Table A1.

Workshop Inputs, Exercises and Outputs.

WS	Inputs	Exercises
WS1 January 2017 3 h workshop	Healthcare Team members: Presentation by team members on work of their team Health Systems Researchers: Presentation on Co-Lead research programme Presentation on Co-design as a method and the aims of the intervention and how we will evaluate it including exploring how teams currently measure team performance	Introductions Word association exercise using words: effective teams, patient safety, safety culture, leading in teams, joy and meaning Small group exercise: How can teams know they are performing well? What helps teams to know they are performing? How can teams consider patient safety? How can teams know they are contributing to the achievement of organisational goals? What values should guide healthcare teams? Discussion in pairs: Suggestions for planning components of future workshops
WS2 February 2017 3 h workshop	Healthcare Team members Reflection Exercise given in advance: Please reflect on a time when you were a member of a team that did not function so well, where being on the team was a source of frustration for you. Number of question given to aid reflection. Please read the following article: Weller J, Boyd M, Cumin D. Teams, tribes and patient safety; overcoming barriers to effective teamwork in healthcare. Postgrad Med J 2014; 90:149–154. Health Systems Researchers Presentation on trust as trust came up a lot in first session as essential for team performance.	Feedback from all Co-Design team members on Reflection Exercise People were asked to divide into pairs, share as much as comfortable from personal reflection on experience of being in a team that did not function so well. Individual feedback was gathered through Stickies exercise on 5 levels of barriers identified in reflection exercise Feedback was invited in main group on 5 levels and also on any learning from Weller article on how to overcome any of the barriers that might have been raised here. Developing Trust in healthcare teams Individual word association exercise before presentation and group discussion after. One different Case Study of effective team interventions given to three small groups to discuss following question in relation to each: Why do you think the intervention worked? Do you think this intervention would work in your organisation/team? What aspect do you think could be incorporated into the co-design intervention?
WS3 March 2017 3 h workshop	Healthcare Team members Each of the teams represented were given a PowerPoint template to fill in details on their team around the following themes: How the team was formed; team membership; understanding of roles and responsibilities on the team; communication, co-ordination and collaboration across team members; leadership and decision-making; dignity, social support and trust; relationship with the wider hospital, hospital group, health service. Health Systems Researchers Presented ‘honeycomb’ format of possible intervention pieces colour coded according to the three main concepts—Collective Leadership, Team performance and Safety Culture.	Each team presented on their ‘homework’ by using the PowerPoint template. Health Systems Researchers Exercises on developing intervention to improve team roles and relationships
WS4 April 2017 3 h workshop	Healthcare Team members Teams were given the exercise of developing an induction pack or set of headings for an induction pack to induct new people onto the team Health Systems Researchers Bringing together all the work to date from the first three workshops. Presented revised ‘honeycomb’ format of possible intervention pieces colour coded according to the three main concepts—Collective Leadership, Team performance and Safety Culture. Mapping the relationship of Co-Lead concepts (Collective Leadership, Team Performance and Safety Culture) onto Behaviours we hope to impact onto Intervention Components to change those behaviours Developing Collective Leadership Components of the Intervention	Presentation of draft and discussion on the three main concepts and how they relate to team behaviours and to the possible components of the intervention So for example: What behaviours would be witnessed / evident in a team where there was Collective Leadership? List all behaviours What intervention(s) would foster this / these behaviours? List all interventions according to the Collective Leadership behaviour they would promote. Taking a few Collective Leadership interventions and outlining those and asking the Co-design team to discuss if they would work in their team/organisation. It was felt we had covered some Team Performance interventions already but had not focused on Collective Leadership. Safety Culture it was felt could come later. “if you wanted to improve CL on your team, what would you do with your team? How would you do it and when would you do it?”
WS5 May 2017 3 h workshop	Healthcare Team members Two teams asked to think, based on the development of the intervention to date, which parts and how they would go about implementing it with their team. They were asked to give a presentation on this at the next workshop. National Clinical Lead Q&S made a presentation on Safety Culture and different frameworks to explore patient safety, safety culture, safety measurement. Health Systems Researchers Presentation on the behaviours needed for a good Safety Culture and what types of intervention would help foster those. Measurement and Monitoring of Patient Safety framework (Vincent et al. 2013) & results of study into what data is being gathered at the team level.	One team presented a ‘roadmap’ of a possible suite of interventions they felt their team needed based on the honeycomb map. Exercise on co-designing team-level Q&S indicators “What would you like to know about team performance?” The overall structure/template for the draft intervention toolkit was presented and some sample tools. Discussion on this. Two interventions were discussed in more details: Role Clarity and Team Charter/Team induction
WS6 June 2017 Day long workshop	Healthcare Team members Presentation on current status of Collective Leadership for Safety Culture Intervention Toolkit which included a set of ‘Foundational Components’ that each team should do and then a set of ‘Targeted Components’ that teams could pick and chose from depending on their needs and what emerged from the initial implementation of the Foundational Components. Facilitated discussion on Implementing the Intervention and the practicalities involved. Presentation on the suggested evaluation approach and scales and how each team would also select their own QPI/SPI to review and facilitated discussion on this. A discussion took place on the involvement of patient representatives in the process and how only one patient representative made the workshops. A spoken and written evaluation was carried out. The co-design team were reminded of each workshop’s activities and asked to evaluate their experience of the overall process.	Each person was asked to review: what would work for your team from current intervention components what is still needed for your team based on current list of component pieces The practicalities of implementing the intervention were discussed in detail: identifying intervention teams identifying local team members to run with the intervention involving PPI on each intervention team exploring what interventions have taken place with this team before identifying barriers and facilitators identifying start date for rolling out intervention setting up meetings with each intervention team to begin process/hospital senior management to inform of process Exercise to decide on scales to measure Effective team performance Collective leadership Safety culture Discussion on how to get further feedback from Patients, Patient Reps, Public on Toolkit
Workshop with Patient Reps & Advocates July 2017	A joint presentation was made by members of the research team and the patient representative who had participated in the co-design process on both the process of designing the intervention and the intervention components that had been agreed on along with evaluation criteria.	Small group discussions on their experiences of healthcare teams in hospitals or other healthcare settings and how that team’s functioning could have been improved from a patient safety perspective (to begin identifying any gaps in the intervention toolkit). Small group discussion following presentation on Co-Lead on how team’s performance could have been improved from a Collective Leaderhsip perspective (to continue identifying any gaps in the intervention toolkit). Detailed discussion in small groups on the intervention toolkit pieces and any gaps. Group discussion on implementation and evaluation, ideas/suggestions around this and their possible role in both.