Cross-boundary teaming for innovation: Integrating research on teams and knowledge in organizations

Contribution of Coordination Theories to the Determination of Human Factors Associated With Operating Room Perceived Performance

BACKGROUND

The efficient and fluid organization of surgical interventions in an operating room (OR) and operating suite (OS) is important as these are among the most expensive units to run in medical-surgical facilities. The complexity of OS organization requires careful coordination, defined here as the directing of individuals' efforts toward achieving common and explicitly recognized goals. There is currently sparse literature on OS coordination, especially in the French context. This study aimed to respond to this gap by reporting on the coordination mechanisms associated with the perceived performance of OS across 4 facilities in an urban setting in France.

METHODS

We used a qualitative comparative case study based on ethnographic methodology to explore 4 facilities (2 teaching, 1 general, and 1 private). Several investigation techniques were used for data collection (semistructured interviews, participant and nonparticipant observations, and informal interviews) in the OR, the OS, the regulation council (dedicated to adapting the necessary resources to specific procedures and patients' health status), and the OS council (dedicated to strategic and operational OS transformations and adaptations, and responsible for finding solutions to organizational problems). Analysis was guided by Okhuysen and Bachky's theoretical framework on coordination and multi-team systems theory. Data were compared across the 4 facilities and triangulated using the different techniques to ensure coherence and accuracy.

RESULTS

Overall, 48 interviews with health care providers and hospital managers and 200 hours of direct observations were performed. The OR exhibited a high degree of coordination, whereas improved perception of performance in the OS depended on managerial competency, trust, and authority. Perceived performance in the regulation council and OS council, on the other hand, depended on the identification of formal objectives by all stakeholders and the development of common understanding (developing agreement, direct information sharing, creating common perspective, substitution, bringing groups together, and storing of knowledge).

CONCLUSIONS

Based on existing literature on multi-team systems (as represented in the OS organization), this study identifies success factors influencing OS coordination. These include the OS manager's leadership skills; the identification of formal system objectives; and professional differentiation between stakeholders (absence/decrease of a sense of belonging to a multi-team system). This differentiation was related to the high degree of specialization within OS teams, each bringing different norms, cultures, and contingencies that induce dissonance in organization and task performance. Interventions targeting these success factors might improve coordination, and thus performance, in the OS.

With whom should I work? Partners' network characteristics and innovation persistence

In studying the implications of collaboration networks on innovation persistence, previous research has primarily focused on the network characteristics of focal inventors, often overlooking those of their partners. The purpose of this study is to demonstrate what and how partners' network characteristics-specifically, network centrality and structural holes-affect the focal inventor's innovation persistence, by positing and testing the diversity and novelty of knowledge recombination as important mediators. We collected a panel patent dataset in the lithography industry between 2000 and 2023 and conducted data analysis using ordinary least squares (OLS) regression model, robustness test, and endogeneity test. Results indicate that partners' network centrality has an inverted U-shaped impact on innovation persistence, whereas partners' structural holes positively influence innovation persistence. The findings further show how the diversity and novelty of knowledge recombination mediate the relationships between partners' network characteristics and innovation persistence. This paper provides valuable insights for inventors, researchers, and policymakers, emphasizing the crucial role of partnerships and knowledge recombination in promoting innovation persistence.

The ripple effect of strain in times of change: how manager emotional exhaustion affects team psychological safety and readiness to change

Introduction

Managers assume a pivotal role during periods of organizational change, yet there exists a notable gap in our understanding of how their emotional exhaustion may impact their capacity to generate readiness to change within their teams. Grounded in the conservation of resources theory (COR), this study explores the crossover effect of managers' emotional exhaustion on team readiness to change. We expect this to occur through higher levels of laissez-faire leadership, which impacts the teams' psychological safety.

Methodology

Data was gathered within a Canadian governmental organization undergoing two significant changes-cultural change and digitalization-with a specific focus on leadership as a pivotal factor in preparing teams for change. Employing surveys from 372 team members and 62 managers affected by this change, we conducted path analysis to empirically test the proposed model across 74 teams and their respective managers.

