CHUM: collaborative healthcare utilization model--an example of a self-directed team in a hospital setting.

Self-directed work teams are innovative tools used in industry to improve productivity and quality. Work teams are complementary to the process of Total Quality Management (TQM) and build on the same foundations of customer satisfaction, goal setting, and staff education and training (Arikian, 1991; Sheehy & Musselwhite, 1990). The Collaborative Healthcare Utilization Model (CHUM) encompasses a self-directed team which enables nurse managers and physicians to lead a busy, tertiary care surgical service. The opportunity to develop CHUM arose when a middle management (director) position was removed from the nursing division. Development of the self-directed team included "selling" the idea and piloting the venture in an environment where work teams are not part of the organizational structure. The authors describe their experience in introducing a self-directed team into a hospital setting.