Presentation
PS6 - Examining Teams and Multi-Team Systems for At-Home Health
SessionPoster Session 2
DescriptionAt-home healthcare is becoming an increasingly popular method of providing treatment. Whether a patient is severely ill, injured, or immobile, healthcare providers can provide quality treatment while the patient remains in the comfort of their home. At-home healthcare can be done through home visits and/or virtual care. Currently, literature examines patient safety (Lindblad et al., 2018), quality of care (Emmesjö et al., 2022), and aspects of team science such as communication and team performance (Keiser et al., 2022), and coordination (Osakwe et al., 2024; Möckli et al., 2023 ). Most healthcare operations deal with multiteam systems (MTSs). MTSs refer to two or more interdependent teams that work together to achieve a common overarching goal (Zaccaro et al., 2020). Each team in the MTS usually has unique expertise and sub-goals to complete. At-home healthcare, for example, may have an MTS composed of teams of nurses, physicians, and physiotherapists working together to take care of a patient (Adamakidou et al., 2020). Within an MTS, constructs from team science should be leveraged to achieve the desired goals due to the increased complexity of the system. However, it is important to note that home healthcare is not always delivered by a team. Sometimes, it can be a single provider. There is a disconnect in recognizing that there is a patient-provider team that exists. Recognizing that this interaction exists allows providers to leverage team science.
Although some research examines communication and coordination to increase team performance and outcomes, while conducting a literature review, little literature was available focusing on these topics. The literature that does exist seems to leave out important constructs such as boundary spanning, shared mental models (SMMs), and mutual trust that can facilitate improvement in communication, coordination, team performance, and much more. Although there is plenty of team science literature that examines these constructs, even in the healthcare industry, it must be explored with at-home healthcare as a unique environment. Effective boundary spanning facilitates the development of SMMs, which then facilitates the development of mutual trust. We will examine team science literature for each of the three constructs mentioned, the benefits of integrating them into a team model, and tie them to at-home healthcare.
Boundary spanning, which involves individuals or teams performing functions such as resource allocation, information exchange, and coordination between teams in an MTS, is essential in MTSs (Davison & Hollenbeck, 2012). The teams involved in at-home healthcare may be working remotely and/or asynchronously, making it difficult to communicate, coordinate, and work well together overall. Exploring boundary-spanning functions in home healthcare teams can enhance teamwork, aid in conflict resolution, and promote the development of shared mental models (SMMs).
Creating a shared mental model, which is an agreed-upon understanding between two or more individuals (Mathieu et al., 2000), will be difficult to create within in-home healthcare teams, considering they may not only be from different organizations but also rarely interact in person. Due to the unique nature of MTSs, traditional models of teams may not apply. Understanding how to develop effective SMMs in home healthcare teams is crucial, as strong SMMs enhance teamwork, improve decision-making, and boost team performance (Gisick et al., 2018), ultimately leading to better patient outcomes. One way this is accomplished is by creating an environment in which mutual trust is established.
Mutual trust is the shared belief by team members that other teammates will perform their roles and have their teammates' interests at heart (McComb et al., 2017). Mutual trust facilitates a willingness to communicate freely and has a mediating effect on teamwork and cooperation. However, without mutual trust, team members will spend their time, expertise, and resources checking their teammates’ work rather than completing their roles and collaborating effectively (Salas et al., 2005). If members of a home-care team do not have mutual trust established and partake in the mentioned behaviors, the quality of care provided to patients decreases. Especially considering that home healthcare has much stricter time constraints than regular healthcare settings, where providers may have access to the patient for a smaller time frame. Relating to mutual trust, psychological safety is a shared belief among the individuals in a team that determines whether or not it is safe to take interpersonal risks in the workplace (Edmondson, 1999). Having psychological safety established is linked to several outcomes including increased learning and performance, improved creativity, communication, and knowledge-sharing, and has been shown to help establish mutual trust (Newman et al., 2017).
Overall, this presentation examines the current state of the literature and addresses the gaps that exist. It specifically highlights the constructs of boundary spanning, shared mental models, and mutual trust as key areas that should be studied to maximize patient safety and the quality of care in at-home healthcare. This presentation is a call to action for healthcare organizations, practitioners, and researchers to study this area of science and to integrate these constructs into any at-home healthcare services. Doing so will fill in some of the missing gaps in the literature, allowing us to leverage the knowledge of team science in other applications to improve safety, quality, and, ultimately, patient outcomes.
