In today’s workplace, teams of coworkers often collaborate on projects, presentations, and other professional responsibilities. Managers tend to assemble these teams according to each member’s job role, experience, and skill set, but the internal relationships and communication within a team may be even more important determinants of successful group performance.

Luci Leykum and Holly Lanham, researchers at the University of Texas Health Science Center at San Antonio, study the relationships at play within teams of physicians at hospitals. In a recent study funded by the Department of Veterans Affairs, they explored how different styles of communication within a team relate to the quality of treatment the group provides to patients. Their findings may be relevant not only to health care teams but may also give clues about effective teams in other industries.

Leykum and Lanham observed 11 teams made up of attending physicians, residents, interns, and house staff over the course of 28 days as they interacted before, during, and after their daily rounds. They evaluated each team’s habits based on attributes including trust, diversity, respect, heedfulness (awareness of how each person’s role impacts the rest of the team), mindfulness, social/task relatedness, and rich/lean communication.

It turns out that trust among team members and mindfulness of alternative points of view are critical elements of a functional team. Patients who were overseen by teams that did not exhibit those characteristics spent more time in the hospital than patients treated by teams that did demonstrate those qualities — as many as three to seven extra days.

Groups that demonstrated trust and mindfulness (which Lanham describes as “openness to new ideas, seeking novelty even in routine situations, and having a rich, discriminating awareness of details”) communicated more directly and effectively, allowing them to do more effective triage and catch problems they might have otherwise missed. These behaviors may also reduce the likelihood of complications that would lengthen the hospital stay.

As a result, Lanham and Leykum, who presented their research at the recent Health Care Symposium at the McCombs School of Business, recommend loosening up the hierarchy or narrowly defined job roles within teams. Instead, they argue, teams should embrace shared responsibility, reflective conversations, and interpersonal relationships.

Toward a More Flexible Hierarchy

Organizations often embrace internal hierarchies because they establish a clearly defined chain of command. But Lanham says there are several negative aspects to hierarchies that often go overlooked.

“Hierarchies … can be a barrier to organizational behaviors such as problem solving, learning, and innovating or discovering new and better ways to meet performance goals, satisfy customers, raise profit margins, etc.,” Lanham says.

Lower-level employees are often hesitant to speak up when they need further instruction or have ideas to contribute for fear of rocking the boat. But in that type of environment, Lanham says, all members of the team miss out on potential learning opportunities.

“If you want the people who work for you to learn how to do their jobs better, they will at times need to be able to say, ‘I don’t know,’” she says. “One way to get employees to say this is to model it for them. This is important in hospital teams because patients’ lives depend on it. It’s also important, however, in business — particularly in thinking about ethical considerations that businesses face, such as protecting consumers from harm, providing employees with a safe work environment, increasing shareholder wealth, etc.”

Rethinking Job Roles

Like hierarchies, narrowly defined job roles can constrain a team’s ability to express new ideas and share information openly.

Leykum and Lanham’s findings suggest that when each team member only takes on responsibilities within his or her own prescribed skill set, the team does not operate as effectively as a unit. It is preferable for individuals to be able to adjust as the situation may require.

On one team Leykum observed, the attending physician occasionally took the lead on tasks that normally would be done by people lower in the hierarchy — perhaps the issue was particularly complex, it was a busy day, or a team member was out. Leykum says this was a powerful and effective use of role-modeling because it demonstrated to the team that everyone should do what is needed to help each other and take care of people in a timely fashion.

“How we move from saying, ‘This is what I do, this is what you do,’ to ‘This is what we do,’ is very important,” Leykum says.

Job roles should be somewhat malleable, but they should not relax the group’s structure to the point that a manager’s authority or oversight begins to erode, she says. The key is to be able to adapt.

“One of the things I observed in some teams was an ability to improvise, or use what they know or do as the basis for trying something new,” Leykum says. “That way, it is building on a platform of knowledge, not just trying something completely different.”

Recommendations for Managers

Managers of employee teams can take away several lessons from Leykum and Lanham’s research when assembling teams or planning group projects. One of the most important ingredients is mutual trust.

“Building trust as the basis for positive relationships is critical,” Leykum says. “Just by being deliberate in asking for different peoples’ viewpoints, thinking about how one person’s actions may influence another, and admitting that they don’t know something are powerful actions in creating trust.”

Making time for conversation and reflection is also key. “This allows people to think and make sense of things together, in a way that has a positive influence on the relationships,” Leykum says.

Willingness to consider alternative viewpoints from other team members is another factor that could affect a company’s performance as a whole, Lanham adds. “If people are operating on autopilot, they are less likely to seize an opportunity that presents itself, such as noticing a more efficient way to perform repetitive tasks, or notice when a machine isn’t working quite right, which could result in harm for employees or inferior products for consumers,” she says.


About the Author

This article was written by Rob Heidrick of Texas Enterprise. Texas Enterprise shares the business and public policy knowledge created at The University of Texas at Austin with Texas and with the world. Texas Enterprise stories by drawing on research from all over the university. see more.

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