Primary Author:	Caitlin L. McAllister, BS
Organization	School of Medicine, University of Texas Health Science Center at San Antonio

Abstract

Purpose

The purpose of this study was to determine whether inpatient medical teams could be distinguished based on the relationships among team members.

Background

How inpatient physician teams function is often thought of in terms of the skill sets of individuals on the team, e.g., having a “strong” resident or “good” intern. While individual skills are important, an increasing literature suggests that team performance is more than just the sum of individual performance, and that the relationships among team members are critical to team function. Seven important characteristics of relationships have been identified in healthcare settings: trust, diversity, respect, heedfulness, mindfulness, social and task relatedness, and rich and lean communication.

Materials & Methods

Nine inpatient teams were observed daily during rounds for approximately four weeks. Rounds were audiotaped, and detailed field notes were taken and reviewed for this analysis. Relationship characteristics were operationalized in terms of team behaviors observed during rounds. Table 1 summarizes behaviors felt to reflect each of the relationship characteristics (see attachment).

Team profiles were created based on multiple reviews of field notes. Team behaviors were stratified using the following categorization:
+ = team consistently exhibited positive behavior
– = team consistently exhibited negative behavior
0 = no relevant behaviors were observed for the team

Results

We observed behaviors reflecting relationship characteristics on all teams. Teams varied greatly in the pattern of relationship behaviors, with three teams exhibiting behaviors reflective of positive relationships across all characteristics, and two teams for whom no positive behaviors were noted. Table 2 summarizes each team with regard to relationship behaviors (see attachment).

Conclusion

Physician teams can be distinguished based on behaviors that reflect relationships among team members. Physician team relationships may be important to team function, particularly how team members make sense of what is happening with their patients. They may also influence patient outcomes. We are currently examining the association between team relationships and patient outcomes.

© Improvement Science Research Network, 2012

The ISRN published this as received and with permission from the author(s).