Trainee Learning Tied to Team Productivity in Pediatric Inpatient Teams
Organizations increasingly use dynamic teams, which are short-lived and have changes in team members over time. Dynamic teams enable more agility to accommodate schedule constraints and adaptively assign experts as new problems emerge and evolve. They also make it difficult for members to learn on the job or for the team to work efficiently, suggesting potential hidden costs to individuals as well as teams and their clients or customers.
“Dynamic teams are common in a wide range of industries today, and particularly in medical settings,” explains Anna Mayo, assistant professor of organizational behavior at Carnegie Mellon’s Heinz College, who led the study. “For instance, in a teaching hospital, a physician team might comprise an attending physician and trainees for a shift, day, or maybe week at a time. During that brief time, the team will work with a shifting set of other clinicians, such as nurses, to provide care.”
In a new study by Mayo and colleagues, the researchers sought to determine how dynamic teams can support learning and productivity in a hospital setting. Their study took place in 2017-2018 in a large academic children’s hospital with 91 physician teams in the general pediatric inpatient unit (in which 222 physician trainees learned from 21 attending physicians while providing patient care in dynamic teams). The study found that brief interventions with the core team of physicians at the beginning of their week together boosted the extent to which they coordinated both internally among the physicians and externally with other roles, such as nurses. Further, medical trainees’ learning was highest when teams coordinated both internally and externally. Importantly, learning was associated with better productivity, specifically as reflected in shorter patient stays.
The study, by researchers at Carnegie Mellon University, Children’s National Hospital, and UPMC Children’s Hospital of Pittsburgh, is published in Organization Science.
Physician teams were assigned randomly to launch their work with one of two interventions—one focused on internal coordination of tasks and role responsibilities among the physician team, while the other focused on coordinating work with potential contributors from outside of the physician team (e.g., nurses, pharmacists, social workers, specialists from other departments). The study also included a control condition in which teams did not receive an intervention, and it examined the interventions’ effects over the teams’ week-long lifespans. The study found that:
- Interventions directing attention to internal roles and teamwork among the physicians, or to external roles outside of the physician team, boosted internal and external coordination, respectively.
- Teams’ external coordination was associated with improved team efficiency based on the percentage of morning discharges of patients.
- Teams’ internal coordination was strongly related to improved individual learning, with individual learning being highest when teams achieved both high internal and external coordination.
- The individual learning of team members was associated with shorter patient stays, demonstrating a potential for synergies between individual learning and team productivity.
- Teams that received the internally focused intervention were slightly more likely to achieve high levels of both internal and external coordination, which produced the synergistic learning and productivity outcomes.
“Our findings provide vital causal evidence of the impact of focusing attention when teams are dynamic,” suggests Anita Williams Woolley, professor of organizational behavior at Carnegie Mellon’s Tepper School of Business, who coauthored the study. “More and more funds are being spent on new technologies intended to help teams coordinate despite their temporary, cross-disciplinary and complex nature. Yet, this study reveals the power of a simple and low-cost intervention based on fundamental aspects of human attention.”
Mayo added, “This study also shows that, contrary to concerns that trainee learning may come at the expense of patient care, the two can go hand-in-hand. It also uncovers one approach to achieving just that.”
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Summarized Summarized from an article in Organization Science, "Coordination in Dynamic Teams: Investigating a Learning–Productivity Tradeoff," by Mayo, AT (Carnegie Mellon University), Woolley, AW (Carnegie Mellon University), John, L (Children’s National Hospital), March, C (UPMC Children’s Hospital of Pittsburgh), Witchel, S (UPMC Children’s Hospital of Pittsburgh), and Nowalk, A (UPMC Children’s Hospital of Pittsburgh). Copyright 2024 INFORMS. All rights reserved.
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