You can have all the best parts of a car but if you just throw the pieces together, you aren’t going to create an automobile. You need to fit the pieces together properly to create a working car.

And the same is true for certain types of work groups, too, according to Reuben McDaniel, professor of information management, and Luci Leykum, associate dean for clinical affairs in the School of Medicine at the UT Health Science Center at San Antonio.

Hospital care teams with lower relationship rates had higher complication rates, and one team had a patient die from an unrecognized infection.McDaniel and Leykum presented their research on high knowledge temporary teams--teams of highly trained and educated people working together for a short time period--in a talk titled “Care Teams in Hospitals- How Making Sense and Improvising Can Keep You Alive.” The Nov. 8, 2011 talk was part of the Undergraduate Business Council’s Faculty Research Presentation Series.

Traditionally, in the business world, high knowledge temporary teams are thought of as entities that should run like machines in which each team member should know their role and do their job. However, McDaniel and Leykum did not think this was the best way to look at these teams, so they followed a group of hospital care teams, a good example of high knowledge temporary teams, in order to understand the association between team relationships and outcomes.

The pair’s hypothesis was that these teams are more than a collection of skill sets of the individuals and that there is something about the relationships within the teams that has a large effect on their outcome.

In order to research this hypothesis, McDaniel and Leykum attributed behaviors to different aspects of relationships, to be able to measure and monitor them within the group. For example, in order to see the level of trust between the group members, Leykum and McDaniel looked at how often the members portrayed themselves as vulnerable to each other.  Seeing an attending physician say “I don’t know” was very powerful because they are admitting to their team that there is something within their profession that they don’t understand. 

McDaniel and Leykum found that relationship qualities characterize how well a group works together, as well as how productive their outcome is. 

They discovered that hospital care teams with lower relationship rates had higher complication rates, and one team had a patient die from an unrecognized infection.

They also discovered that teams with similar skill sets vary greatly in terms of relationships, and that we need to pay attention to team level behaviors through reflection and conversation. It is important that team members take the opportunity to talk with each other so that each member becomes aware of how their actions affect the others, they said. Also, it is important to talk in general, not just during shift changes or about how the patients are doing.

The pair also found that teams need to eliminate role definition and instead create an entity where everybody is responsible for everything so that nothing falls through the cracks. While this can create redundancy, that redundancy brings vigilance. If everything is everyone’s responsibility, then everyone is paying attention to every detail.

It is important for team members to realize that there are multiple people involved in the care of a patient, or the outcome of a project. If team members don’t have a relationship that allows them to talk to each other, no one will recognize when something is going wrong.