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Palliative care is a complex environment in which teams of health care professionals are constantly challenged to match the configuration of care delivery to suit the dynamics of the whole of a patient’s bio‐medical, social and spiritual situations as they change during the end of life process. In such an environment these teams need to engage in ongoing interaction between different professional disciplines, incremental improvement in care delivery, learning and radical innovation. This is aimed at combining operational effectiveness and strategic flexibility, exploitation and exploration in a way that ensures the best possible end of life experience for the patient. This paper examines previous research on the management competences and the organisational capabilities necessary for continuous innovation, and analyses evidence emerging from a study of palliative care. Work on the relationships between innovation capacities, organisational capabilities and team‐based competence is drawn together. Evidence is presented from research into the management of innovation in palliative care.

This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment. This highly innovative environment is singularly focused on relieving the suffering of patients and their socially related carers during an end of life experience. The singular focus enables and encourages palliative care practitioners to break through and diminish or accommodate professionally‐based paradigm conflicts and organisational politics. This facilitates collaborative team‐based efforts, including the patient and the patient’s social support group, to address the multi‐causal uncertainties that characterise end of life in palliative care. The continuous innovation model used in the European Union funded CIMA project is used as a starting point for this research. While many businesses have struggled to implement self‐regulating teams and have invested considerable resources in attempting to gain some advantage from teamwork it appears palliative care professionals have adopted self‐regulating work teams in a highly uncertain environment as the most suitable human resource structure and practice.

This paper is the second in a series that will examine the management of innovation by cross‐functional, multidisciplinary patient care teams in palliative care. Two further outcomes of this research are reported here. The first is that within palliative care a number of distinct individual behaviours are identified that act as foundations for the successful development and application of innovative practices by multidisciplinary teams. The second is that interviews with multidisciplinary palliative care teams in case studies in Australia confirm the existence and use of these behaviours. Individual behaviours within these teams are found to fall into two groups: those used by palliative care professionals when working with patients and patient‐based carers; and those used by professionals when dealing with each other away from patients. The purpose of both groups is to generate useful valid information, knowledge and learning that can be transferred across boundaries regardless of boundary type or location.

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an uncertain, complex and dynamic environment.

A range of literature was reviewed to suggest configuration and characteristics that were tested using semi‐structured interviews with the senior medical staff member at each of three Australian case study organisations. Data gathered from these interviews was supplemented with data gathered from semi‐structured interviews with multidisciplinary management teams and patient care teams dealing with inpatients and home‐care patients.

A hybrid configuration is suggested, based on Mintzberg's typology of organisations. Responses from interviews modify some characteristics of the suggested configuration, though generally appearing to support it. Characteristics of the external and internal environments are described.

Palliative care is rarely written off outside the healthcare literature and comparatively infrequently within it. Configuration is used to suggest the characteristics of innovative teams in an uncertain, dynamic, complex environment. The use and management of multidisciplinary patient care teams in palliative care offers interesting insights for a broad range of organisations.

A contribution to the discourse on the relationship between configuration and innovation based in organisations without commercial imperative, delivering multi‐level care for and by people involved in the end‐of‐life process.

The paper continues a line of publications, beginning in 2002, describing the management of innovation in multidisciplinary palliative care teams. The originality and value of this paper and this line of research is in taking a management view of a unique environment that offers insights and lessons to a broad range of organisations.

Palliative care is a complex environment in which teams of healthcare professionals are constantly challenged to match the configuration of care delivery to suit the dynamics of the patient's bio‐medical, social and spiritual situations as they change during the end‐of‐life process. In such an environment these teams need to engage in ongoing interaction between different professional disciplines, incremental improvement in care delivery, learning and radical innovation. This is aimed at combining operational effectiveness, strategic flexibility, exploitation and exploration, in a way that ensures the best possible care for the patient. This paper examines previous research on the management competences and the organisational capabilities necessary for continuous innovation, and analyses evidence emerging from a study of palliative care. Work on the relationships between innovation capacities, organisational capabilities and team‐based competence is drawn together. Evidence is presented from research into the management of innovation in palliative care.

This paper aims to investigate whether an organisation's configuration, with regard to its operating environment, could have a bearing on the learning that occurs within the organisation because the configuration can be considered an artefact capable of enabling learning and capable of facilitating the storage and utilisation of the results of learning. This raises an interesting question about the ability of organisations to shape the configuration that enables and facilitates them, which in turn would shape the learning itself.

Reported in this paper is research in healthcare organisations in Brazil and Australia that use a multidisciplinary model of care delivery which test these relationships.

The paper's findings indicate that in the Brazilian case learning has to do with the formal acquisition of knowledge for use within professions, by professionals who are in practice and teaching. In the Australian case learning has to do with the flexible acquisition of knowledge across professions, within and between teams.

This paper is useful to those wishing to facilitate learning in an organisation.

This paper is the third in a series that will examine the management of innovation by multidisciplinary patient care teams in palliative care in Australia and reports on the existence and use of organisational levers to enable and influence required characteristic behaviours in the teams. These levers work in concert with organisational capabilities to resource the required behaviours. Interviews with management teams in three Australian palliative care case study organisations confirm the existence and use of organisational levers. It appears that levers are available organisationally and utilised where necessary but fall into three distinct groups, those utilised by any person or group needing them, those utilised more specifically by management teams and those utilised by multidisciplinary patient care teams. It is noted that these groups are dependent on the existence of the levers for the optimisation of their efforts.

The purpose of the paper is to show that free flowing teamwork depends on at least three aspects of team life: functional diversity, social cohesion and superordinate identity.

The paper takes the approach of a discussion, arguing for a strong need to understand multidisciplinary and cross‐functional barriers for achieving team goals in the context of health care. These barriers include a strong medically dominated business model, historically anchored delineations between professional identities and a complex organisational environment where individuals may have conflicting goals.

The paper finds that the complexity is exacerbated by the differences between and within health care teams. It illustrates the differences by presenting the case of an operating theatre team.

Whilst the paper recommends some ideas for acquiring these skills, further research is needed to assess effectiveness and influence of team skills training on optimising multidisciplinary interdependence in the health care environment.

The paper shows that becoming a team member requires team membership skills.

This paper aims to explore the role of mental models in knowledge development in order to demonstrate how the type and strength of the mental models held by a team contribute to its success in general and to innovation in particular.

Two cases are analysed (a successful and an unsuccessful team) which were developed via observation and interviews. The mental models in each case were analysed to map them to the success or otherwise of the teams.

The first case demonstrates that mental models in a multidisciplinary team can provide opportunity for a shared generation of knowledge for process innovation while open to external influence. The second case demonstrates that, where there are strongly shared mental models that prevent the team from constructing an accurate picture of their present by closing out external influences and pre‐selecting desired knowledge, opportunities for innovation are shut down.

Where mental models provide a sharing framework without closing out the networks and systems that sustain them, they can foster and support innovation. Managing team openness becomes a priority for supporting innovation. Team leaders will need to consider what types of mental models are developing and foster a focus on innovative outcomes and not processes. A concentration on understanding the current context via challenging given assumptions is recommended.

The paper offers clear, practical examples of the results of teams being encouraged to utilise open and closed systems of mental models.