No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations
European Journal of Work and Organisational Psychology
Abstract
Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork.
... Support and guidelines from immediate leaders can reduce pressure among health professionals working together in the emergency department. This is consistent with previous studies Lyubovnikova, et al. [17] and Healy and Tyrrell [18]. For example, one study performed in Ireland by Healy and Tyrrell [18] informed that stress and heavy workloads among emergency department staff can be reduced if there is good teamwork and good managerial skills [19]. ...
... It is very important to understand that nurses are not likely to provide support for one another without a leader's instruction. Another research study conducted in the United Kingdom by Lyubovnikova, et al. [17] reported that the sickness and absences of healthcare staff and patients' mortality can be lowered if there is real team membership at the organizational level. 17 Another factor that was highlighted in the interviews was the lack of effective teamwork. ...
... Another research study conducted in the United Kingdom by Lyubovnikova, et al. [17] reported that the sickness and absences of healthcare staff and patients' mortality can be lowered if there is real team membership at the organizational level. 17 Another factor that was highlighted in the interviews was the lack of effective teamwork. Participants did not like the concept that they were required to work at any time without any assistance and they had a problem with their heavy workload. ...
The management of hospitals are facing increasing challenges in managing the service and quality of the emergency department. This study identifies the challenges faced by healthcare professionals who work in the emergency department and identifies practical solutions to enhance the sustainable management and leadership of the emergency department. A qualitative study was conducted with health professionals who work in the emergency department in three public hospitals in Saudi Arabia, including six managers, five physicians and seven nurses. Data were collected through one-on-one interviews from purposively selected the emergency department at public hospitals in Saudi Arabia. Three themes emerged from interviews that described the challenges and experiences of health professionals: ethical dimensions, management dimensions, and health system dimensions. The results of the current study indicate that patient overcrowding, long waiting hours in emergency departments, having to make decisions concerning which patients to treat first and the quality of services, leadership and team effectiveness were major contributors to the struggles faced by health professionals inside the emergency department. This study provides the most comprehensive information available to date about the challenges faced by the emergency department managers and leadership and provides suggestions to develop short and long-term strategies to reduce overcrowding in hospitals.
... Besides organisational effectiveness, teamwork is associated with the delivery of safe and high-quality care and increased job satisfaction (Kalisch et al., 2010;Lemieux-Charles & McGuire, 2006;Manser, 2009;Markle-Reid et al., 2010;Welp & Manser, 2016). At the same time, confusion and inconsistencies exist about the use of team and teamwork terminologies in healthcare (Flores-Sandoval et al., 2021;Lyubovnikova et al., 2015;Rydenfält, Borell, & Erlingsdottir, 2019). ...
... Due to the diverse and inconsistent use of terminologies related to teams and teamwork, a qualitative assessment of each study was conducted to determine if they actually were concerned with teamwork (Flores-Sandoval et al., 2021;Lyubovnikova et al., 2015;Rydenfält et al., 2017;Rydenfält, Borell, & Erlingsdottir, 2019). An inclusive approach to the definition of teams was applied. ...
... This study reviews the scope of the existing literature on teamwork in home care nursing. As previous studies have indicated, the terms team and teamwork are not always used in a consistent manner (Lyubovnikova et al., 2015;Rydenfält, Borell, & Erlingsdottir, 2019;West & Lyubovnikova, 2012). In comparison, the included studies did not always give a good indication of which professionals constituted the team (e.g. ...
Due to an increased number of complex multi‐ and long‐term ill patients, healthcare and nursing provided in patients' homes are expected to grow. Teamwork is important in order to provide effective and safe care. As care becomes more complex, the need for teamwork in home care nursing increases. However, the literature on teamwork in the patients' home environment is limited. The aim of this study is to describe the scope of the current literature on teamwork in home care nursing and outline needs for future research. Seven electronic databases were systematically searched and 798 articles were identified and screened. Seventy articles remained and were assessed for eligibility by two of the authors. Eight themes were identified among the 32 articles that met the inclusion criteria. Studies concerned with teamwork regarding isolated tasks/problems and specific teamwork characteristics were most common. Methods were predominantly qualitative. Multiple method approaches and ethnographic field studies were rare. Descriptions of the context were often lacking. The terms ‘team’ and ‘teamwork’ were inconsistently used and not always defined. However, it is apparent that teamwork is important and home care nurses play a crucial role in the team, acting as the link between professionals, the patient and their families. Future studies need to pay more attention to the context and be more explicit about how the terms team and teamwork are defined and used. More research is also needed regarding necessary team skills, effects of teamwork on the work environment and technology‐mediated teamwork.
... Rather, they should work as a team of generalists and specialists who each have a part to play in getting the patient back to full health (like the pit crew in Formula 1 racing). Improved teamwork can lead to improved clinical outcomes [22,23], patient experience [24], and healthcare worker outcomes [23,25]. Improved clinical outcomes include reduced rates of error and patient mortality [23]. ...
... Rather, they should work as a team of generalists and specialists who each have a part to play in getting the patient back to full health (like the pit crew in Formula 1 racing). Improved teamwork can lead to improved clinical outcomes [22,23], patient experience [24], and healthcare worker outcomes [23,25]. Improved clinical outcomes include reduced rates of error and patient mortality [23]. ...
... Improved teamwork can lead to improved clinical outcomes [22,23], patient experience [24], and healthcare worker outcomes [23,25]. Improved clinical outcomes include reduced rates of error and patient mortality [23]. Principal factors of the teamwork include role clarity, mutual trust, and quality exchange of information [22]. ...
Background
Wide-ranging concerns exist regarding the use of black-box modelling methods in sensitive contexts such as healthcare. Despite performance gains and hype, uptake of artificial intelligence (AI) is hindered by these concerns. Explainable AI is thought to help alleviate these concerns. However, existing definitions for explainable are not forming a solid foundation for this work.
Methods
We critique recent reviews on the literature regarding: the agency of an AI within a team; mental models, especially as they apply to healthcare, and the practical aspects of their elicitation; and existing and current definitions of explainability, especially from the perspective of AI researchers. On the basis of this literature, we create a new definition of explainable, and supporting terms, providing definitions that can be objectively evaluated. Finally, we apply the new definition of explainable to three existing models, demonstrating how it can apply to previous research, and providing guidance for future research on the basis of this definition.
Results
Existing definitions of explanation are premised on global applicability and don’t address the question ‘understandable by whom?’. Eliciting mental models can be likened to creating explainable AI if one considers the AI as a member of a team. On this basis, we define explainability in terms of the context of the model, comprising the purpose, audience, and language of the model and explanation. As examples, this definition is applied to regression models, neural nets, and human mental models in operating-room teams.
Conclusions
Existing definitions of explanation have limitations for ensuring that the concerns for practical applications are resolved. Defining explainability in terms of the context of their application forces evaluations to be aligned with the practical goals of the model. Further, it will allow researchers to explicitly distinguish between explanations for technical and lay audiences, allowing different evaluations to be applied to each.
... Coworkers collaborating in teams is a common way of working in the health-care sector and the quality of team collaboration has a direct impact on the quality of an organization's outcomes and performance (Boughzala and De Vreede, 2015). A large body of research indicates that effective team collaboration in health care is associated with increased patient safety (Manser, 2009;Häggström and Bäckström, 2014), reduced critical incidents and adverse advents (Manser, 2009), reduced patient mortality and sickness absence (Lyubovnikova et al., 2014), more effective use of resources and reduced health-care costs (Vyt, 2008). ...
... West and Lyubovnikova (2012) have discovered that groups of professionals in the health-care sector perceive that they are working in a team but are not truly meeting the criteria for a "real team." A team that does not fulfil the criteria for a team can be defined as a "pseudo team" (Lyubovnikova et al., 2014). The "pseudo team" is a group of individuals who call themselves a team but who have different views of the objectives for the team and who are working alone or in separate formations to reach those dissimilar goals. ...
... Reflecting on performed team collaboration to increase care quality and patient safety, and IJQSS 13,1 sharing experiences and knowledge together and over organizational boundaries should be a priority. This is in line with the study by Lyubovnikova et al. (2014) who state that working in "real teams" requires shared goals, interdependence, flexibility and reflexivity. ...
Purpose
Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward. Measuring team collaboration in the patient transfer process can help gain insights into how team collaboration is perceived and how it can be improved. The purpose of this paper is to describe the development and testing of a questionnaire aiming to measure perceived team collaboration in the patient transfer process from ICU to the general ward. This study also aims to analyze the results to see how the survey could help improve team collaboration within ICU transitional care.
Design/methodology/approach
Statements, factors and main areas intended to measure perceived team collaboration were developed from a theory. The questionnaire was tested in two ICUs at two hospitals located in Sweden, and the results were analyzed statistically.
Findings
The results showed that the questionnaire could be used for measuring perceived team collaboration in this process. The results from the survey gave insights that can be useful when improving team collaboration in ICU transitional care.
Research limitations/implications
The collaboration between two research subjects, Nursing Science and Quality Management, has given new perspectives in how cultural and systemic differences and opportunities can help improving team collaboration in ICU transitional care, by shifting focus from the individual to team, culture, system, process and continuous improvement.
Practical implications
The developed questionnaire can be used to measure perceived team collaboration and to identify areas for improving team collaboration in the ICU transitional care process.
Originality/value
There is a sparse amount of research about measuring team collaboration in ICU transitional care, and this study contributes to filling this research gap.
... (1) Team communication: regular communication between team members with the aim of adapting behaviours to function better collectively (e.g. Kock, 2007;Lyubovnikova et al., 2014) (2) Team competences and learning: unique or complementary skills and learning within the team (e.g. Katzenbach, 1998;Katzenbach and Smith, 1993) (3) Team composition, structure and membership: a bounded set of individuals (more than two) who perceive themselves and are perceived by others as a clearly defined social unit (e.g. ...