Results

Managers' emotional exhaustion has a negative indirect effect on team readiness to change. The double mediation pathway implies a positive relationship on laissez-faire leadership, which hinders psychological safety. In turn, psychological safety hampers team readiness to change.

Conclusion

Managers must invest significant resources to fulfill their roles and responsibilities during strategic change. Those who feel exhausted during change may look for ways to protect some of their resources by reducing the time and energy they invest leading their team. This self-preserving resource strategy has detrimental consequences on teams' effectiveness during change due to an indirect crossover effect that affects the levels of psychological safety on the team.

Cognitive versatility and adaptation to fluid participation in hospital emergency department teams

Role-based frameworks have long been the cornerstone of organizational coordination, providing clarity in role expectations among team members. However, the rise of "fluid participation"-a constant shift in team composition and skill sets-poses new challenges to traditional coordination mechanisms. In particular, with fluid participation, a team's roles can oscillate between disconnected and intersecting, or between lacking and having overlap in the capabilities and expectations of different roles. This study investigates the possibility that a disconnected set of roles creates a structural constraint on the flexible coordination needed to perform in volatile contexts, as well as the mitigating role of cognitive versatility in a team's strategically-central member. Utilizing a sample of 342 teams from a hospital Emergency Department, we find that teams with a disconnected role set are less effective than teams with an intersecting role set as demonstrated by longer patient stays and increased handoffs during shift changes. Importantly, the presence of a cognitively versatile attending physician mitigates these negative outcomes, enhancing overall team effectiveness. Our findings remain robust even after accounting for other variables like team expertise and familiarity. This research extends the Carnegie School's seminal work on fluid participation by integrating insights from psychology and organizational behavior, thereby identifying key individual attributes that can bolster team coordination in dynamic settings.

Team Functioning and Performance in Child Advocacy Center Multidisciplinary Teams

The quality of teamwork in Child Advocacy Center (CAC) multidisciplinary teams is likely to affect the extent to which the CAC model improves outcomes for children and families. This study examines associations between team functioning and performance in a statewide sample of CAC teams. Multidisciplinary team members (N = 433) from 21 CACs completed measures of affective, behavioral, and cognitive team functioning. Team performance was assessed with three measures: team member ratings of overall performance, ratings of mental health screening/referral frequency, and caregiver satisfaction surveys. Linear mixed models and regression analyses tested associations between team functioning and performance. Affective team functioning (i.e., liking, trust, and respect; psychological safety) and cognitive team functioning (i.e., clear direction) were significantly associated with team members' ratings of overall performance. Behavioral team functioning (i.e., coordination) and cognitive team functioning were significantly associated with mental health screening/referral frequency. Team functioning was not associated with caregiver satisfaction with CAC services. Aspects of team functioning were associated with team members' perceptions of overall performance and mental health screening/referral frequency, but not caregiver satisfaction. Understanding associations between team functioning and performance in multidisciplinary teams can inform efforts to improve service quality in CACs and other team-based service settings.

Interdisciplinary interventions that improve patient-reported outcomes in perioperative cancer care: A systematic review of randomized control trials

INTRODUCTION

Interdisciplinary teams are often leveraged to improve quality of cancer care in the perioperative period. We aimed to identify the team structures and processes in interdisciplinary interventions that improve perioperative patient-reported outcomes for patients with cancer.

METHODS

We searched PubMed, EMBASE, and CINAHL for randomized control trials published at any time and screened 7,195 articles. To be included in our review, studies needed to report patient-reported outcomes, have interventions that occur in the perioperative period, include surgical cancer treatment, and include at least one non physician intervention clinical team member: advanced practice providers, including nurse practitioners and physician assistants, clinical nurse specialists, and registered nurses. We narratively synthesized intervention components, specifically roles assumed by intervention clinical team members and interdisciplinary team processes, to compare interventions that improved patient-reported outcomes, based on minimal clinically important difference and statistical significance.

