These focus group data were compiled into a report which was presented in several feedback sessions, making it possible for each staff member on the unit to attend. The purpose of this second step in the process was not only to give the staff a report of the results of the focus groups they participated in but to also create a need for change. According to Kotter,47 the first step in any change process is to create a sense of urgency. He notes that "we underestimate the enormity of the task [of change], especially the first step, establishing a sense of urgency."47(p35) It is not uncommon for teams to deny that they have problems working together effectively even when they are obvious. Kotter47(p36) points out: "people will find a thousand ingenious ways to withhold cooperation from a process" they do not buy into. Focus group data, using quotations from staff members themselves, their patients, and the physicians they work with, were designed to be compelling and mitigate tendencies of staff to discount reality. These data were referred to repeatedly during the project.
After each presentation, staff members were asked if they were interested in working on a project to improve teamwork. As noted above, it is crucial in a change process to overcome complacency in order to gain the cooperation of those involved. Each group of staff indicated that they were committed to improving teamwork and supporting a project designed to improve it.