References
Adamakidou, T., Triantafyllopoulou, M. N., Feleki, P., Papadopoulou, L., & Kalokairinou, A. (2020). Team Members' Roles in Home Healthcare: Evidence From the “AKEΣΩ—1” Project in Greece. Home Healthcare Now, 38(6), 318-326.
Davison, R. B., & Hollenbeck, J. R. (2012). Boundary spanning in the domain of multiteam systems. In Multiteam systems (pp. 323-362). Routledge.
Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative science quarterly, 44(2), 350-383.
Emmesjö, L., Hallgren, J., & Gillsjö, C. (2022). Home health care professionals’ experiences of working in integrated teams during the COVID-19 pandemic: a qualitative thematic study. BMC Primary Care, 23(1), 325.
Gisick, L. M., Webster, K. L., Keebler, J. R., Lazzara, E. H., Fouquet, S., Fletcher, K., ... & Chan, R. (2018). Measuring shared mental models in healthcare. Journal of Patient Safety and Risk Management, 23(5), 207-219.
Keiser, M. M., Turkelson, C., Smith, L. M., & Yorke, A. M. (2022). Using interprofessional simulation with telehealth to enhance teamwork and communication in home care. Home Healthcare Now, 40(3), 139-145.
Lindblad, M., Flink, M., & Ekstedt, M. (2018). Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers. BMJ open, 8(12), e024068.
Mathieu, J. E., Heffner, T. S., Goodwin, G. F., Salas, E., & Cannon-Bowers, J. A. (2000). The influence of shared mental models on team process and performance. Journal of applied psychology, 85(2), 273.
McComb, S. A., Lemaster, M., Henneman, E. A., & Hinchey, K. T. (2017). An evaluation of shared mental models and mutual trust on general medical units: implications for collaboration, teamwork, and patient safety. Journal of patient safety, 13(4), 237-242.
Möckli, N., Espinosa, J. A., Simon, M., Meyer-Massetti, C., & Zúniga, F. (2023). Clarifying the muddy concept of home healthcare coordination: A comprehensive theoretical framework. Heliyon, 9(3).
Newman, A., Donohue, R., & Eva, N. (2017). Psychological safety: A systematic review of the literature. Human resource management review, 27(3), 521-535.
Osakwe, Z. T., Seymour, C., Fabry, S., Michi, D., Maldonado, S., Videon, T., & Kaplan, D. B. (2024). Teamwork and Nurse Care Coordination in Home Healthcare. Home Healthcare Now, 42(3), 179-183.
Salas, E., Sims, D. E., & Burke, C. S. (2005). Is there a “big five” in teamwork?. Small group research, 36(5), 555-599.
Zaccaro, S. J., Dubrow, S., Torres, E. M., & Campbell, L. N. (2020). Multiteam systems: An integrated review and comparison of different forms. Annual Review of Organizational Psychology and Organizational Behavior, 7(1), 479-503.
Although some research examines communication and coordination to increase team performance and outcomes, while conducting a literature review, little literature was available focusing on these topics. The literature that does exist seems to leave out important constructs such as boundary spanning, shared mental models (SMMs), and mutual trust that can facilitate improvement in communication, coordination, team performance, and much more. Although there is plenty of team science literature that examines these constructs, even in the healthcare industry, it must be explored with at-home healthcare as a unique environment. Effective boundary spanning facilitates the development of SMMs, which then facilitates the development of mutual trust. We will examine team science literature for each of the three constructs mentioned, the benefits of integrating them into a team model, and tie them to at-home healthcare.
Boundary spanning, which involves individuals or teams performing functions such as resource allocation, information exchange, and coordination between teams in an MTS, is essential in MTSs (Davison & Hollenbeck, 2012). The teams involved in at-home healthcare may be working remotely and/or asynchronously, making it difficult to communicate, coordinate, and work well together overall. Exploring boundary-spanning functions in home healthcare teams can enhance teamwork, aid in conflict resolution, and promote the development of shared mental models (SMMs).
Creating a shared mental model, which is an agreed-upon understanding between two or more individuals (Mathieu et al., 2000), will be difficult to create within in-home healthcare teams, considering they may not only be from different organizations but also rarely interact in person. Due to the unique nature of MTSs, traditional models of teams may not apply. Understanding how to develop effective SMMs in home healthcare teams is crucial, as strong SMMs enhance teamwork, improve decision-making, and boost team performance (Gisick et al., 2018), ultimately leading to better patient outcomes. One way this is accomplished is by creating an environment in which mutual trust is established.