RESULTS

We included 34 studies with a total of 4,722 participants, of which 31 reported a clinically meaningful improvement in at least one patient-reported outcome. No included studies had an overall high risk of bias. The common clinical team member roles featured patient education regarding diagnosis, treatment, coping, and pain/symptom management as well as postoperative follow up regarding problems after surgery, resource dissemination, and care planning. Other intervention components included six or more months of continuous clinical team member contact with the patient and involvement of the patient's caregiver.

CONCLUSIONS

Future interventions might prioritize supporting clinical team members roles to include patient education, caregiver engagement, and clinical follow-up.

Creativity in Scientific Research: Multidisciplinarity Fosters Depth of Ideas Among Scientists in Electronic "Brainwriting" Groups

OBJECTIVE

The aim of this study was to examine the potential benefits of multidisciplinarity among agri-food researchers working in small groups to generate ideas to stimulate innovation in the context of a laboratory project.

BACKGROUND

Research on the role of multidisciplinarity in scientific research teams remains limited, particularly regarding the generation of ideas to innovate in a real laboratory project, and on a task with a real challenge for innovation.

METHOD

Researchers and agri-food research staff were assigned to small groups of either multidisciplinary or unidisciplinary composition to produce ideas on a cross-cutting theme for an innovative laboratory project using an electronic "brainwriting" application.

RESULTS

A greater depth in idea generation (number of ideas per category) was observed in the multidisciplinary condition than in the unidisciplinary condition.

CONCLUSION

The main benefits of this study were to experimentally examine the effects of multidisciplinarity in small scientific research groups on the production of ideas in a field study conducted on the premises of an agri-food laboratory.

APPLICATION

This study provides advice on how to promote innovative projects by stimulating ideation processes, which includes constructing small multidisciplinary groups and using an electronic "brainwriting" technique.

The Dynamics of Team Learning: Harmony and Rhythm in Teamwork Arrangements for Innovation

Innovation teams must navigate inherent tensions between different learning activities to produce high levels of performance. Yet, we know little about how teams combine these activities-notably reflexive, experimental, vicarious, and contextual learning-most effectively over time. In this article, we integrate research on teamwork episodes with insights from music theory to develop a new theoretical perspective on team dynamics, which explains how team activities can produce harmony, dissonance, or rhythm in teamwork arrangements that lead to either positive or negative effects on overall performance. We first tested our theory in a field study using longitudinal data from 102 innovation teams at a Fortune Global 500 company; then, we replicated and elaborated our theory in a study of 61 MBA project teams at an elite North American university. Results show that some learning activities can occur within the same teamwork episode to have harmonious positive effects on team performance, while other activities combine to have dissonant negative effects when occurring in the same episode. We argue that dissonant activities must be spread across teamwork episodes to help teams achieve a positive rhythm of team learning over time. Our findings contribute to theory on team dynamics, team learning, and ambidexterity.

Differing Professional Perspectives on the Interprofessional Collaboration in IPUs: A Mixed-methods Study

Introduction

An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires employees from diverse professional backgrounds to interact, but there is limited knowledge on how professionals perceive such interprofessional collaboration. We aimed to provide insight into how different professionals perceive Integrated Practice Unit (IPU) composition and what factors influence the quality of interprofessional collaboration within IPUs.

Methods

A survey was administered to employees from different professional backgrounds (medical specialists, nurses, allied health professionals, administrative employees) working in IPUs to assess their perception of the composition of their IPU and the quality of the interactions. Subsequently, semi-structured interviews were conducted to gain a deeper understanding of the findings of the survey.

Results

Medical specialists and nurses were most frequently considered to be part of an IPU and indicated that they have high quality interactions. Allied health professionals were less often considered part of the team by all other professional groups and all report low quality interaction with this group. The extent to which a professional group is perceived as a team member depends on their visibility, involvement in the treatment of the patient, and shared interest. Differences in the quality of interprofessional collaboration are influenced by organizational structures, knowledge of each other's expertise, and by ways of communication.

Conclusions

In VBHC, there seems to be a lack of common perception of an IPU's composition and a failure to always achieve high quality interprofessional collaboration. Given the importance of interprofessional collaboration in VBHC, effort should be invested in achieving a shared understanding and improved collaboration.