... 302). Similarly, Lyubovnikova et al. (2014) propose that an individual is a real team member when they report that their team's task requires them to work interdependently. ...
Purpose
The purpose of this paper is to describe the perception of real teamwork and sustainable quality culture as well as success factors for achieving a sustainable quality culture within an organisation, focusing on top management teams (TMTs). An additional purpose is to explore the relationship between real teamwork and sustainable quality culture.
Design/methodology/approach
A mixed-methods design focusing on TMTs was used. Four TMTs were open-sampled and located in different parts of Sweden. The data were collected through questionnaires and focus group discussions between April 2022 and December 2022. Follow-up meetings were thereafter held with the participants. A meta-analysis was conducted of the data from the four TMTs.
Findings
Two overarching conclusions of this study were: to follow the developed methodology can be one way to increase TMTs' abilities for real teamwork alongside a sustainable quality culture, and the results also showed the importance of a systems view, emotional commitment and continuous improvement for improving real teamwork and creating a sustainable quality culture.
Practical implications
Practical implications were suggestions on how to increase the TMTs' abilities for real teamwork alongside a sustainable quality culture. A deepened understanding of real teamwork and a sustainable quality culture was also achieved by the participants.
Originality/value
The novelty of this paper is the use of a new methodology for assessing teamwork and sustainable quality culture. To the authors' knowledge, no similar research has previously been performed to investigate teamwork alongside a sustainable quality culture, focusing on TMTs.
... Gremyr et al., 2020;Katzenbach and Smith, 2016;Salas et al., 2015;Woods and West, 2010) and outcome and who regularly communicate with each other with the aim of adapting their behaviours to function better collectively (e.g. Kock, 2007;Lyubovnikova et al., 2014). They are "together embedded in an encompassing organisational system with boundaries and linkages to a broader system context and task environment" (Kozlowski and Ilgen, 2006, p. 79). ...
... Katzenbach and Smith (1993) state that five elements are required to fulfil the definition of a real team: size, purpose and goals, skills, working approach and mutual accountability. Other requirements mentioned in the literature are that members of a real team identify themselves as being a member of a team, their team task require them to work closely and interdependently towards a common objective, clear and specified roles, mandate to decide how to carry out team tasks and regularly meetings to reflect, communicate and review team processes (Richardson, 2011;Lyubovnikova et al., 2014). In this paper is a real team seen as a team that possesses eleven prerequisites or capacities for acting as a real team. ...
Purpose
The purpose was to present a developed, tested and evaluated methodology for assessing teamwork and sustainable quality culture, focusing on top management teams (TMTs).
Design/methodology/approach
The developed methodology was based on a convergent mixed-method design, including two data collection methods: questionnaire and focus group discussion. Two pilot tests were performed with two TMTs. This design involved analysing, merging and interpreting data, first separately by data collection method and theme and then in a meta-interpretation. Lastly, there was a follow-up meeting for evaluating results.
Findings
Findings from the study were that the methodology can be used to assess teamwork and sustainable quality culture, and the results also showed the strength of using two data collection methods to provide a broader picture of teamwork and sustainable quality culture. A follow-up meeting validated the results and provided additional value to the two TMTs in the form of suggestions on how to improve their teamwork and sustainable quality culture.
Practical implications
Applying this methodology can guide TMTs in how to improve their teamwork and sustainable quality culture within their organisations.
Originality/value
This is a new methodology, containing a developed questionnaire and an interview guide, aiming to assess and evaluate teamwork within TMTs and sustainable quality culture. The practice of the methodology adds value to both TMTs and their organisations, as well as provides a theoretical and methodological contribution to research on teamwork and sustainable quality culture.
... [ [38][39][40] Patient safety (CS2) ...
... EM is considered a high-risk specialty in which inter-professional healthcare workers must engage to guarantee patient safety. Studies have shown that successful teamwork and communication training has improved patient outcomes [38][39][40]. However, Aouicha et al. described a worrying situation among those healthcare professionals in ED who lack a patient safety culture in their practice [41]. ...
The implementation of competency-based medical education (CBME) focuses on learners’ competency outcomes and performance during their training. Competencies should meet the local demands of the healthcare system and achieve the desired patient-centered outcomes. Continuous professional education for all physicians also emphasizes competency-based training to provide high-quality patient care. In the CBME assessment, trainees are evaluated on applying their knowledge and skills to unpredictable clinical situations. A priority of the training program is essential in building competency development. However, no research has focused on exploring strategies for physician competency development. In this study, we investigate the professional competency state, determine the driving force, and provide emergency physicians’ competency development strategies. We use the Decision Making Trial and Evaluation Laboratory (DEMATEL) method to identify the professional competency state and investigate the relationship among the aspects and criteria. Furthermore, the study uses the PCA (principal component analysis) method to reduce the number of components and then identify the weights of the aspects and components using the ANP (analytic network process) approach. Therefore, we can establish the prioritization of competency development of emergency physicians (EPs) with the VIKOR (Vlse kriterijumska Optimizacija I Kompromisno Resenje) approach. Our research demonstrates the priority of competency development of EPs is PL (professional literacy), CS (care services), PK (personal knowledge), and PS (professional skills). The dominant aspect is PL, and the aspect being dominated is PS. The PL affects CS, PK, and PS. Then, the CS affects PK and PS. Ultimately, the PK affects the PS. In conclusion, the strategies to improve the professional competency development of EPs should begin with the improvement from the aspect of PL. After PL, the following aspects that should be improved are CS, PK, and PS. Therefore, this study can help establish competency development strategies for different stakeholders and redefine emergency physicians’ competency to reach the desired CBME outcomes by improving advantages and disadvantages.
... However, the perceptions of teamwork may differ among HCPs, which may lead to HCPs working in dysfunctional teams. Such teams, termed "false teams" or "pseudo teams" [8], have been identified as threats to patient safety [8,9]. ...
... However, the perceptions of teamwork may differ among HCPs, which may lead to HCPs working in dysfunctional teams. Such teams, termed "false teams" or "pseudo teams" [8], have been identified as threats to patient safety [8,9]. ...
Background
The work of healthcare professionals (HCPs) in the emergency department (ED) involves effective communication and efficient teamwork, which may be perceived differently by patients and HCPs. Therefore, it is important to explore patient perspectives of information exchange and clinical assessment.
Aim
To evaluate experiences of care, communication, and teamwork from ED patients’ perspectives.
Methods
Semi-structured interviews were conducted with 17 patients who were assessed in a Swedish ED during Spring 2021. Thematic analysis was used.
Results
Participants’ experiences reflected the complex environment of the ED. Findings emphasize the importance of information exchange in relation to a caring approach. Three themes emerged: the need for a caring approach by HCPs towards patients’; the need for dialogue between patient and HCPs; and the need for information on ED environment constraints.
Conclusions
Patients felt comforted when they experienced a caring empathic approach from the HCPs. For example, patients valued an individual holistic approach rather than feeling that they were being objectified by their medical conditions. This was important in coping with the anxiety caused by a stressful ED environment. There is a critical need for effective exchange of information between patients and HCPs.
... Disparate perceptions of teamwork among HCPs and management can result in inappropriate teamwork, leading to a dysfunctional work environment. Lyubovnikova et al. [5] have Open Access *Correspondence: jenny.milton@gu.se shown a relationship between real team membership (i.e., the team has shared objectives, engage in team reflexivity, and show structural interdependence) and lower patient mortality. ...
... shown a relationship between real team membership (i.e., the team has shared objectives, engage in team reflexivity, and show structural interdependence) and lower patient mortality. Healthcare delivery by dysfunctional teams may undermine interprofessional communication and increase the frequency of errors, both of which have been shown to be associated with adverse events and patient mortality [5]. ...
Background
Interprofessional teams contribute to patient safety during clinical care. However, little is known about how interprofessional teams manage and cope with critical incidents in the emergency department (ED). Therefore, the study aimed to describe healthcare professionals (HCPs) perceptions of critical incidents linked to the enablers of and barriers to interprofessional teamwork in a high-risk setting, the ED.
Methods
Individual interviews with HCPs regarding events at the ED were held during the period of May 2019–January 2020. The Critical Incident Technique approach was used to guide the interviews and the qualitative analysis. Data were analyzed inductively using qualitative content analysis.
Results
Interview participants (n = 28) included 7 physicians (25%), 12 registered nurses (43%), 7 nurse assistants (25%) and 2 administrators (7%). Overall, 108 critical incidents were described. Eight categories that described functional and dysfunctional experiences within interprofessional teamwork were identified: salience of reflection; professional experience makes a difference; demanding physical and psychosocial work environment; balancing communication demands; lacking management support, structure, and planning; tensions between professional role and responsibility; different views on interprofessional teamwork; and confidence in interprofessional team members.
Conclusion
Findings of this study indicate that poor ED-specific communication and limited professional experience are essential factors in handling critical incidents related to interprofessional teamwork. An important aspect of critical incident management is the ergonomics of the physical work environment and how it enables interprofessional teamwork. This study emphasizes the factors enabling interprofessional teamwork to manage critical incidents in the complex working environment of the ED.
... Effective teamwork is crucial in ensuring patient safety and improving clinical outcomes. 83 In a systematic analysis of optimal approaches to delivering collaboration education programs in hospitals, Eddy et al. 84 identified six methods for promoting patient safetyfocused training. These methods include recommendations for leaders, such as incentivizing clinicians to participate in teamwork education programs, requiring program planners to identify learning needs prior to implementation, providing learning strategies that encourage collaboration through debriefing and reflection activities, and utilizing high-fidelity simulation to create more realistic opportunities for improving communication skills necessary for effective teamwork. ...
