and government.1 The National Institutes of Health’s
“roadmap” states that “research teams of the future”
must be multidisciplinary and involve public and pri-
vate alliances to spur innovation and accelerate the
translation of science to practice.2 More broadly, the
global “New Public Management” movement, known
as “reinventing government” in the United States, calls
for agencies to decentralize and partner to develop cre-
ative solutions to health and social problems.2–4
So, public health managers have to link up with new
partners. But how can managers actually form collabo-
rative teams that improve public health work?
Frank LaFasto and Carl Larson, who have studied
thousands of teams in a variety of organizations, de-
fine teams as “a special type of collaborative group that
forms to create or change something specific.”5 Teams
are built to act. This makes them different from task
forces or boards that are formed only to advise or sup-
port an effort. Furthermore, collaborative teams rely on
joint decision making and peer leadership and may not
have a single leader with executive authority.5,6 Team
members, therefore, need to be able to work together
to accomplish specific tasks. Because health programs
can stand or fall depending on how well teams work
J Public Health Management Practice, 2008, 14(1), 76–79
Copyright C 2008 Wolters Kluwer Health |Lippincott Williams & Wilkins
76
together, developing competent teams has become a
priority in health management and leadership training.
Offered by the School of Public Health and the
Kenan-Flagler Business School at the University of
North Carolina at Chapel Hill, the Management
Academy for Public Health is a leadership and man-
agement training program that has worked with teams
of public health managers and community partners for
almost a decade.7 The Academy’s hallmark is its fo-
cus on team and project-based learning. Teams learn
skills in managing people, money, and data. To practice
the skills and develop innovative strategies, each team
develops a business plan for a health program within
its community or state. Nonprofit business experts and
academy faculty coach teams through business plan de-
velopment and implementation.8
Recently, we interviewed representatives from 40
teams who attended the academy during 2003–2005.
We asked them what factors are most important to
accomplishing team goals, in this case implementing
their business plans. Many of their conclusions echoed
LaFasto and Larson. We have selected the top five
themes to present here, along with some suggestions
for how you, as a manager, could try to implement their
advice.
Corresponding Author: Kimberley Freire, PhD, MPH, North Carolina Institute For
Public Health, Campus Box 8165, Chapel Hill, NC 27599 (freire@email.unc.edu).
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Kimberley Freire, MPH, is a doctoral candidate, Department of Health Behavior &
Health Education, School of Public Health, University of North Carolina at Chapel Hill.
Rebecca Davis, MPH, is a doctoral candidate, Department of Health Behavior &
Health Education, School of Public Health, University of North Carolina at Chapel Hill.
Karl Umble, PhD, MPH, is Program Planner and Evaluator, North Carolina Institute
for Public Health, School of Public Health, University of North Carolina at Chapel Hill.
Anne Menkens, MA, is Project Director, North Carolina Institute for Public Health,
School of Public Health, University of North Carolina at Chapel Hill.

● Team Members Must Commit to
a Common Goal
The first task of the team is to articulate and agree on
what they are trying to achieve. As one manager put
it, “You all need to know where you’re going and what
you’re doing.” Articulating a common goal is as much
about the process as it is the end point. Some respon-
dents explained that reaching a common goal meant
that all team members had input and “bought in” to
their overall business plan concept.
How can you keep the team goal-oriented? There is
nothing like writing things down to get them moving
forward. Get your team members to hash out exactly
what their expectations are, identify and agree on the
primary goals, write them down, and all sign the doc-
ument. In our office, we print out the list and make it
into a poster, laminated, and mounted on the wall of
our meeting room. At the end of the time frame for
the project, we put stars next to the goals that have
been met, add new ones, or carry over those that need
further work. Logic models are another excellent tool
for building consensus and mutual understanding of
where the team is trying to achieve—and how progress
can be measured.9
● Team Members Must Commit to Doing
the Work
When team members “buy in” to the project goal, they
are likely more motivated to execute project tasks than
when they concede to a majority or unilateral deci-
sion. As one respondent explained, “All people on
the team need to be passionate about the plan, other-
wise you’ll run out of steam halfway through.” This
seems particularly important for teams with few mem-
bers and those operating without a solid organiza-
tional structure to provide support and team replace-
ments. Good teams quickly identify members who are
not able or willing to see tasks through: the “weak-
est links” can drag on team members’ motivation and
progress toward their goal. But when they see all mem-
bers contributing, they draw on the energy and stay
focused.
How can you build commitment? Think about draw-
ing many people into your decision-making process,
so you are not just dumping work on people’s desks.
Once a project is under way, find out who needs and
wants more direction from you, and step in to help.
On the other hand, give more freedom to those who
want to work more independently. If you identify a
weak link, work with that person to identify how he or
she can contribute to the program, or what problems
Creating Public Health Management Teams That Work ❘ 77
he or she is experiencing that are not being expressed.
Strong social ties also help; we will put forth a lot of
effort to help our colleagues when we are also friends
in the journey. So team leaders should build the bonds
among team members—over meals or coffee, through
going to a ball game—to forge stronger commitment.