Readiness for Interprofessional Learning Among Students of Four Undergraduate Health Professions Education Programs

BACKGROUND

In interprofessional learning, students from different professions learn about, from, and with each other so that they can collaborate effectively, deliver high-quality healthcare, and achieve positive health outcomes. This study aimed to explore the readiness of students from four health professions education programs for interprofessional learning.

METHODS

A cross-sectional descriptive study was carried out on 339 students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to collect data. Descriptive statistics were used. Paired-samples t-test and ANOVA test were used to compare the responses of participants. Correlations between dependent and independent variables were explored by Pearson's correlation test. The statistical significance level was set at p < 0.05.

RESULTS

The reliability study of the collected data showed excellent internal consistency (Cronbach's ɑ = 0.819). Results revealed a statistically significant difference between the responses of students from the four programs regarding the "Roles and Responsibilities" subscale (p = 0.000). A statistically significant difference between male and female students regarding two statements within the "Teamwork and Collaboration" subscale and one statement within the "Negative Professional Identity" subscale (p < 0.05) was also detected. The correlation study showed a weak but statistically significant correlation between RIPLS mean scores and the students' study program (p < 0.015).

CONCLUSION

In conclusion, the students showed readiness for IPL as evidenced by their positive perception of the interprofessional learning concepts.

Perk or Peril? Making Sense of Member Differences When Interorganizational Collaboration Begins

Team member differences can be found in various characteristics and be seen as both perks and perils. But what makes one group focus on certain dimensions and differences’ positive implications, while another collective notices other aspects and sees trouble ahead? We address this question in the context of interorganizational teams’ first stages, when impressions are limited and valuations must be made promptly. Our findings from in-depth interviews offer a sensemaking perspective on perceived otherness and explicate when and why differences are interpreted as helping or hindering collaborative practices. Moreover, we illuminate how coorientation and representation dynamics shape otherness perceptions and valuations.

Transformation of Task Conflict Into Relational Conflict and Burnout: Enhancing Effect of Leader's Discriminatory Effect

Organizational conflict was proposed by dividing it into task conflict and relationship conflict. However, conflict is dynamic and therefor, the conflict transformation is recognized as an important topic in organizational conflict. In particular, task conflict can be easily transformed into relationship conflict due to emotional expression and misattribution in the process of conflict. In addition, task conflict can negatively affect employees' attitudes if it is transformed into relationship conflict even though task conflict can function properly. This transformation of conflict can become more active under certain conditions, and leaders play an important role in this transformation because leaders have an important influence on conflict management. Therefore, this study examined the effect of the transition from task conflict to relationship conflict on burnout and the moderating effect of leaders in the relationship between task and relationship conflict. To this end, surveying 721 employees in 15 departments, and multilevel mediation and moderation analysis were performed. As a result of analysis, employees' burnout increased when task conflict transformed into relationship conflict. In addition, greater the LMX differentiation of leader, greater the effect of task conflict on relationship conflict. Finally, theoretical and practical implications were discussed for leadership and conflict management.

Influences of Boundary-Spanning Leadership on Job Performance: A Moderated Mediating Role of Job Crafting and Positive Psychological Capital

Due to the pursuit of a flexible organization, the interest in internal as well as external boundary management has increased as a key to achieve high performance. This study identified boundary-spanning leadership (BSL) as a critical factor enhancing job crafting and job performance of subordinates. By examining the mediating effect of job crafting and the moderating effect of positive psychological capital (PsyCap), the authors aimed to present the effects of BSL assimilating job resources, such as external information and knowledge into organization. Data were collected from 238 workers of 11 companies using questionnaires in South Korea to test the moderated mediation model. The results of regression analysis using LISREL and SPSS, revealed that the manager's BSL provoked job crafting, which in turn achieved job performance of subordinates. Moreover, PsyCap positively moderated the effect of BSL on job crafting of subordinates. The findings suggested, therefore, in order to maximize the positive effects of BSL in an organization, it should also be necessary to understand and boost PsyCap along with enhancing job crafting.