Ensuring patient safety is a crucial element in providing high-quality healthcare services. Therefore, this study aimed to assess the current state of patient safety culture in healthcare settings within low-and middle-income countries. A thorough search was conducted across multiple databases, including Science Direct, Scopus, Google Scholar, EMBASE, and PubMed. Data extraction was carried out using Microsoft Excel, and statistical analysis was performed using STATA software (version 14). To evaluate publication bias, methods such as Egger's regression tests, rank tests, and forest plots were utilized. The I2 statistic was used to assess heterogeneity, followed by an overall estimated analysis. Additionally, subgroup analyses were performed based on sample size and type of healthcare. After reviewing 1,143 articles, 21 publications involving 17,782 research participants were selected. The results indicated that the prevalence of patient safety culture in healthcare facilities in low-and middle-income countries was 48.25 percent (95 percent CI: 41.26, 55.24), with an I2 value of 78.8 percent. Among the various dimensions of patient safety culture, teamwork within units received the highest score (67.8%), while non-punitive responses to errors received the lowest score (27.6%). Compared to previous studies, it can be concluded that patient safety cultures in low-and middle-income countries are lacking, underscoring the need for targeted interventions to address this issue.
... Effective teamwork is crucial in ensuring patient safety and improving clinical outcomes. 83 In a systematic analysis of optimal approaches to delivering collaboration education programs in hospitals, Eddy et al. 84 identified six methods for promoting patient safetyfocused training. These methods include recommendations for leaders, such as incentivizing clinicians to participate in teamwork education programs, requiring program planners to identify learning needs prior to implementation, providing learning strategies that encourage collaboration through debriefing and reflection activities, and utilizing high-fidelity simulation to create more realistic opportunities for improving communication skills necessary for effective teamwork. ...
... At the same time, the physicians' status was visible through their understanding of themselves as the ones responsible for a patient's life and death. Medical responsibility was constructed as the decisive responsibility, even though research stresses the importance of nursing knowledge (Aaiken et al. 2014;Griffiths et al. 2016) and professional collaboration in teams (Lyubovnikova et al. 2015) for reducing patient mortality. This hierarchical polarization between care and cure has a long history; the professions are socialized into these epistemologies and identities (Wikström et al. 2018;Coombs 2003). ...
... The concept of shared objectives has been studied as a key characteristic of real teams (West and Lyubovnikova, 2012), and has been frequently associated with improved patient safety and staff well-being in healthcare organisations (e.g., Lyubovnikova et al., 2015). Satisfying important esteem and affiliation needs of team members, which, in turn, facilitates the generation of shared objectives, thus enabling heightened team outcomes (Lyubovnikova et al., 2018). ...
... The concept of shared objectives has been studied as a key characteristic of real teams (West and Lyubovnikova, 2012), and has been frequently associated with improved patient safety and staff well-being in healthcare organisations (e.g., Lyubovnikova et al., 2015). Satisfying important esteem and affiliation needs of team members, which, in turn, facilitates the generation of shared objectives, thus enabling heightened team outcomes (Lyubovnikova et al., 2018). ...
... Conversely, engaging with the workforce and promoting MW improves performance, reduces sickness absence rates and significantly promotes a safe collective working environment (Lyubovnikova et al., 2015). Organisations who do not consider employee wellbeing expose themselves to significant financial losses; PwC (2013) estimated this at £29bn per annum. ...
Purpose
The “Germanwings” air crash in 2015 in which 150 people were killed highlighted the challenges pilots working in the aviation industry face. Pilots regularly work for extensive periods in inhospitable and high-pressure operational conditions, exposing them to considerable work-related stress. This has raised calls for a more systemic cultural change across the aviation industry, championing a more holistic perspective of pilot health and well-being. The study aims to explore how peer coaching (PC) can promote an inclusive psychosocial safety climate enhancing pilot well-being and can mitigate hazardous attitudes and dysfunctional behaviours.
Design/methodology/approach
Adopting an interpretative phenomenological analysis (IPA), semi-structured interviews and questionnaires were conducted with military and civilian peer coach/coachee pilots and key industry stakeholders, totalling 39 participants. The research provided significant insights into the perceived value of PC in promoting both pilot health and mental well-being (MW) and flight safety across the aviation industry.
Findings
The study highlights four key PC superordinate themes, namely, coaching skills, significance of well-being, building of peer relationships and importance of confidentiality and autonomy. Such combined themes build reciprocal trust within peer conversations that can inspire engagement and effectively promote personal well-being. The contagious effect of such local interventions can help stimulate systemic cultural change and promote a positive psychosocial safety climate throughout an organisation and, in this case, across the aviation industry. This study provides a PC conceptual framework “Mutuality Equality Goals Autonomy Non-evaluative feedback, Skill Confidentiality Voluntary Supervisory (MEGANS CVS),” highlighting the salient features of PC in promoting MW.
Research limitations/implications
The study highlights the salient features of PC and its role in promoting peer conversations that enable personal transition, openness and acceptance. This study also highlights how PC and well-being can be used to encourage inclusivity and engagement, thereby strengthening institutional resilience.
Practical implications
This study highlights how PC that can assist HRM/HRD professionals to embed a more inclusive and salutogenic approach to MW that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours. It further notes that whilst the MEGANS CVS peer coaching framework has been applied to pilots, it can also be applied across all sectors and levels.
Social implications
This study highlights the value of PC as an inexpensive means to engage at the grassroots level, which not only improves personal performance, safety and well-being but by building peer relationships can also act as a catalyst for positive and deep organisational cultural change.
Originality/value
This study offers the MEGANS CVS framework that exposes insights into PC practice that can assist HRM/HRD professionals embed a more inclusive and salutogenic approach to health and well-being that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours, and whilst this framework has been applied to pilots, it can also have relevance across all sectors and levels. This study calls for a “salutogenic turn,” employing MW and PC to transform organisational capabilities to be more forward-thinking and solution-focused, promoting an inclusive “just culture” where leaders positively lead their people.
... 30 Health facilities with reported high levels of clear roles for each healthcare worker and management who is mindful of interdependence have lower rates of injuries and illnesses on duty and low turnover of healthcare workers. 31 Participants in this study reported positively on the ability of ClinAs to work with other healthcare workers, perform any act delegated to them and their understanding of their scope of practice. These outcomes indicate the contributions of ClinAs to teamwork and a holistic approach to the delivery of healthcare services. ...
Background: Clinical associates (ClinAs) were introduced into the South African healthcare system to increase the numbers of skilled health professionals. Little is known on how they are viewed. This study explored stakeholder views on the utility and employment strategies of ClinAs in the public sector.
Methods: A mixed-methods design was used. An online survey was used to collect data from operational stakeholders, while online interviews explored strategic stakeholders’ views.
Results: Forty-five operational stakeholders participated. The view of ClinAs’ contribution to the joint management of four common health conditions was strong (91% – 96%). The poorest agreement was their perceived contribution to maternal health (38%). There was a strong agreement (mean = 6.13, s.d.: 0.94) that conditions of ClinAs practice are met. Clinical associates were viewed as being able to work with others (mean = 6.11, s.d.: 0.98) and contribute to service improvement (mean = 6.47, s.d.: 0.62). There was a low agreement regarding the positive impact of recruitment (mean = 2.93, s.d.: 1.99) and retention strategies on ClinAs (mean = 2.75, s.d.: 1.51). The six key strategic stakeholders ascribed the slow progress made in career development, career progression, post creation and professional autonomy to the uncertainty regarding the scope of practice and perceived lack of support.
Conclusion: The utility of ClinAs to provide health services in the public sector is clear, and their contribution is valued. The lack of progress around many of the human resource issues is a constraint that needs a champion if this cadre is to fully realise their potential.
Contribution: Clinical associates are valued at service delivery level, but appear overlooked higher up.
... Effective teams are better prepared to protect patients from risks and to improve clinical outcomes [159]. In a systematic review investigating the most effective strategies for providing teamwork education programs in hospitals, Eddy et al. [160] recommended six strategies to facilitate programs aligned with cultivating a patient safety culture. ...
Introduction: Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America.
Purpose: Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC).
Methods: This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated.
Results: In total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66).
Conclusions: Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.
... That is, team practice outside real-world situations is negligible. Studies have shown the relationship between teamwork within units and clinical patient outcomes, including error rates and patient mortality [37,38]; therefore, Austrian hospitals should implement team training to improve teamwork within units. A meta-analysis showed that team training may improve healthcare [39]. ...
This study aimed to investigate the patient safety culture in Austria. We identified factors that contributed to a higher degree of patient safety and subsequently developed evidence-based suggestions on how to improve patient safety culture in hospitals. Moreover, we examined differences in the perception of patient safety culture among different professional groups. This study used a cross-sectional design in ten Austrian hospitals (N = 1,525). We analyzed the correlation between ten patient safety culture factors, three background characteristics (descriptive variables), and three outcome variables (patient safety grade, number of adverse events reported, and influence on patient safety). We also conducted an analysis of variance to determine the differences in patient safety culture factors among the various professional groups in hospitals. The findings revealed that all ten factors have considerable potential for improvement. The most highly rated patient safety culture factors were communication openness and supervisor/manager’s expectations and actions promoting safety; whereas, the lowest rated factor was non-punitive response to error. A comparison of the various professional groups showed significant differences in the perception of patient safety culture between nurses, doctors, and other groups. Patient safety culture in Austria seems to have considerable potential for improvement, and patient safety culture factors significantly contribute to patient safety. We determined evidence-based practices as recommendations for improving each of the patient safety factors.
... Open access research, a statistical and practical significant relationship between patient mortality and the use of management tools. 4 By management tools we refer to concepts such as leadership, culture, organisation and work/job design which can enable healthcare professionals to work in real teams, with shared objectives, structural interdependence and engagement in team reflexivity. Furthermore, Edmondson et al highlight that the healthcare profession is one of 'high stakes' facing a significant level of uncertainty in delivering care to patients, yet there are significant variations in psychological safety among groups within the sector. 5 In order to deliver good quality care to the patient, Kohn et al argue that safe organisational systems need to be designed. ...
