Have you ever been part of a great team at work, one that made you love to come to work every morning, filled you with energy, and encouraged you to accomplish goals you thought were impossible? On the flip side, have you ever been on a team where there was constant conflict and disagreement, where you were walking on eggshells and afraid to speak up or share honest feelings?
Based on industry metrics and the phasing into “premier sites” as well as communication with industry leaders from sponsors/CROs, we have found that high-performing teams are indeed rare. While there are a myriad of reasons for this, the role of the team leader in creating high-performing teams is worth exploring.
Team performance is highly correlated to leader performance.1 The reality of team improvement, however, is usually not that simple; saying that team improvement comes about only because of the leader’s performance risks an error of attribution. It is more likely that improvement comes also from a relationship between teammates in which each individual leverages the strength of the others.
Nevertheless, while teammates and the team leader together drive high performance, the leader’s influence on the team is significant enough that we can retain a focus on the leader as the catalyst for improvement. Leaders in high-performing teams know how to create energy and enthusiasm in the team through pull rather than push. Team members are inspired by a feeling that the work they are doing is of great importance. After all, what could be more fulfilling than having a role in advancing healthcare?

Which Leadership Behaviors are Most Critical in Improving Team Performance?

Among the common traits of high-performing teams, mutual accountability and a clear understanding of members’ responsibilities are the most critical factors contributing to the leader’s success.2 Does the team leader demonstrate respect and genuineness? Does he or she hold people accountable to a high level of collaboration? Team leaders who display these types of behavior typically develop followership by building trust, respect and loyalty.
These leaders also make conflict productive in order to positively impact team behavior and collaboration. They take other’s opinions into consideration and carefully weigh what others say. Perhaps most importantly, they don’t exercise positional authority. Unfortunately, giving up control and seeing beyond oneself is not the norm in leadership roles. It may not be surprising, then, that mutual understanding and respect are also the most commonly reported areas of needed development for team leaders.
Taking it a step further, research indicates that engaging in transparent communication is the most commonly reported area of needed development for team members. This could reinforce the assertion that if the team leader does not establish an environment of trust, mutual respect and camaraderie wherein members feel comfortable being candid, the entire team is negatively impacted. “Teams can execute more quickly, make better decisions, solve more complex problems, and do more to enhance creativity and build skills than an individual can. Their use also increases productivity and morale; well- functioning teams can outperform individuals and even other types of working groups.”2

What Do the Best Teams Do Best?

The best teams are continually being coached – by the leader and by each other. The leader engages the team, inspires it to action and holds it accountable to evolve, learn and grow. Mutual respect and a deep sense of purpose and commitment to the team’s members and to the mission allow for this coaching to occur in a safe environment. Wageman et al. studied 120 executive teams and found that every CEO in the sample had a strong external focus, attending to matters in the broader environment. However, the leaders of outstanding teams had an equally strong internal focus on how the team coached and
developed itself.3 Leaders also have a major impact on turnover and retention. The number one reason employees quit their jobs is because of a poor-quality relationship with their direct manager.4 No one wants to work for a boss who doesn’t take an interest in their development or validate their contributions. In sum, one of the most critical elements of building a high-performing team is the interaction between the leader and team members where the leader acts as a facilitator of team development and not the sole driver of the team’s performance.
Note: This article originally appeared in the Summer, 2019 edition of SCRS Insite: The Global Journal for Clinical Research Sites.

  1. Folkman, J. 5 Ways to Build a High-Performance Team. Accessed April 29, 2019 from:
  2. Developing and Sustaining High-Performance Work Teams. Accessed April 29, 2019 from:
  3. Wageman, R., Nunes, D.A., Burruss, J.A., et al. Senior Leadership Teams: What it Takes to Make Them Great. Harvard
    Business School Press. 2008.
  4. Valcour, M. If You’re Not Helping People Develop, You’re Not Management Material. Accessed April 29, 2019 from:

About the Author
Nicole Mills is Director of Clinical Research at Medix and currently works in our Scottsdale, Arizona office. Read more of here work here!