Some metaheuristic algorithms for solving multiple cross-functional team selection problems

We can find solutions to the team selection problem in many different areas. The problem solver needs to scan across a large array of available solutions during their search. This problem belongs to a class of combinatorial and NP-Hard problems that requires an efficient search algorithm to maintain the quality of solutions and a reasonable execution time. The team selection problem has become more complicated in order to achieve multiple goals in its decision-making process. This study introduces a multiple cross-functional team (CFT) selection model with different skill requirements for candidates who meet the maximum required skills in both deep and wide aspects. We introduced a method that combines a compromise programming (CP) approach and metaheuristic algorithms, including the genetic algorithm (GA) and ant colony optimization (ACO), to solve the proposed optimization problem. We compared the developed algorithms with the MIQP-CPLEX solver on 500 programming contestants with 37 skills and several randomized distribution datasets. Our experimental results show that the proposed algorithms outperformed CPLEX across several assessment aspects, including solution quality and execution time. The developed method also demonstrated the effectiveness of the multi-criteria decision-making process when compared with the multi-objective evolutionary algorithm (MOEA).

Entry Points: Gaining Momentum in Early-Stage Cross-Boundary Collaborations

To address complex social challenges, it is widely recognized that leaders from public, for-profit, and civic organizations should join forces. Yet, well-intended collaborators often struggle to achieve alignment and fail to gain traction in their joint efforts. This article proposes the concept of “entry points” as a key milestone in a collaboration's early stages. Using a unique set of rich, longitudinal data, we examine how ten cross-boundary teams with representation from ten city governments in North America and Europe searched for these entry points (i.e., opportunities for focused action to advance learning and progress towards their collective goals). Based on systematic coding, we propose factors that impeded or enabled the teams' abilities to find entry points in their collaborative work. The paper contributes to literatures on cross-boundary collaboration, problem-oriented governance, and paradoxes in organizational behavior, and it offers an analytic framework to help cross-boundary collaboration practitioners identify their entry points.

Workplace bullying and team performance: the mediating role of team psychological contract breach

Purpose

This paper aims to examine the relationship between workplace bullying (WPB) and team performance (TP). And it also attempts to investigate the mediating role of team psychological contract breach (TPCB) in the relationship between WPB and TP.

Design/methodology/approach

Multiple sources and a time-lagged approach were applied at six-week intervals to 64 work teams across 12 different firms in Turkey to test the hypotheses. A linear regression analysis was conducted to evaluate the association between variables.

Findings

The results indicate that WPB leads to negative perceptions of TPCB, which, in turn, have a negative impact on TP.

Research limitations/implications

This study design cannot establish causality, in spite of the fact that the authors used time-lagged data to decrease common method bias.

Practical implications

Managers or team leaders can design activities or programs (i.e. counselling sessions) to promote group cohesiveness, as well as immediately address complaints from team members who feel aggrieved to counteract the negative effects of bullying and reprimand perpetrators; such actions can mitigate perceptions of psychological contract breach.

Originality/value

Few studies have been conducted to test the mediating role of TPCB in the team context. This study stands out as it examines the mediating effect of TPCB in the relationship between WPB and TP. The findings advance the understanding of how WPB could negatively affect TP in a mediation model.

Designing the Collaborative Organization: A Framework for how Collaborative Work, Relationships, and Behaviors Generate Collaborative Capacity

We offer a framework for developing the collaborative workplace, developed through a case study of a subsystem of Intuit Canada, a knowledge-based product development firm known for strong collaboration. Grounded in interviews, observations, informal conversations, and archival data, our framework reveals a series of factors that shape work, relationships, and behaviors to promote collaboration widely. Beyond factors, we uncover what it is about them, the underlying properties that created the conditions for employees to work, relate and contribute collectively. We show how the factors interrelate to create two collaborative subsystems; one fostering widespread alignment around strategic goals and the other fostering locally led interactivity to operationalize those goals. We illustrate how the duality works in practice and conclude with implications for future research and practice.