Introduction
Patient and public involvement (PPI) has not been used to its full potential when examining the organisational science and management principles side of healthcare. With more and more acknowledgement of the relationship between management tools and patient outcomes, having meaningful engagement with the patient and the public in conducting research with the potential to enhance the patient experience, has never been more important. This study aims to outline the process in identifying members for a PPI for the organisational science and management principles side of healthcare, as well as providing guidelines for the establishment of PPIs in this nascent field. In addition, it aims to produce a charter for the panel, by and with the panel members, ensuring they are involved at every stage of research.
Methods and analysis
A hybrid of both a priority-setting and partnership approach to PPI will provide guidance on identifying, recruiting and establishing a PPI for research on the organisational science and management principles in healthcare. The panel will consist of approximately 20 members including patients, members of the public and researchers. A World Café approach to panel workshops will be adopted to produce a charter for the group. An assessment of panel engagement will be conducted through analysis of records of the meetings/workshops, as well as one-to-one interviews with all panel members at key points in time. Assessment criteria will be agreed with all members of the PPI panel. Data will be transcribed and managed using NVivo through a thematic analysis.
Ethics and dissemination
Ethical approval for the evaluation of the PPI has been received from the Kemmy Business School’s Ethics Committee. Papers outlining the process in establishing a PPI in the area of organisational science and management principles of healthcare, and the results of the assessment of the panel’s engagement will be published in journals.
... Teamwork plays an important role in the prevention of adverse events [5]. A largescale survey by the UK National Health Service reported that efficient teams had lower levels of patient mortality and sickness absence [6]. In another study, the implementation of a team training program reduced the surgical mortality rate of inpatients by 18% [7]. ...
Introduction:
Communication and teamwork are critical for ensuring patient safety, particularly during prehospital cardiopulmonary resuscitation (CPR). The Team Emergency Assessment Measure (TEAM) is a tool applicable to such situations. This study aimed to validate the TEAM efficiency as a suitable tool even in prehospital CPR.
Methods:
A multi-centric observational study was conducted using the data of all non-traumatic out-of-hospital cardiac arrest patients aged over 18 years who were treated using video communication-based medical direction in 2018. From the extracted data of 1494 eligible patients, 67 sample cases were randomly selected. Two experienced raters were assigned to each case. Each rater reviewed 13 or 14 videos and scored the TEAM items for each field cardiopulmonary resuscitation performance. The internal consistency, concurrent validity, and inter-rater reliability were measured.
Results:
The TEAM showed high reliability with a Cronbach's alpha value of 0.939, with a mean interitem correlation of 0.584. The mean item-total correlation was 0.789, indicating significant associations. The mean correlation coefficient between each item and the global score range was 0.682, indicating good concurrent validity. The mean intra-class correlation coefficient was 0.804, indicating excellent agreement.
Discussion:
The TEAM can be a valid and reliable tool to evaluate the non-technical skills of a team of paramedics performing CPR.
... For example, West and colleagues showed that healthcare professionals are more effective when leaders are compassionate, whereas they perform worse when they perceive high degrees of control and coercion (West et al., 2014). Furthermore, when healthcare workers feel their work and needs are acknowledged and valued, their satisfaction, commitment, and sense of belonging increase [37], they make fewer mistakes and report fewer relational problems with colleagues [78,79]. At the same time, experiencing compassion at work has positive effects on personal well-being. ...
Managing the COVID-19 pandemic posed several challenges for healthcare professionals, which likely heightened their risk of burnout (Amanullah and Ramesh Shankar, 2020) and, consequently , their general physical and mental health. Although it may not be possible to address and eliminate the causes of burnout, current research informs healthcare organizations about protective strategies to reduce its detrimental consequences. The promotion of compassionate interactions among healthcare professionals may play such a role. Compassion within healthcare organizations positively affects individual performance and well-being. Building on these considerations and within the framework of the Conservation of Resources theory, this study explores the relationships among burnout dimensions, received compassion at work, and general health in 711 Italian healthcare professionals (68.5% female), aged between 21 and 73 years (Mage = 36.4, SD = 11.2). Analyses were conducted to investigate the association between burnout and general well-being (H1) and between burnout symptoms and perceived compassion at work (H2); and the mediational role of compassion in the relationship between burnout symptoms and general well-being. H1 and H2 were confirmed (r < 0.01 for both), and a SEM model showed the mediating role of compassion at work in the association between burnout symptoms and general well-being (RMSEA < 0.08, SRMR < 0.08, CFI and TLI > 0.90). Theoretical and practical implications of the findings are discussed in the paper.
... Effective teamwork is associated with fewer medical errors [24] and decreased mortality [25]. Lyubovnikova et al. [26] reported that effective teamwork protected patients from harm and created a positive and engaging workplace. Healthcare professionals in labor wards perceived teamwork and open communication to be important for the safe care of women in childbirth [27]. ...
Background
In complex healthcare organizations, such as intrapartum care, both patient safety culture and teamwork are important aspects of patient safety. Patient safety culture is important for the values and norms shared by interprofessional teams in an organization, and such values are principles that guide team members’ behavior. The aim of this study was 1) to investigate differences in perceptions of patient safety culture and teamwork between professions (midwives, physicians, nursing assistants) and between labor wards in intrapartum care and 2) to explore the potential associations between teamwork and overall perceptions of patient safety and frequency of events reported.
Methods
The design was cross-sectional, using the Swedish version of the Hospital Survey on Patient Safety Culture (14 dimensions) and the TeamSTEPPS® Teamwork Perceptions Questionnaire (5 dimensions). Midwives, physicians, and nursing assistants in three labor wards in Sweden in 2018 were included. Descriptive statistics, the Kruskal–Wallis H test, two-way ANOVA, and standard multiple regression analysis were used.
Results
The questionnaires were completed by 184 of the 365 healthcare professionals, giving a response rate of 50.4%. Two-way ANOVA showed a significant main effect of profession on two patient safety culture dimensions and one teamwork dimension and a significant main effect of labor ward on four patient safety culture dimensions and four teamwork dimensions. A significant interaction effect of profession and labor ward was found on four patient safety culture dimensions and four teamwork dimensions. The regression analysis revealed that four out of the five teamwork dimensions explained 40% of the variance in the outcome dimension ´Overall perceptions of patient safety´.
Conclusions
The results of the study indicate that profession and labor ward are important for healthcare professionals' perceptions of patient safety culture and teamwork in intrapartum care. Teamwork perceptions are significant for overall patient safety.
... Research suggests that when team members work in silos and fail to share information, patient safety is put at risk (Lyubovnikova et al., 2015). Non-technical skills (NTS), encompassing interpersonal and interprofessional communication skills, are essential for optimal team performance and necessary for the delivery of efficient and safe care. ...
In healthcare settings, suboptimal interprofessional teamwork and communication contribute to unsafe care and avoidable harm. Interprofessional teamwork is essential in high-risk clinical areas such as the emergency department (ED). The aims of this study were to describe interprofessional teamwork in a hospital ED and to evaluate factors influencing interprofessional communication before and after implementation of a department-wide multifaceted intervention. Structured observations were under-taken during 2015/16 and 2019. Differences in interprofessional communication practices, teamwork, and sources of interruptions were compared before and after the intervention. The following domains were surveilled: (a) healthcare professionals (HCPs) communication initiatives, (b) HCPs' contribution to patient assessment, (c) interprofessional communication processes, and (d) team interruptions. The intervention included strategies to enable use of communication tools, changes to team structures, changes in work environment, ethical principles, and establishment of a code of professional conduct during interprofes-sional communication. Team interruptions significantly decreased post-intervention, and our findings suggest that organizational changes affect domains of teamwork. Statistically significant differences were observed in the initiated communication pre-intervention and contribution to patient assessment significantly increased post-intervention. Multifaceted organizational interventions can positively affect interprofessional team communication and work-flow in the ED, thus patient safety and quality of care can be improved. ARTICLE HISTORY
... Among the team climate factors, common goals and task orientation were the elements that most contributed to satisfaction at work, which suggests the importance of both dimensions for the implementation and performance of teams. The existence of common and clear objectives is described as a key characteristic of effective teams 11 and is associated with the well-being of professionals and improvement in patient safety 26 . It was also observed that the greater the team climate in relation to team goals and task orientation, the greater the satisfaction with hierarchical relationships. ...
Objective:
To analyze the association between team climate, team characteristics and satisfaction at work in teams of the Estratégia Saúde da Família com Saúde Bucal (Family Health Strategy with Oral Health) (ESF with SB).
Methods:
Cross-sectional correlational study with ESF teams with SB in the municipality of São Paulo. Universe of 1,328 teams and random sample of 124 teams with 1,231 professionals. Applied questionnaire with data teams' characterization, team climate scale, and satisfaction at work. Analysis of validity, of climate and satisfaction scores through mean among professionals in each team, cluster analysis, association between variables by Pearson's correlation and Chi-square, and tested linear regression model for the two factors of satisfaction at work.
Results:
There was a directly proportional association between team climate and satisfaction at work. The better the climate with regard to team goals, the greater the intrinsic satisfaction at work and with the physical environment. The better the climate with regard to team goals and task orientation, the greater the satisfaction with hierarchical relations. The group with best team climate reported higher percentage of teams ranked with better satisfaction at work, and in the group with the worst team climate there was higher percentage of teams with the lowest satisfaction at work.
Conclusions:
The study provides consistent although moderate evidence of association between favorable teamwork climate and job satisfaction in ESF with SB. It emphasizes the dimensions of climate, common goals and task orientation, and may serve as subsidy for management and permanent education of teams, aiming at the quality of care to the health needs of users, family and community in APS.
... Team work has been so palpably at the core of the response to the pandemic. We have always known that teams and team working are important: good care is the production of functional teams and not individuals [6]. Team skills are included in curricula but recognized more in theory than in practice. ...
