Towards diagnostic excellence on academic ward teams: building a conceptual model of team dynamics in the diagnostic process

Abstract

Objectives Achieving diagnostic excellence on medical wards requires teamwork and effective team dynamics. However, the study of ward team dynamics in teaching hospitals is relatively underdeveloped. We aim to enhance understanding of how ward team members interact in the diagnostic process and of the underlying behavioral, psychological, and cognitive mechanisms driving team interactions. Methods We used mixed-methods to develop and refine a conceptual model of how ward team dynamics in an academic medical center influence the diagnostic process. First, we systematically searched existing literature for conceptual models and empirical studies of team dynamics. Then, we conducted field observations with thematic analysis to refine our model. Results We present a conceptual model of how medical ward team dynamics influence the diagnostic process, which serves as a roadmap for future research and interventions in this area. We identified three underexplored areas of team dynamics that are relevant to diagnostic excellence and that merit future investigation (1): ward team structures (e.g., team roles, responsibilities) (2); contextual factors (e.g., time constraints, location of team members, culture, diversity); and (3) emergent states (shared mental models, psychological safety, team trust, and team emotions). Conclusions Optimizing the diagnostic process to achieve diagnostic excellence is likely to depend on addressing all of the potential barriers and facilitators to ward team dynamics presented in our model.

Editorial: Promoting teamwork in healthcare

“…Delivering healthcare is inherently collaborative, involving diverse teams across various stages of patient care, from ad-hoc emergency and anesthesia teams delivering immediate care to surgeries and tumor boards conferring on long-term cancer treatment (Lamb et al, 2011 ; Tschan et al, 2015 ; Choi et al, 2023 ). Thereby, quality of patient care hinges on the successful intra- and interprofessional collaboration among healthcare professionals, and sensitive interaction with patients and their families (World Health Organization, 2010 ; Committee on Diagnostic Error in Health Care et al, 2015 ; Graber et al, 2017 ).…”