The Informal Champion’s Role in Promoting the Care of Inter-Professional Teams

This study aimed to examine how allied healthcare professionals as informal leaders can lead reforms to improve patient care on an interprofessional team. With 284 interprofessional team members working in 59 geriatric facilities, our findings demonstrated that informal leaders exhibiting more championship behaviors gained higher innovation success scores. In addition, the champion’s professional tenure and institutional size were both negatively associated with innovation success. We discuss important implications for this understudied issue in interprofessional team research: how a low-status informal leader can direct reform aimed at improving patient care within a healthcare organization.

Teaming in Interdisciplinary Chronic Pain Management Interventions in Primary Care: a Systematic Review of Randomized Controlled Trials

BACKGROUND

Current pain management recommendations emphasize leveraging interdisciplinary teams. We aimed to identify key features of interdisciplinary team structures and processes associated with improved pain outcomes for patients experiencing chronic pain in primary care settings.

METHODS

We searched PubMed, EMBASE, and CINAHL for randomized studies published after 2009. Included studies had to report patient-reported pain outcomes (e.g., BPI total pain, GCPS pain intensity, RMDQ pain-related disability), include primary care as an intervention setting, and demonstrate some evidence of teamwork or teaming; specifically, they needed to involve at least two clinicians interacting with each other and with patients in an ongoing process over at least two timepoints. We assessed study quality with the Cochrane Risk of Bias tool. We narratively synthesized intervention team structures and processes, comparing among interventions that reported a clinically meaningful improvement in patient-reported pain outcomes defined by the minimal clinically important difference (MCID).

RESULTS

We included 13 total interventions in our review, of which eight reported a clinically meaningful improvement in at least one patient-reported pain outcome. No included studies had an overall high risk of bias. We identified the role of a care manager as a common structural feature of the interventions with some clinical effect on patient-reported pain. The team processes involving clinicians varied across interventions reporting clinically improved pain outcomes. However, when analyzing team processes involving patients, six of the interventions with some clinical effect on pain relied on pre-scheduled phone calls for continuous patient follow-up.

DISCUSSION

Our review suggests that interdisciplinary interventions incorporating teamwork and teaming can improve patient-reported pain outcomes in comparison to usual care. Given the current evidence, future interventions might prioritize care managers and mechanisms for patient follow-up to help bridge the gap between clinical guidelines and the implementation of interdisciplinary, team-based chronic pain care.

Explore to Learn

Explorative information systems behaviors are the ways in which individuals actively revise their usage and discover creative means of applying the system, extending the potentials of the system, and enhancing task performance. This study has developed a specific concept of explorative system behavior-explorative information technology (IT) learning-to describe users' post-training learning behavior-novel use. Adapting a herding lens, we study the individual and team-level triggers of explorative learning cognitions. The study tests the proposed cross-level model and collects data from 225 individuals who are divided into 51 teams. The results indicate that individuals tend to innovatively use a system through developed exploration cognitions in team settings as a response to examined herd behavior triggers. The study uncovered that members of cohesive teams and learners with high uncertainty perceptions are more likely to imitate the observed explorative learning behaviors of their peers and reproduce such behaviors in the long term.

Personal Competition Among Sports Players and Their Performance as a Team: A Moderated Mediation Model

Personal competition among colleagues and co-workers has been observed in order to prove their professional superiority over others. Such behaviors have grave consequences on the overall team performance. The aim of this study was to investigate the role of personal competition on team performance incorporating the mediating role of the playing dumb behavior of knowledge hiding. The study has further checked the moderating effect of task interdependence on the relationship between personal competition and playing dumb. Data for the present study had been collected through questionnaires from the sports players actively associated with games through their educational institutes in China. The sample size of the study was 339, selected on the basis of convenience sampling. Smart PLS had been employed to analyze the data through structural equation modeling (SEM). The results of the study showed a strong impact of personal competition on team performance and the playing dumb variable. Furthermore, playing dumb has been found to have a strong mediating impact on team performance. The study has theoretically contributed to the literature of competition and performance by investigating the mediating role of playing dumb. The study also offers certain practical implications to the managers of the corporate world to devise such human resource policies that take appraisals from the colleagues so as to rectify the negative workplace behaviors and could be worked out accordingly.