The COVID 19 pandemic has not only been a massive disruptor of the delivery of health care but has also disrupted the education of many health care professionals including doctors in postgraduate training programmes. Supporting these individuals and getting their training on track is clearly a priority for educators. But the impact of the pandemic has created opportunities and exposed some important questions for health care education. Some of the ways these may be harnessed and used to expedite the modernisation of medical education are explored in this paper.
... Future studies should try to replicate our findings using larger sample sizes that allow for more robust assumptions about the relationship between team authentic leadership, bed occupancy rates, team flourishing, and team performance. Finally, the performance of hospital teams is not easily assessed, especially because performance outcome indicators such as infection rate after surgery, patient mortality, and hospital readmissions cannot always be directly related with the quality of team processes (Neuman et al., 2014;Lyubovnikova et al., 2015;Schmutz et al., 2019). As an example, a team can deliver a specific treatment protocol with 100% accuracy, and the patient health condition still worsens. ...
This study integrates the job demands-resources model and authentic leadership theory to test the general hypothesis that authentic leadership is a job resource that enables flourishing and performance in healthcare teams. Furthermore, this article tests the hypothesis that the daily bed occupancy is a job demand that weakens this relationship. Participants were 106 nurses that were distributed across 33 teams from two hospitals. The results suggest that the authentic leadership of team leaders is positively related with subjective and objective team performance, but only when daily bed occupancy is low. Authentic leadership had no relationship with team flourishing, regardless of the daily bed occupancy. Our findings suggest that the extent to which authentic leadership is adequate to promote the performance of teams working in a hospital setting is sensitive to contextual boundary conditions. Leading authentically might only be effective under specific circumstances.
... Second, individuals may also find it hard to establish valuable relationships (i.e., contacts that are motivated to share resources; Krackhardt, 1992) within teams in which they only spend a small percentage of their work time (O'Leary et al., 2011). Specifically, such limited time exposure may prevent these employees from becoming part of the team's ingroup (Kleiner, 2003;Lyubovnikova et al., 2014) and, thus, from accessing and sharing valuable resources across teams (Mortensen, 2014). Therefore, an uneven distribution of time across teams may also restrain processes of status enhancement. ...
In many firms and industries, it is the norm rather than the exception to work in more than one team at the same time. Despite increased research interest in recent years, we do not fully understand when such multiple team membership (MTM) is “good” or “bad” for employees’ perceptions of stress and exhaustion. In this article, we integrate the person‐job fit framework with opposing views of the role theory literature (i.e., role strain and role accumulation) to propose that an employee's personal reaction to working in multiple simultaneous teams decisively depends on his or her polychronic orientation. We expect that individual MTM is related to increased role efficacy, but not to role stress, for employees with higher (rather than lower) polychronic orientation, thus reducing the perception of emotional exhaustion. The opposite pattern is hypothesized for multiteamers with lower polychronic orientation. We find support for the proposed conditional indirect effects in a sample of 341 German employees. Our findings highlight an employee's polychronic orientation as a stable and context‐independent contingency factor in the MTM–exhaustion linkage, and hold important implications for organizations, as well as individual employees, who seek to deal more effectively with role multiplicity in MTM settings.
... At the same time, the physicians' status was visible through their understanding of themselves as the ones responsible for a patient's life and death. Medical responsibility was constructed as the decisive responsibility, even though research stresses the importance of nursing knowledge (Aaiken et al. 2014;Griffiths et al. 2016) and professional collaboration in teams (Lyubovnikova et al. 2015) for reducing patient mortality. This hierarchical polarization between care and cure has a long history; the professions are socialized into these epistemologies and identities (Wikström et al. 2018;Coombs 2003). ...
... In total, it can be said that collaborative teams not only protect patients from harms and enhance outcomes of society health but also create a more positive, engaging and resilient workplace. As stated in one study, hospitals in which there are good levels of collaboration between healthcare professionals with respect to clear roles and better management of interdisciplinary work, have lower rates of adverse consequences of higher rates of staff retention (Lyubovnikova et al., 2015). Moreover, the climate in the workplace is remarkably associated with the level of engagement and belonging, commitment to responsibilities and job satisfaction (Daugherty Biddison et al., 2016). ...
Purpose
This study aimed to assess interprofessional collaboration among healthcare professionals at governmental hospitals in the Gaza Strip.
Design/methodology/approach
This is qualitative study at six governmental hospitals, four general and two specialized. Thirty healthcare professionals were purposefully recruited to seven semi-structured interviews and three focus group discussions. Analysis was carried out using the open-coded thematic analysis.
Findings
Eight themes had been identified: (1) unity of goals among health professionals, (2) physicians as team leaders, (3) patient involvement, (4) decision-making and conflict management (5) relationships among professionals, (6) general responsibilities and autonomy, (7) mutual trust and information exchange and (8) collaboration with the community to coordinate care. The first three themes were impediments, whilst “decision-making and conflict resolution” was a significant enabler of interprofessional collaboration. The last four themes were the lowest in their level and varied from one hospital to another as well.
Research limitations/implications
The main limitation in this study was the number of participants; a relatively large sample might be needed for more data saturation. Therefore, health professionals from diverse backgrounds and different managerial levels have been recruited.
Practical implications
Policymakers could rely upon the recommendations in strengthening the enablers of interprofessional collaboration and overcoming barriers, both on system, organizational and individual levels.
Originality/value
This study was conducted at six hospitals of different specialties and sizes, and health professionals from different six professions have been recruited. In addition, two qualitative tools were used, interviews and focus group discussions.
... We have a duty to patients to continue working as a cohesive multi-disciplinary team after the COVID-19 crisis abates, continually striving to improve patient outcomes and reduce medical error. 42,43 Reflective practice ...
The COVID-19 pandemic has changed training and recruitment in urology in unprecedented ways. As efforts are made to ensure trainees can continue to progress, lessons can be learned to improve training and urological practice even after the acute phase of the pandemic is over. Novel methods of education through virtual learning have burgeoned amidst the social distancing the pandemic has brought. The importance of training in human factors and non-technical skills has also been brought to the fore while operating under the constraints of personal protective equipment and working in new teams and unfamiliar environments. This paper critically appraises the available evidence of how urological training has been affected by COVID-19 and the lessons we have learned and continue to learn going forward.
Level of Evidence
Not Applicable.
... Their "team performance curve" demonstrates a path from a simple working group through pseudo-teams and potential teams to "real" and "high-performing" teams (Katzenbach & Smith, 1993, p. 84). Lyubovnikova, West, Dawson, and Carter (2015) and Stout, Zallman, Arsenault, Sayah, and Hacker (2017) discussed this idea of "real team" and made it a regular part of team terminology. Sedlacek (2015Sedlacek ( , 2017 and Mathews (2018) similarly used the concept of a real team but in missionary team literature. ...
This dissertation applied one model of complex adaptive systems (CAS) theory to missionary teams to determine the impact of their multiple embedded contexts on team coherence. The literature on missionary teams falls into two broad approaches: scholars contributing to member care literature with few contributions to the leadership of missionary teams, and professional and trade writers addressing practitioners. None of these approaches examine missionary teams as a group phenomenon. This study explored a missionary team as a group phenomenon using CAS theory, thus addressing a gap in the missionary literature and utilizing the recent applications of CAS theory in groups. The CAS literature indicated a group’s contextual environments impact the coherence of the team. This study asked the research question, to what degree do a missionary group's various environments or multiple embedded contexts impact the coherence of the group? To answer the research question, a single case study methodology was used to examine 1 missionary team operating in Europe. The embedded contexts included its sending organization, U.S. partner churches, and local partners in the host country. The research confirmed these embedded contexts do impact team coherence through the flow of their resources and attempts to address their own fitness needs. Implications for researchers and practitioners, the significance of the study, and its limitations conclude the study. Recommendations for future research include further exploration into the local and global CAS dynamics of missionary groups, particularly the impact of the team’s local resource network.
The experience of suffering is ubiquitous in healthcare facilities, but against this backdrop, is compassion a ‘nice to have’ or does it also affect patient safety? This article uses mixed methods across two studies to understand team compassionate care behaviours as a shared unit property and its association with patient safety outcomes. Using data from 188 healthcare teams, Study 1 finds that team compassionate care behaviours mediated the relationship between team psychological safety and fewer patient hospital-associated infections. Furthermore, the positive relationship between team psychological safety and team compassionate care behaviours was weakened when team workload demands were high. In Study 2, we interviewed 25 nurses to understand the experiences and gain further insights into the relationships between the focal variables. Together, our findings provide evidence that compassion emerges at the team level, is driven by team antecedents, moderated by team environments and tangibly affects patient safety.
JEL Classification: M00
Objectives: Interprofessional collaboration (IPC) among professionals in occupational health service is crucial when rendering a service to clients and customers. The aim of this study was to describe and compare perceptions relating to IPC among professionals working as occupational health (OH) providers in Sweden.
Methods: This cross-sectional study with a descriptive and comparative design included 456 respondents representing different OH professions in Sweden. Data were collected using the Swedish short version of the Assessment of Interprofessional Team Collaboration Scale adapted for OH (AITCS)-SII(OH), with its three subscales Partnership, Cooperation and Coordination, and were analysed and presented descriptively. Items and sum scores were dichotomized into inadequate and adequate and compared between sexes, workplaces, types of employment and professions.
Results: According to the responses, items related to openness, honesty and trust were perceived as adequate among the respondents. The findings show that perceptions about IPC differed among the professions. The perception of IPC did also differ between different types of organizations.
Conclusion: The result show diverse perceptions between professionals and organizations. The perception of IPC may be influenced by the professional’s education in occupational safety and health. Study findings may be used to support further development of IPC in the occupational health service for the best of the clients. To develop IPC in the best interests of both professionals and customers/clients, further studies need to be performed to gain a deeper understanding of IPC in the OH context.