If you make your team more of a caring “family,” it
will be easier to address conflicts or misunderstand-
ings when they emerge. Strong teams must trust one
another’s commitment and intentions, as well as one
another’s wisdom and skills.
● Teams Should Build on Their Members’
Strengths
Management Academy strengthens management and
leadership skills. As managers’ skills grow, our research
shows, so does their confidence. Some team members,
however, are good at managing people, while others are
more comfortable—and effective—with money or data.
“Don’t try to make creative people into accountants,”
one participant told us, a sentiment echoed by many.
Identify team members’ strengths and “nonstrengths,”
identify leaders, and set people up to succeed at their
assigned tasks.
How can you identify and build on strengths? Many in-
dividual development instruments help identify indi-
viduals’ strengths and preferences with regard to work
style, personality traits that affect work, and strengths
to build on. Team-building experts often work such in-
struments into their activities, for the benefit of both
the manager’s and individuals’ own understanding of
their strengths and weaknesses. Use your team mem-
bers’ annual evaluations to talk about what they like
best to do, what you perceive they are best at, and think
about ways you can help them be more effective at all
of their tasks. If you do not use the instruments, start off
team projects with an open discussion of who is good
at what, how each member likes to work, and how the
team will function. That can help the team get off on
the right foot. Many teams find “team charters” to be a
great tool.10
● Team leaders Must Facilitate Effective
Communication
Collaborative leadership is driven by consensus instead
of executive decision making. That means communica-
tion is essential. Some of our participants believe that
the team leaders’ major role is to facilitate communi-
cation so that the team can reach agreement on ac-
tions. Team leaders should seek input from all team
78 ❘ Journal of Public Health Management and Practice
members and encourage dialogue among members,
especially when problems or conflicts arise. In fact, sev-
eral participants expressed that “healthy conflict can be
a dialogue,” and managing conflict through productive
discussions was key to progressing in plan implemen-
tation. With respect to leaders and communication, one
manager explained:
The leader needs to have the skill to manage the team. . .
to encourage [the person who is introverted] to give
ideas and concepts and make sure that the person that
tends to dominate the conversation is held to a
minimum—in a kind and tactful manner so that one
person does not dominate the entire plan.
Communication is important to bringing together
people with different personalities, work styles, and
perspectives to work toward a common goal.
How can you facilitate better communication? Do not
be afraid to bring up or deal openly with conflicts
or other difficult issues. Without pointing fingers or
putting any one on the spot, try to air things that seem
to be holding up work. Leaders may need to apolo-
gize for oversights or mistakes—and thereby to set the
tone for humility and problem-solving on the team. Be
sure also to communicate when things are going well:
hold up good examples of teamwork and accomplish-
ments, give “awards” that show you are recognizing
the hard work the team is putting in. At the end of a
period of hard work, our team often has a meeting in
which specific accomplishments are named and kudos
are generously given—supplemented with gourmet ice
cream bars!
● Balance Team Member Diversity and
Common Interests
Team diversity is important to accomplishing project
goals. Many participants talked about how different
skills, perspectives, and interests made their team
stronger. In particular, teams need expertise in fi-
nance and data management, program development,
and community outreach. Some participants, however,
found that common interests with teammates helped
build their relationships. For example, one team con-
sisted of epidemiologists from different health districts.
This team found their common backgrounds helped
them discuss project issues and empathize with their
teammates.
How can you build diverse teams that work well? If
you have a role in hiring process in your organiza-
tion, you may be able to build your staff with the
teams in mind. Hire people with good team skills, in
addition to technical competence. Hiring people who
“fit” with the values of the team and organization, and
who work well on teams, will help programs flourish.
Those kinds of people are also likely to stay longer
in your shop. In your dealings with the community,
local business people and other healthcare profession-
als try to forge connections with people who will bring
a different perspective to your teams. You may have to
educate people as to what public health is and does,
how public health affects many other realms of soci-
ety, and why they should care about (and become part-
ners with) public health practice. In sum, finding people
with different perspectives and interests can help your
team, as long as the interests are not extremely diver-
gent, and as long as they know how to work well on a
team.
As organizations move toward a new management
style that emphasizes collaboration and innovation,
competent teamwork is very important. In our study,
managers shared their advice on what managers and
supervisors should consider when developing teams
within their organizations, as well as when they link
across professional fields and sectors. Focusing on team
goal development, emphasizing project buy-in while
clearly defining individual tasks and goals, identify-
ing and using individual strengths, and allowing for
teams to be made up of members with variable skill sets
while building on common interests or backgrounds
are all key components to successful team develop-
ment. We recognize, and our own research shows, that
a large part of what makes a team successful is ex-
ternal to the team: the organizations, communities,
and other outside interests have substantial influence
on what teams can accomplish. A good start, how-
ever, is to build a team that has the best potential to
work.
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Creating Public Health Management Teams That Work ❘ 79
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