Fostering Innovation in Diversified Business Groups with the Creation of Cross-subsidiary Collaborative Structures

Today’s industrial context leads companies to use collaboration and partnerships to tackle global issues and create value. For diversified business groups, it represents a good opportunity to make the most of their internal competencies by creating new synergies between their subsidiaries to foster innovation. However, building successful collaborative projects remains a complex process. Thus, an action research approach was used through a case study in a French diversified business group to have in-depth and intrinsic observations in the complex dynamics of collaboration and innovation management. This paper presents a method to create cross-subsidiary collaboration structures on innovative and strategic topics, with theoretical and practical recommendations.

Cognitive cultural intelligence and entrepreneurial alertness: evidence from highly educated, employed immigrants in the USA

Purpose

There is a dearth of research on how immigrants' cognitive attributes influence their willingness to be self-employed. To offset this paucity, the current study draws on the insights of social cognitive theory (SCT) to examine the immigrants' entrepreneurial alertness.

Design/methodology/approach

The authors hired Qualtrics to recruit educated, working immigrants in the USA and tested the hypotheses using a sample of 555 highly educated, employed immigrants from 92 home countries.

Findings

This study finds that immigrants' cognitive cultural intelligence (CQ) contributes to entrepreneurial alertness in a positive way. In addition, immigrants' perceived environmental differences and global identity positively moderate the relationship between cognitive CQ and entrepreneurial alertness.

Originality/value

This research provides a clear picture of how cognitive CQ impacts immigrants' entrepreneurial alertness; thus, the findings of this study offer ample implications for policymakers. By applying SCT, the current study extended research on immigrants' entrepreneurial alertness by shifting the focus from their individual (e.g. demographic background) or family characteristics to their cognitive attributes. This study suggests that policymakers and entrepreneurship education programs in the U.S.A. should consider offering various types of cultural training programs.

The power of proximity: Effects of a multidisciplinary fibroid clinic on inter-specialty perceptions and practice patterns

Background

Multidisciplinary collaboration has generally been shown to have positive effects on healthcare but can be difficult to facilitate. This study assessed the effects of a multidisciplinary fibroid clinic on practice patterns and clinician perceptions to better understand drivers of interspecialty collaboration.

Materials and methods

Annual rates of hysterectomies, myomectomies, and uterine fibroid embolizations (UFEs) performed in an urban healthcare system were collected from 2012–2019. Rates of each procedure were compared over time before and after launching a multidisciplinary fibroid clinic at the academic medical center. Referral rates were also compared. The gynecologists and interventional radiologists (IRs) involved in the clinic were interviewed 2 years prior to and after the clinic launch about their approaches to fibroids and perceptions of others who treat this condition. A phenomenological approach was used to identify and compare themes within the interviews by two researchers with excellent inter-rater agreement (κ = 0.80).

Results and discussion

Annual rates of fibroid procedures increased over time (p<0.01) but the relative number of UFEs decreased (p = 0.01). UFE referrals by the clinic gynecologists significantly increased as did the number of combined fibroid procedures (p<0.01). However, the rates of one fibroid procedure relative to others were not different between the clinic and rest of the healthcare system (p = 0.55). Specialty-specific perceptions of fibroid treatments and inter-specialty dynamics did not change. Despite this, clinicians unanimously perceived the clinic and post-clinic practice patterns as positive and distinct from their previous work and relationships between gynecology and IR elsewhere. Limitations of this study included its single clinic design and potential confounder of differences in advertising pre- versus post-clinic.

Conclusion

Creating the right practice environment may be more important for fostering inter-specialty collaboration and work satisfaction than shared mental models or procedural volumes in certain practice settings.

Teamwork in clinical genomics: A dynamic sociotechnical healthcare setting

RATIONALE, AIMS AND OBJECTIVES

Teamworking across sociotechnical boundaries in healthcare is growing as technological advances in medicine abound. With this progress, teams need to find new ways of working together in non-traditional settings. The novel field of clinical genomics provides the opportunity to rethink the existing approach to teamworking and how it needs to evolve. Our aim was to identify the key factors influencing teamworking in the emerging field of clinical genomics and how can they be applied in practice.