Lessons from service and system failures describe the pivotal roles played by governance and leadership in delivering high-quality, safe care. This Element sets out what the terms governance and leadership mean and how thinking about them has developed over time. Using real-world examples, the authors analyse research evidence on the influence of governance and leadership on quality and safety in healthcare at different levels in the health system: macro level (what national health systems do), meso level (what organisations do), and micro level (what teams and individuals do). The authors describe behaviours that may help boards focus on improving quality and show how different leadership approaches may contribute to delivering major system change. The Element presents some critiques of governance and leadership, including some challenges that can arise and gaps in the evidence, and then draws out lessons for those seeking to strengthen governance and leadership for improvement. This title is also available as Open Access on Cambridge Core.
The work group, with its own dynamics and development stages, is an often-overlooked element in the organizational psychology literature and in the management literature. As a manager, you need to understand how emotions and reason interact in groups and how this interaction influences your efforts to improve the organization’s performance.
Our Culture columnists explore the significance of the extended surgical team as a part of the future surgical workforce.
Background
: Ward rounds (WRs) are a daily organisational process in hospitals. Studies have found variation however in the definition and objectives of WRs, where they take place, who partakes in them and how they impact patient care.
Objectives
: This study was undertaken as part of a longitudinal improvement project in relation to WRs taking a socio-technical systems approach. The objective of this study was to explore junior doctors understanding of the goals, process sequence, social relations particularly understanding of roles and responsibilities, and information and knowledge in relation to WRs. We also wished to hear junior doctors’ perceptions of how WRs may be improved.
Methods
: Our study took place in a large 1000 bed acute teaching hospital. A survey was developed by the improvement project team and administered to junior doctors at the hospital (n=148).
Results
: A response rate of 30.4% was achieved (n=45 completing the survey). Junior doctors perceive the primary goals of WRs to be reviewing patient history and current status (39%) and progressing care plans (38%). They believe their main role on WRs to be writing notes (46.5%). 75% of participants reported that they fully understood their responsibilities on WR, while 67% fully understood the responsibilities of others. 80% reported learning on WRs lower than all other forms of learning.
Conclusions
: The findings of this study will help inform our current ‘AS IS’ understanding of WR practice and co-design of improvements. We would argue that further systems level research is needed to examine the impact of lack of agreed goals; clarity in relation to roles and responsibilities; involvement of nursing and health and social care professionals in the WR, and perceived educational value of WRs on staff and patient outcomes.
As centrally important as the role of the leader is in establishing and sustaining teamwork, the team members themselves obviously play critical roles as well. Certainly, beyond initial team formation (“forming”) most of the work of the team is coordinated by the team members themselves, without close moment-by-moment supervision by the team leader. Especially with teams that have been well led to the point of “norming” and “performing,” the work of their members is highly interdependent and largely self-managed. They must collaborate, and to do so effectively, they must communicate. Increasingly, the principles of effective teamwork have been embraced in healthcare. Data show clearly that effective teams in healthcare are associated with better patient outcomes and with greatly reduced risk of burnout for the providers. Effective teamwork requires a number of well-researched intra-team processes, which are overviewed in this chapter.
This chapter looks at teams within the current context of healthcare and the importance of psychological safety. It considers the role of the leader in a team, how to build and manage effective teams, and explores the value of support and challenge in helping teams work well. The effectiveness of teamwork is crucial within healthcare, and it is the connection of core values and aims which bind healthcare teams and can make them highly capable. A group is defined as a number of individuals assembled together or having some unifying relationship. Established teams usually fall into three basic sets they are : high‐performance teams, OK teams or functional teams and struggling teams. Healthcare is a high‐stakes environment. Therefore, the demands on healthcare teams are constant, complex and dynamic, and we have witnessed this at a much higher level during the pandemic. One key to effective teamworking is to support and promote diversity.
Background Interprofessional practice and teamwork are critical components to patient care in a complex hospital environment. The implementation of electronic health records (EHRs) in the hospital environment has brought major change to clinical practice for clinicians which could impact interprofessional practice.
Objectives The aim of the study is to identify, describe, and evaluate studies on the effect of an EHR or modification/enhancement to an EHR on interprofessional practice in a hospital setting.
Methods Seven databases were searched including PubMed, Scopus, Web of Science, CINAHL, Cochrane, EMBASE, and ACM Digital Library until November 2021. Subject heading and title/abstract searches were undertaken for three search concepts: “interprofessional” and “electronic health records” and “hospital, personnel.” No date limits were applied. The search generated 5,400 publications and after duplicates were removed, 3,255 remained for title/abstract screening. Seventeen studies met the inclusion criteria and were included in this review. Risk of bias was quantified using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis of the findings was completed based on type of intervention and outcome measures which included: communication, coordination, collaboration, and teamwork.
Results The majority of publications were observational studies and of low research quality. Most studies reported on outcomes of communication and coordination, with few studies investigating collaboration or teamwork. Studies investigating the EHR demonstrated mostly negative or no effects on interprofessional practice (23/31 outcomes; 74%) in comparison to studies investigating EHR enhancements which showed more positive results (20/28 outcomes; 71%). Common concepts identified throughout the studies demonstrated mixed results: sharing of information, visibility of information, closed-loop feedback, decision support, and workflow disruption.
Conclusion There were mixed effects of the EHR and EHR enhancements on all outcomes of interprofessional practice, however, EHR enhancements demonstrated more positive effects than the EHR alone. Few EHR studies investigated the effect on teamwork and collaboration.
The Royal College of Radiologists (RCR) is based in the United Kingdom but is a global organisation with members and fellows worldwide. In this invited article, the chair of the RCR Radiology Events and Learning (REAL) panel recounts his experience in looking at radiological errors. He starts with his personal work auditing his own mistakes as a junior consultant, describes what he learned in his departmental role in a large teaching hospital running a Radiology Events and Learning Meeting (REALM) and gives an overview of some of the work done over the last two decades by the RCR. This includes publishing national guidelines which set standards for running a REALM, setting up the REAL panel which produces a quarterly newsletter of cases from RCR members, and running an annual conference to share information with local radiology departments around the country. A review of the literature describing the drivers for this work and looking at the parallels with industry lies alongside the practical tips he found useful which he hopes would be helpful to anyone setting up their own departmental errors or discrepancy meeting.
This chapter provides a brief overview of the science of teamwork and team training. We define common terminology review key concepts from the science of teams. We introduce a systems-based framework for the factors influencing team training effectiveness including the management of the curriculum, organizational and training environments, scenarios, performance measurement, feedback, and continuous improvement. We provide a discussion of key tasks that should be completed before, during, and after a team training activity in order to maximize the value of the team training program.
Human societies function by having shared values that guide decision-making, resource allocation and relationships. A central value in all societies, countries and cultures is compassion—a value that shapes our reaction to those who are suffering and in need of help. Compassion is elicited when we perceive another’s suffering with the intention to act to help.
Background: Leadership is the ability to influence, guide and ecourage employees to achive organizational goals. Leadership has a significant role in organizations’ success or failure. Hospital managers should use an appropriate leadership style to achieve organizational goals. The purpose of this study was to identify the critical success factors of leadership in a hospital.
Methods: This qualitative case study was conducted in 2018 at Hasheminejad hospital, a university hospital, in Tehran, Iran. The research population consisted of managers and hospital employees. Purposeful sampling with maximum variation was used to recruit interviewees. Semi-structured interviews were conducted with 45 hospital managers and employees. Furthermore, relevant hospital documents were collected. Content thematic analysis method was used for data analysis using the MAXQDA 11 software.
Results: The leadership success depends on the leader and the employees’ personality traits such as intelligence, knowledge, abilities, attitudes, beliefs, values and behaviors, and factors within and outside of the organization. Mission, vision, strategies and plans, rules and regulations, organizational structure, organizational culture, professional development of managers and employees, employees’ participation, motivation and satisfaction, and patient satisfaction are organizational factors affecting leadership in a hospital. In addition, support of senior managers in the university and political and economic factors influence a leader’s success.
Conclusion: Personality traits and internal and external factors influence the quality of leadership in hospitals. Hospital managers should develop their leadership competencies considering these factors.
Ref. Etemadian M, Mosadeghrad A M, Soleimani M J, Hedayati S P. Leadership critical success factors in a hospital: Case Study of Hasheminejad Hospital. Razi Journal of Medical Sciences. 2020; 27 (1) :38-61. [in Persian]
Organizational teams are capable of addressing complex and multifaceted problems through innovative solutions, but their capacity to innovate is far from guaranteed. The quest to address this dilemma has yet to explore the interactive roles of professional and team identification; a surprising omission as both professional and team identification have been separately shown to play an important role in determining team innovation. Responding to this research gap, we explore the potential for professional identity salience to enhance or undermine healthcare team innovation through minority dissent, and argue that team identification is capable of differentiating between these two contrasting effects. Our survey‐based study of 63 US healthcare teams supports our moderated mediation model, which provides evidence of the potential complementarity of different forms of identification and opens an opportunity for teams to reap the benefits, as well as avoid the detriments, typically associated with each form.
The relationship between subordinates' perceptions of abusive supervision and supervisors' evaluations of subordinates' organizational citizenship behavior (OCB) was explored among a sample of 373 Air National Guard members and their military supervisors. As predicted, the relationship between abusive supervision and subordinates' OCB was stronger among subordinates who defined OCB as extra-role behavior (compared with those defining OCB as in-role behavior), and this effect was fully mediated by the interactive effect of procedural justice and OCB role definitions. The study's implications for theory and research are discussed, its limitations are identified, and directions for future research are suggested.
A very early Meta-Analysis of Organizational Change and Work Innovation in 131 field sites from 1961-1991 . This study started with over 1,800 field sites: however, because of insufficient data, poor reporting of data, and just inadequate research, we only could use 131 studies in the meta-analysis. Chapter reports on 60 design features ( action levers ) and work innovations from organizational structure,( 17), human resources (14), and technological (14) that were positively associated with organizational effectiveness.
