Melissa Valentine, Health Policy (Management) PhD
Thesis Chair: Amy Edmondson
Team Scaffolds: How Minimal In-Group Structures Support Fast-Paced Teaming
Team effectiveness research has shown that team design enables effective team behaviors. One essential design feature is team member stability, which in today's hyper-fluid, fast-paced work places is not always feasible. The current understanding in the research literature is that coordination in work settings characterized by constantly changing personnel can be organized around roles and role structures, which allow coordination to be depersonalized. When work is depersonalized, it does not depend on the unique skills, knowledge, or relationships of any one individual person, but instead can be carried out by anyone with the necessary training. However, many of the benefits of teams - like accountability and social support - are missing or inhibited in depersonalized coordination. Thus, a critical question is how to enable team-based work even in depersonalized work settings where the composition of people involved is constantly changing.
In my dissertation research, I develop the idea of a team scaffold: a team-like structure that can be set up and maintained independent of the occupants. I leveraged a change currently taking place in the high-stakes, fast-paced setting of the emergency departments (ED) of hospitals. Many EDs are attempting to implement some form of team-based work flow, but the ED is organized around multiple, staggered shifts, so that the composition of individuals in the ED changes constantly, rendering real teams impossible. I conducted a multi-method study of three different EDs that attempted to implement team-based operations.
Using qualitative interview and observation data and quantitative network data, I conducted three main analyses. The first analysis examines coordination in one ED over time and shows that team scaffolds dramatically improve the coordination behaviors of the ED staff who are working together only for a short time. The second analysis compares the team scaffold design implemented by each of the three EDs and shows that seemingly small differences in design have significant consequences for whether a team-level dynamic emerges. The results suggest that the most important design feature in supporting a team-level dynamic among constantly changing groups of people is assigning shared responsibility to the whole group for a whole task - without this, even co-location and stable membership did not support a team-level dynamic. The third analysis, which is in development, compares the changing networks in each of the three EDs over time. Taken together, these analyses clarify the essential design features of team scaffolds and show how they enable effective coordination among groups of people working together only for a short time.