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This two-part study aims to contribute to the body of knowledge on team development by examining the development of self-managing teams (SMTs) in healthcare. Based on an exploration of the team development literature, a perspective on SMT development was created, which suggested that SMTs develop along a non-sequential pattern of three processes–team management, task management and boundary management and improvement–that is largely the result of individual, team, organizational and environmental-level factors.

The perspective on SMT development was assessed in a Dutch mental healthcare organization by conducting 13 observations of primary mental healthcare SMTs as well as 14 retrospective interviews with the self-management process facilitator and advisors of all 100 primary mental healthcare SMTs.

Empirical results supported the perspective on SMT development. SMTs were found to develop along each of the three defined processes in a variety or possible patterns or simultaneously over time, depending on many of the identified factors and three others. These factors included individual human capital, team member attitudes and perceived workload at the individual level, psychological safety, team turnover, team size, nature of the task and bureaucratic history at the team level, and management style and material and social support at the organizational level.

This study provides a non-sequential model of SMT development in healthcare, which healthcare providers could use to understand and foster SMTs development. To foster SMT development, it is suggested that cultural change need to be secured alongside with structural change.

Even though various team development models have been described in the literature, this study is the first to indicate how SMTs in the healthcare context develop toward effective functioning.