With the arrival of the National Plan, this timely paper presents preliminary findings from a major survey of multidisciplinary team working and effectiveness. The three-year study covered primary, secondary and community health care teams.
Objectives: To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. Design: Cross sectional surveys. Setting: Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. Participants: 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). Main outcome measures: Perceptions of error, stress, and teamwork. Results: Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. Conclusions: Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.
Speaking up in high-risk organizations plays a pivotal role in the mitigation of errors and can make the difference between life and death. To date, speaking up has been studied mostly within teams. However, many high-risk organizations rely on the effective collaboration across teams in ad hoc multiteam systems (MTS). This study widens the scope of research from teams to MTS and empirically compares the mechanisms involved in speaking up within versus across teams in ad hoc MTS-aircrews. In a sample of 1490 aircrew members of a European airline, we found that crewmembers’ individual level perceptions of psychological safety mediated both the relationship between status and speaking up and between perceived leader inclusiveness and speaking up within teams. Across teams, however, psychological safety and leader inclusiveness—as perceived by pursers in their role as boundary spanners—showed no effect. Instead, it was pursers’ within-team perceptions of psychological safety that mediated between status and speaking up across teams. Teams in ad hoc MTS may thus serve as safe harbours supporting their members also in interactions across team boundaries. Implications of findings for research on MTS and practical recommendations to improve speaking up within and across teams in ad hoc MTS are discussed.
Research on teams has prompted the development of many alternative taxonomies but little consensus on how to differentiate team types. We show that there is greater consensus on the underlying dimensions differentiating teams than there is on how to use those dimensions to generate categorical team types. We leverage this literature to create a conceptual framework for differentiating teams that relies on a dimensional scaling approach with three underlying constructs: skill differentiation, authority differentiation, and temporal stability.
In the past, there was a fairly strong alignment between what teams experienced, the topics that team researchers were studying, and the practices that organizations used to manage their teams. However, the nature of teams and the environment in which they operate has changed, and as a result, new needs have emerged. Although there have been some innovative advancements, research and practice have not always adjusted to remain aligned with emerging needs. We highlight 3 significant change themes that are affecting teams: (a) dynamic composition, (b) technology and distance, and (c) empowerment and delayering. For each theme, we share our observations, review the related science and identify future research needs, and specify challenges and recommendations for employing effective team-based practices in applied settings. We conclude with thoughts about the future and suggest that new theories, research methods, and analyses may be needed to study the new team dynamics.
The commentaries to our focal article were both interesting and stimulating. As we generally agreed with the major points raised in the commentaries, we use this response to frame an on-going tension point or challenge regarding team definitions, highlight a few unifying themes that weave through our initial article and the commentaries, and discuss the transition from research to informed practice. The past few decades have been exciting times for team researchers and practitioners, and the time is ripe for new energies and approaches.
Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings.
A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes.
Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice.
Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.
A century of research on small groups has yielded bountiful findings about many specific features and processes in groups. Much of that work, in line with a positivist epistemology that emphasizes control and precision and favors the laboratory experiment over other data collection strategies, has also tended to treat groups as though they were simple, isolated, static entities. Recent research trends that treat groups as complex, adaptive, dynamic systems open up new approaches to studying groups. In line with those trends, a theory of groups as complex systems is offered and some methodological and conceptual issues raised by this theory are identified. A 3-pronged research strategy based on theory development, computational modeling, and empirical research that holds promise for illuminating the dynamic processes underlying the emergence of complexity and the ongoing balance of continuity and change in groups is proposed.
Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS).
Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies, board minutes and publicly available datasets. We narratively synthesised data across the studies to produce a holistic picture and in this paper present a high-level summary.
We found an almost universal desire to provide the best quality of care. We identified many 'bright spots' of excellent caring and practice and high-quality innovation across the NHS, but also considerable inconsistency. Consistent achievement of high-quality care was challenged by unclear goals, overlapping priorities that distracted attention, and compliance-oriented bureaucratised management. The institutional and regulatory environment was populated by multiple external bodies serving different but overlapping functions. Some organisations found it difficult to obtain valid insights into the quality of the care they provided. Poor organisational and information systems sometimes left staff struggling to deliver care effectively and disempowered them from initiating improvement. Good staff support and management were also highly variable, though they were fundamental to culture and were directly related to patient experience, safety and quality of care.
Our results highlight the importance of clear, challenging goals for high-quality care. Organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported.
The authors summarize 35 years of empirical research on goal-setting theory. They describe the core findings of the theory, the mechanisms by which goals operate, moderators of goal effects, the relation of goals and satisfaction, and the role of goals as mediators of incentives. The external validity and practical significance of goal-setting theory are explained, and new directions in goal-setting research are discussed. The relationships of goal setting to other theories are described as are the theory’s limitations.
This research explores how group- and organizational-level factors affect errors in administering drugs to hospitalized patients. Findings from patient care groups in two hospitals show systematic differences not just in the frequency of errors, but also in the likelihood that errors will be detected and learned from by group members. Implications for learning in and by work teams in general are discussed.
The idea ofteamwork in health care emerged at several times during the th 20 centuryas the resultofshifts in the nature and demandsofhealth care and societal needs. Examples include medical and surgical teams serving the military in World War II, primary care teams staffing Community Health Centers created by President Johnson's War On Poverty, and geriatric care teams established to serve the rapidly growing number of aging citizens. Collaborative teamwork surfaced as a rational solution to health care needs, but political and economic consensus to support widespread implementation was lacking. The increasing complexity ofproviding health care seemed best served by the skills and efforts of interdisciplinary teams, but such care was viewed as expensive so e.valuation ofits effectiveness became essential. There were major problems in conducting such evaluation, however. First, no clear theory guided the concept and practice of teamwork. Early attempts to employ theoretical constructs explaining the behavioral and organizational phenomena of teamwork borrowed from theories of group dynamics, communication, organizational development, and general systems. Further, few reliable, validated instruments existed to evaluate team process, function, or effectiveness. The best early efforts at research and evaluation came from academic centers funded by the Office of Interdisciplinary Programs of the Bureau of Health Professions (1975-78) and from the Veterans Affairs' Interprofessional Team Training & Development Program.
Measuring and managing for team performance: Emerging principles from complex environments" Teamwork has always been an important component of successful military operations. However, as the nature of military operations evolves in the post-cold war era, the ability of teams to work effectively in a dynamic and complex environment may play an even more critical role. As the nature of military organizations evolves and becomes more complex, it will be important to understand why some teams function better than others and how to instill the requisite skills in numerous geographically dispersed teams. The authors of this paper extracted twenty principles of teamwork from studies of decision making teams working in three complex tactical naval settings. Nine of the principles regard the nature of teamwork; seven regard team leadership; four regard the roles of individual team members. The findings presented here provide suggestions for managing teams effectively, measuring team performance, and for training teams in complex settings. They have application to peacekeeping operations, which are highly complex.
Self-regulating work groups are a promising alternative to traditional forms of work design. Their emergence from socio-technical systems theory and field experimentation is discussed, and their theoretical bases and implementation strategies presented. Managerial functions appropriate to their design and supervision are also proposed.
Monitoring hospital mortality rates is widely recommended. However, the number of preventable deaths remains uncertain with estimates in England ranging from 840 to 40?000 per year, these being derived from studies that identified adverse events but not whether events contributed to death or shortened life expectancy of those affected.
METHODS: Retrospective case record reviews of 1000 adults who died in 2009 in 10 acute hospitals in England were undertaken. Trained physician reviewers estimated life expectancy on admission, to identified problems in care contributing to death and judged if deaths were preventable taking into account patients' overall condition at that time.
RESULTS: Reviewers judged 5.2% (95% CI 3.8% to 6.6%) of deaths as having a 50% or greater chance of being preventable. The principal problems associated with preventable deaths were poor clinical monitoring (31.3%; 95% CI 23.9 to 39.7), diagnostic errors (29.7%; 95% CI 22.5% to 38.1%), and inadequate drug or fluid management (21.1%; 95% CI 14.9 to 29.0). Extrapolating from these figures suggests there would have been 11?859 (95% CI 8712 to 14?983) adult preventable deaths in hospitals in England. Most preventable deaths (60%) occurred in elderly, frail patients with multiple comorbidities judged to have had less than 1 year of life left to live.
CONCLUSIONS: The incidence of preventable hospital deaths is much lower than previous estimates. The burden of harm from preventable problems in care is still substantial. A focus on deaths may not be the most efficient approach to identify opportunities for improvement given the low proportion of deaths due to problems with healthcare.
Part I: Teams Chapter 1: The Challenge Part II: Enabling Conditions Chapter 2: A Real Team Chapter 3: Compelling Direction Chapter 4: Enabling Structure Chapter 5: Supportive Context Chapter 6: Expert Coaching Part III: Opportunities Chapter 7: Imperatives for Leaders Chapter 8: Thinking Differently About Teams
Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.
Recognizing that current theories of team learning do not apply to short-term action teams, we conceptualize how action teams may learn and test hypotheses regarding the performance-related effects of such learning, the mechanisms mediating such effects, and the conditions governing their magnitude. We operationalized the level of action team learning (ATL) in terms of the regularity and number of role-based, guided team reflexivity experiences of an action team's members. Testing our hypotheses on 250 surgical teams, we find that higher levels of ATL are associated with shorter surgical duration, with this effect mediated by team helping and workload sharing, particularly under conditions of greater team task complexity. Additionally, we find higher levels of ATL to be directly associated with a reduced number of adverse events in low-complexity surgeries.
OBJECTIVES
To identify determinants of sickness absence in hospital physicians.
METHODS
The Poisson regression analyses of short (1–3 days) and long (>3 days) recorded spells of sickness absence relating to potential determinants of sickness absence were based on a 2 year follow up period and cohorts of 447 (251 male and 196 female) physicians and 466 controls (female head nurses and ward sisters).
