Group cognition, membership change, and performance: Investigating the benefits and detriments of collective knowledge

Lewis, Kyle; Belliveau, Maura A.; Herndon, Benjamin; Keller, Joshua

doi:10.1016/j.obhdp.2007.01.005

Cited by 259 publications

(238 citation statements)

References 37 publications

Supporting

Mentioning

229

Contrasting

Unclassified

Order By: Relevance

“…12 Research indicates that interactions among healthcare providers can have important influences on outcomes. [13][14][15][16][17] Additionally, the initial implementation of checklists to prevent central-line associated infections appeared to change provider relationships in a way that significantly influenced their success. 18 For example, positive primary care clinic member relationships as assessed by the Lanham framework have been associated with better chronic care model implementation, learning, and patient experience of care.…”

Section: Discussionmentioning

confidence: 99%

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

McAllister

Leykum

Lanham

et al. 2014

Journal of Hospital Medicine

View full text Add to dashboard Cite

IMPORTANCE Improving inpatient care delivery has historically focused on improving individual components of the system. Applying the complexity science framework to clinical systems highlights the important role of relationships among providers in influencing system function and clinical outcomes. OBJECTIVE To understand whether inpatient medical physician teams can be differentiated based on the relationships among team members, and whether these relationships are associated with patient outcomes, including length of stay (LOS), unnecessary length of stay (ULOS), and complication rates. DESIGN Eleven inpatient medicine teams were observed daily during attending rounds for 2‐ to 4‐week periods from September 2008 through June 2011. Detailed field notes were taken regarding patient care activities, team behaviors, and patient characteristics and outcomes. Behaviors were categorized using the Lanham relationship framework, giving each team a relationship score. We used factor analysis to assess the pattern of relationship characteristics and assessed the association between relationship characteristics and patient outcomes. SETTING Observations occurred at the Audie L. Murphy Veterans Affairs Hospital and University Hospital in San Antonio, Texas. PARTICIPANTS Physicians were chosen based on rotation schedules, experience, and time of year. Patients were included based on their admission to the inpatient medicine teams that were being observed. MAIN MEASURES Relationship scores were based on the presence or absence of 7 relationship characteristics. LOS, ULOS, and complication rates were assessed based on team discussions and chart review. The association between relationships and outcomes was assessed using the Kruskal‐Wallis rank sum test. RESULTS We observed 11 teams over 352.9 hours, observing 1941 discussions of 576 individual patients. Teams exhibited a range of 0 to 7 relationship characteristics. Relationship scores were significantly associated with complication rates, and presence of trust and mindfulness among teams was significantly associated with ULOS and complication rates. CONCLUSIONS Our findings are an important step in understanding the impact of relationships on the outcomes of hospitalized medical patients. This understanding could expand the scope of interventions to improve hospital care to include not only process improvement but also relationships among providers. Journal of Hospital Medicine 2014;9:764–771. © 2014 Society of Hospital Medicine

show abstract

Section: Discussionmentioning

confidence: 99%

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

McAllister

Leykum

Lanham

et al. 2014

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…The associated drop in team social identity and context has a negative impact on team know-how to perform certain tasks and to efficiently exchange information [6]. The loss of human and social capital results in a loss of coordination and control knowledge, such that members on teams with these personnel changes have to re-learn the various sources and recipients of team information [16]. Team knowledge about the most efficient ways to address problems changes, due to membership changes, as expert sources must be re-determined.…”

Section: Virtual Team Consistencymentioning

confidence: 99%

The Impact of Virtual Team Consistency on Individual Performance and Perceptual Outcomes Over Time

Fuller

Summers

2017

Proceedings of the 50th Hawaii International Conference on System Sciences (2017)

View full text Add to dashboard Cite

show abstract

“…It is the PCP's responsibility to inform the patient when he or she will be getting a new primary care physician 100 (27) 96 (23) It is the non-physician PACT members' responsibility to inform the patient that their PCP will be leaving and the patient will be getting another PCP 52 (14) 38 (9) I can help make transitions for residents' patients easier 81 (22) 67 (16) There should be a formal approach to making patients aware that their PCP is leaving and they will be getting another PCP 81 (22) 79 ( "Have the leaving PCP discuss the issue with the patient on the last appointment." "3rd year residents in their last 6 months should remind patients in a nice way that they will be getting a new PCP sometime soon."…”

Section: Resident Pactmentioning

confidence: 99%

“…For care to become more shared among PACT members, responsibility, trust, mindfulness, and heedfulness must be present. In addition, research on teams has shown there is a decrement in function when team members change, even if only a single member leaves, 22 underscoring the harm that can potentially occur in resident clinics with EOR transitions and disrupted relationships.…”

Section: Resident Pactmentioning

confidence: 99%

Exploring End-of-Residency Transitions in a VA Patient Aligned Care Team

et al. 2014

View full text Add to dashboard Cite

BACKGROUND: End-of-residency transitions create disruptions in primary care continuity. The national implementation of Patient Aligned Care Teams (PACT) in Veterans Health Administration (VA) primary care clinics creates an opportunity to mitigate this discontinuity through the provision of teambased care. OBJECTIVES: To identify team-based solutions to endof-residency transitions in a resident PACT continuity clinic by assessing the knowledge, attitudes, and perceptions of non-physician PACT members and resident PACT physicians. DESIGN AND PARTICIPANTS: Cross-sectional survey of 27 resident physicians and 24 non-physician PACT members in the Internal Medicine Clinic at the Audie L. Murphy VA Hospital in the South Texas Veterans Health Care System. RESULTS: Twenty-seven residents and 24 non-physician PACT members completed the survey, with response rates of 90 % and 100 %, respectively. All residents and 96 % of non-physician PACT members agreed or strongly agreed that the residents were responsible for informing patients about end-of-residency transitions. Only 38 % of non-physician PACT members versus 52 % of residents indicated that non-physician PACT members should be responsible for this transition. Approximately 80 % of resident physicians and non-physician PACT members agreed there should be a formalized approach to these transitions; 67 % of non-physician PACT members were willing to support this transition. Potential barriers to team-based care transitions were identified. Major themes of write-in suggestions for improving the transition focused on communication and relationships between the patient and PACT and among the PACT members. CONCLUSIONS: PACT implementation changes the roles and relationship structures among all team members. While end-of-residency transitions create a disruption in the relationship system, the remainder of the PACT may bridge this transition. Our results demonstrate the importance of a team-based solution that engages all PACT members by improving communication and fostering effective team relationships.

show abstract

Group cognition, membership change, and performance: Investigating the benefits and detriments of collective knowledge

Cited by 259 publications

References 37 publications

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

The Impact of Virtual Team Consistency on Individual Performance and Perceptual Outcomes Over Time

Exploring End-of-Residency Transitions in a VA Patient Aligned Care Team

Contact Info

Product

Resources

About