Team Scaffolds: How Minimal Team Structures Enable Role-based Coordination

• Main Author: Valentine, Melissa A
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2013
• Subjects: Collaboration; Communication; Design; Dissertations & theses; Efficiency; Emergency medical care; Hypotheses; Influence; Interdependence; Management; Organization Theory; Organizational behavior; Product development; Responsibilities; Skills; Teams; Workforce planning
• ISBN: 9781303187469; 1303187469

In this dissertation, I integrate research on role-based coordination with concepts adapted from the team effectiveness literature to theorize how minimal team structures support effective coordination when people do not work together regularly. I argue that role-based coordination among relative strangers can be interpersonally challenging and propose that team scaffolds (minimal team structures that bound groups of roles rather than groups of individuals) may provide occupants with a temporary shared in-group that facilitates interaction. I develop and test these ideas in a multi-method, multi-site field study of a new work structure, called pods, that were implemented in many hospital emergency departments (EDs) and were sometimes designed to function as team scaffolds. In chapter 3, I conduct an in-depth study of team scaffolds in one ED. I adapt network methods to compare coordination patterns before and after team scaffolds were implemented. My results show that the team scaffolds improve performance, in part by reducing the number of partners with whom each role occupant coordinates. Second, I analyze qualitative interview data to theorize the social experience of working in team scaffolds. Team scaffolds provided a shared in-group that supported a sense of belonging and reduced interpersonal risk. In chapter 4, I implement a cross-case comparison of pod design at two additional EDs. The pods at the comparative sites achieved some of the enabling conditions (proximity and boundedness) identified at the first ED, but did not scaffold group-level coordination. Instead other informal groupings felt like meaningful teams. The way that work was allocated at the two comparative EDs created a misalignment of ownership and interests between nurses and physicians, undermining the sense of teamness. In chapter 5, I conduct a quantitative analysis of pod performance at the three field sites. I consider the effect of the relatively stable resources in each pod and also the relational patterns that accumulate in each pod on operational performance. Within-shift shared patients is associated with operational performance, even though lifetime shared patients is not. Work teams are becoming less bounded and stable and my dissertation provides insight and evidence on the conditions under which relative strangers can identify as and function as a minimal team. I identify structures and mechanisms that enable teaming among hyper-fluid groups of people, and also demonstrate the importance of aligned ownership of work in how people make sense of teams in their work lives.