RESULTS
There were no differences in health outcomes, self rated health status, prevalence of chronic illness, and being a case on the general health questionnaire (GHQ), between the groups but physicians took one third to a half the sick leave of controls. All the health outcomes were strongly associated with sickness absence in both groups. Of work related factors, teamwork had the greatest effect on sickness absence in physicians but not in the controls. Physicians working in poorly functioning teams were at 1.8 (95% confidence interval (95% CI) 1.3 to 3.0) times greater risk of taking long spells than physicians working in well functioning teams. Risks related to overload, heavy on call responsibility, poor job control, social circumstances outside the workplace, and health behaviours were smaller.
CONCLUSION
This is the first study of hospital physicians to show the association between recorded sickness absence and factors across various areas of life. In this occupational group, sickness absence is strongly associated with health problems, and the threshold for taking sick leave is high. Poor teamwork seems to contribute to the sickness absenteeism of hospital physicians even more than traditional psychosocial risks—such as overload and low job control. These findings may have implications for training and health promotion in hospitals.
We used data from 45 production teams (626 individuals) and their supervisors to test hypotheses related to team structure. For teams engaged primarily in conceptual tasks, interdependence exhibited a boolean OR-shaped relationship with team performance, whereas team self-leadership exhibited a positive, linear relationship with performance. For teams engaged primarily in behavioral tasks, we found a boolean AND-shaped relationship between interdependence and performance and a negative, linear relationship between team self-leadership and performance. Intrateam process mediation was found for relationships with interdependence but not for relationships with team self-leadership. Overall, findings support a model of team structure and illustrate how relationships between structural characteristics and a team's performance can be moderated by its tasks.
Self-regulating work groups are a promising alternative to traditional forms of work design. Their emergence from socio-technical systems theory and field experimentation is discussed, and their theoretical bases and implementation strategies presented. Managerial functions appropriate to their design and supervision are also proposed.
Purpose: To describe the experience of verbal abuse in a large multihospital system and determine the relationship of verbal abuse with intent to leave the organization. Design: Descriptive correlational design using mailed questionnaires. Sample: Randomized sample of 1000 nurses received questionnaire; 46% response rate, with a final useable sample of 461 surveys. Findings: Of the respondents, 91% had experienced verbal abuse in the past month. The physician was the most frequent source of verbal abuse, followed by patients, patient families, peers, supervisors, and subordinates. More than 50% of the sample did not feel competent in responding to verbal abuse. Amount of abuse and intent to leave were significantly related (r = .211, p < .01). Discussion: Organizations must adopt zero-tolerance policies for professional verbal abuse. Education and coaching are needed to help nurses to improve their skills when responding to patient-to-nurse and professional-to-professional verbal abuse.
Prior research evidence shows that within-team interdependence moderates the process-performance relationship in small groups. Data collected from 94 top management teams (TMTs) replicated and extended the small groups finding. Specifically, TMTs with high interdependence (i.e., real teams) had higher team and subsequent firm performance when the team was more cohesive and had more communication. However, teams with low interdependence (i.e., working groups) had higher performance when communication and cohesion were lower. This constructive replication provides the first examination of the moderating effect for team interdependence within TMTs on both team and firm performance.
This article reports the results of a comprehensive meta-analysis of turnover antecedents, extending an earlier one by Hom and Griffeth (1995). As such, this updated meta-analysis represents the most wide-ranging quantitative review to date of the predictive strength of numerous turnover antecedents. Importantly, the present investigation identifies various moderators of antecedent-turnover correlations. The implications of these findings for both theory and practice are discussed.
In this article, we summarize and review the research on teams and groups in organization settings published from January 1990 to April 1996. The article focuses on studies in which the dependent variables are concerned with various dimensions of effectiveness. A heuristic framework illustrating recent trends in the literature depicts team effectiveness as a function of task, group, and organization design factors, environmental factors, internal processes, external processes, and group psychosocial traits. The review discusses four types of teams: work, parallel, project, and management. We review research findings for each type of team organized by the categories in our heuristic framework. The article concludes by comparing the variables studied for the different types of teams, highlighting the progress that has been made, suggesting what still needs to be done, summarizing key leamings from the last six years, and suggesting areas for further research.
It is time to move beyond standard conceptual and research paradigms in scientific work on group behavior and performance to better align our models and methods with the phenomena we are studying. Cause–effect models are of limited use in conducting research and generating useable theory about group behavior and performance. This paper proposes and illustrates an alternative conceptual approach that focuses on the conditions within which groups chart their own courses. The paper suggests three implications of a condition-focused approach for those who create, lead, and serve in purposive groups, and closes with a discussion of the conceptual challenges that must be overcome if the potential of a condition-focused approach is to be realized. Copyright © 2012 John Wiley & Sons, Ltd.
The nature of collaboration has been changing at an accelerating pace, particularly in the last decade. Much of the published work in teams research, however, is still focused on the archetypal team that has well-defined membership, purposes, leadership, and standards of effectiveness—all characteristics that are being altered by changes in the larger context of collaboration. Each of these features is worth attention as a dynamic construct in its own right. This article explores what the teams research community has to gain by researching, theorizing, and understanding the many new forms of contemporary collaboration.
The existing body of literature on teamwork behaviors is substantial and offers many different conceptualizations. However, there is a lack of consensus concerning the conceptual structure of teamwork behaviors. Many researchers pursue their own work without any attempt to build on and integrate the work of others. This article reviews the frameworks of teamwork behaviors in the literature on work teams and provides a way of integrating these frameworks. The behavioral dimensions included in this integrative framework are conceptually distinguished and arranged in a hierarchical conceptual structure based on theoretical approaches. Moreover, they are framed from the perspective of the timing of teamwork behaviors to clarify when these behaviors are most likely to have their intended effects. The proposed framework is then connected to the task conditions under which teamwork behaviors are most likely to facilitate collective task accomplishment. Finally, future directions for research regarding teamwork behaviors are discussed.
Teams of people working together for a common purpose have been a centerpiece of human social organization ever since our ancient ancestors first banded together to hunt game, raise families, and defend their communities. Human history is largely a story of people working together in groups to explore, achieve, and conquer. Yet, the modern concept of work in large organizations that developed in the late 19th and early 20th centuries is largely a tale of work as a collection of individual jobs. A variety of global forces unfolding over the last two decades, however, has pushed organizations worldwide to restructure work around teams, to enable more rapid, flexible, and adaptive responses to the unexpected. This shift in the structure of work has made team effectiveness a salient organizational concern.
Teams touch our lives everyday and their effectiveness is important to well-being across a wide range of societal functions. There is over 50 years of psychological research—literally thousands of studies—focused on understanding and influencing the processes that underlie team effectiveness. Our goal in this monograph is to sift through this voluminous literature to identify what we know, what we think we know, and what we need to know to improve the effectiveness of work groups and teams.
We begin by defining team effectiveness and establishing the conceptual underpinnings of our approach to understanding it. We then turn to our review, which concentrates primarily on topics that have well-developed theoretical and empirical foundations, to ensure that our conclusions and recommendations are on firm footing. Our review begins by focusing on cognitive, motivational/affective, and behavioral team processes—processes that enable team members to combine their resources to resolve task demands and, in so doing, be effective. We then turn our attention to identifying interventions, or “levers,” that can shape or align team processes and thereby provide tools and applications that can improve team effectiveness. Topic-specific conclusions and recommendations are given throughout the review. There is a solid foundation for concluding that there is an emerging science of team effectiveness and that findings from this research foundation provide several means to improve team effectiveness. In the concluding section, we summarize our primary findings to highlight specific research, application, and policy recommendations for enhancing the effectiveness of work groups and teams.
Difference scores have been widely used in studies of fit, similarity, and agreement. Despite their widespread use, difference scores suffer from numerous methodological problems. These problems can be mitigated or avoided with polynomial regression analysis, and this method has become increasingly prevalent during the past decade. Unfortunately, a number of potentially damaging myths have begun to spread regarding the drawbacks of difference scores and the advantages of polynomial regression. If these myths go unchecked, difference scores and the problems they create are likely to persist in studies of fit, similarity, and agreement. This article reviews 10 difference score myths and attempts to dispel these myths, focusing on studies conducted since polynomial regression was formally introduced as an alternative to difference scores.
This multi-method field study examines the relative effects of two kinds of leader behaviors—design choices and hands-on coaching—on the effectiveness of self-managing teams. Find- ings show that how leaders design their teams and the quality of their hands-on coaching both influence team self- management, the quality of member relationships, and member satisfaction, but only leaders' design activities affect team task performance. Moreover, design and coaching interact, so that well-designed teams are helped more by effective coaching— and undermined less by ineffective coaching—than are poorly designed teams. (Team Effectiveness; Team Leadership; Self-Managing Teams; Team Coaching)
This article describes the development of the Team Diagnostic Survey (TDS), an instrument intended for use both for the diagnosis of the strengths and weaknesses of work teams and for research on team behavior and performance. The TDS is based explicitly on existing research and theory about the conditions that foster team effectiveness. It provides an assessment of how well a team is structured, supported, and led as well as several indicators of members’ work processes and their affective reactions to the team and its work. The psychometric properties of the TDS are satisfactory, based on analyses of data from 2,474 members of 321 teams in a diversity of organizations. Appropriate uses of the instrument are discussed.
In this article, we summarize and review the research on teams and groups in organization settings published from January 1990 to April 1996. The article focuses on studies in which the dependent variables are concerned with various dimensions of effectiveness. A heuristic framework illustrating recent trends in the literature depicts team effectiveness as a function of task, group, and organization design factors, environmental factors, internal processes, external processes, and group psychosocial traits. The review discusses four types of teams: work, parallel, project, and management. We review research findings for each type of team organized by the categories in our heuristic framework. The article concludes by comparing the variables studied for the different types of teams, highlighting the progress that has been made, suggesting what still needs to be done, summarizing key learnings from the last six years, and suggesting areas for further research.