Mutual trust is the shared belief by team members that other teammates will perform their roles and have their teammates' interests at heart (McComb et al., 2017). Mutual trust facilitates a willingness to communicate freely and has a mediating effect on teamwork and cooperation. However, without mutual trust, team members will spend their time, expertise, and resources checking their teammates’ work rather than completing their roles and collaborating effectively (Salas et al., 2005). If members of a home-care team do not have mutual trust established and partake in the mentioned behaviors, the quality of care provided to patients decreases. Especially considering that home healthcare has much stricter time constraints than regular healthcare settings, where providers may have access to the patient for a smaller time frame. Relating to mutual trust, psychological safety is a shared belief among the individuals in a team that determines whether or not it is safe to take interpersonal risks in the workplace (Edmondson, 1999). Having psychological safety established is linked to several outcomes including increased learning and performance, improved creativity, communication, and knowledge-sharing, and has been shown to help establish mutual trust (Newman et al., 2017).
Overall, this presentation examines the current state of the literature and addresses the gaps that exist. It specifically highlights the constructs of boundary spanning, shared mental models, and mutual trust as key areas that should be studied to maximize patient safety and the quality of care in at-home healthcare. This presentation is a call to action for healthcare organizations, practitioners, and researchers to study this area of science and to integrate these constructs into any at-home healthcare services. Doing so will fill in some of the missing gaps in the literature, allowing us to leverage the knowledge of team science in other applications to improve safety, quality, and, ultimately, patient outcomes.
References
Adamakidou, T., Triantafyllopoulou, M. N., Feleki, P., Papadopoulou, L., & Kalokairinou, A. (2020). Team Members' Roles in Home Healthcare: Evidence From the “AKEΣΩ—1” Project in Greece. Home Healthcare Now, 38(6), 318-326.
Davison, R. B., & Hollenbeck, J. R. (2012). Boundary spanning in the domain of multiteam systems. In Multiteam systems (pp. 323-362). Routledge.
Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative science quarterly, 44(2), 350-383.
Emmesjö, L., Hallgren, J., & Gillsjö, C. (2022). Home health care professionals’ experiences of working in integrated teams during the COVID-19 pandemic: a qualitative thematic study. BMC Primary Care, 23(1), 325.
Gisick, L. M., Webster, K. L., Keebler, J. R., Lazzara, E. H., Fouquet, S., Fletcher, K., ... & Chan, R. (2018). Measuring shared mental models in healthcare. Journal of Patient Safety and Risk Management, 23(5), 207-219.
Keiser, M. M., Turkelson, C., Smith, L. M., & Yorke, A. M. (2022). Using interprofessional simulation with telehealth to enhance teamwork and communication in home care. Home Healthcare Now, 40(3), 139-145.
Lindblad, M., Flink, M., & Ekstedt, M. (2018). Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers. BMJ open, 8(12), e024068.
Mathieu, J. E., Heffner, T. S., Goodwin, G. F., Salas, E., & Cannon-Bowers, J. A. (2000). The influence of shared mental models on team process and performance. Journal of applied psychology, 85(2), 273.
McComb, S. A., Lemaster, M., Henneman, E. A., & Hinchey, K. T. (2017). An evaluation of shared mental models and mutual trust on general medical units: implications for collaboration, teamwork, and patient safety. Journal of patient safety, 13(4), 237-242.
Möckli, N., Espinosa, J. A., Simon, M., Meyer-Massetti, C., & Zúniga, F. (2023). Clarifying the muddy concept of home healthcare coordination: A comprehensive theoretical framework. Heliyon, 9(3).
Newman, A., Donohue, R., & Eva, N. (2017). Psychological safety: A systematic review of the literature. Human resource management review, 27(3), 521-535.
Osakwe, Z. T., Seymour, C., Fabry, S., Michi, D., Maldonado, S., Videon, T., & Kaplan, D. B. (2024). Teamwork and Nurse Care Coordination in Home Healthcare. Home Healthcare Now, 42(3), 179-183.
Salas, E., Sims, D. E., & Burke, C. S. (2005). Is there a “big five” in teamwork?. Small group research, 36(5), 555-599.
Zaccaro, S. J., Dubrow, S., Torres, E. M., & Campbell, L. N. (2020). Multiteam systems: An integrated review and comparison of different forms. Annual Review of Organizational Psychology and Organizational Behavior, 7(1), 479-503.
Event Type
Poster Presentation
TimeTuesday, April 14:45pm - 6:15pm EDT
LocationFrontenac Foyer