METHOD

We drew on three qualitative datasets from interviews undertaken in Australia, 2018/2019, that explored determinants of implementation of clinical genomics with laboratory scientists (n = 7), service and programme leads (n = 21), project officers (n = 2), clinical genetics staff (n = 26) and other medical specialists (n = 21). Data were analysed using a theory-informed matrix approach to identify themes related to teamworking.

RESULTS

We identify that teams in clinical genomics work in an elongated adaptive context where there is rapid evolution of the knowledge base, shifting expectations of staff roles, and fast changes of technology. Delivering care in this setting brings additional challenges to teamworking as members strive to stay abreast of current knowledge and technology. We identify four themes: (a) the role of the team in keeping knowledge up-to-date; (b) professional identity; (c) team adaptability, and (d) practical/organisational considerations.

CONCLUSION

Challenges to teamworking that arise in the elongated adaptive context do not always fit traditional ways of working, and innovative strategies will need to be adopted to ensure the diagnostic advances of clinical genomics are realised. Provision of time and permission for team members to share knowledge and evolve, promoting capacity building, nurturing trustful relationships and establishing boundaries are amongst the practice recommendations for organisational and team leaders, even though these activities may disrupt existing ways of working or hierarchical structures.

Understanding Matchmakers’ Experiences, Principles and Practices of Assembling Innovation Teams

The team composition of a project team is an essential determinant of the success of innovation projects that aim to produce novel solution ideas. Team assembly is essentially complex and sensitive decision-making, yet little supported by information technology (IT). In order to design appropriate digital tools for team assembly, and team formation more broadly, we call for profoundly understanding the practices and principles of matchmakers who manually assemble teams in specific contexts. This paper reports interviews with 13 expert matchmakers who are regularly assembling multidisciplinary innovation teams in various organizational environments in Finland. Based on qualitative analysis of their experiences, we provide insights into their established practices and principles in team assembly. We conceptualize and describe common tactical approaches on different typical levels of team assembly, including arranging approaches like “key-skills-first”, “generalist-first” and “topic-interest-first”, and balancing approaches like “equally-skilled-teams” and “high-expertise-teams”. The reported empirical insights can help to design IT systems that support team assembly according to different tactics.

Developing and evaluating a team development intervention to support interdisciplinary teams

Introduction:

Incentivizing the development of interdisciplinary scientific teams to address significant societal challenges usually takes the form of pilot funding. However, while pilot funding is likely necessary, it is not sufficient for successful collaborations. Interdisciplinary collaborations are enhanced when team members acquire competencies that support team success.

Methods:

We evaluated the impact of a multifaceted team development intervention that included an eight-session workshop spanning two half-days. The workshop employed multiple methods for team development, including lectures on empirically supported best practices, skills-based modules, role plays, hands-on planning sessions, and social interaction within and across teams. We evaluated the impact of the intervention by (1) asking participants to assess each of the workshop sessions and (2) by completing a pre/postquestionnaire that included variables such as readiness to collaborate, goal clarity, process clarity, role ambiguity, and behavioral trust.

Results:

The content of the team development intervention was very well received, particularly the workshop session focused on psychological safety. Comparison of survey scores before and after the team development intervention indicated that scores on readiness to collaborate and behavioral trust were significantly higher among participants who attended the workshop. Goal clarity, process clarity, and role ambiguity did not differ among those who attended versus those who did not.

Conclusions:

Multicomponent team development interventions that focus on key competencies required for interdisciplinary teams can support attitudes and cognitions that the literature on the science of team science indicate are predictive of success. We offer recommendations for the design of future interventions.

A Theory-Based Approach for Identifying Nurse and Team Member Contributions in the Electronic Health Record

INTRODUCTION

Team-based care delivered by an interprofessional team has been shown to be an effective strategy for caring for diverse, complex patient populations. Interprofessional teams can improve outcomes, reduce costs, and enhance the patient experience through patient-centered care. Nurses are essential members of healthcare teams within and across settings.

BACKGROUND

It is imperative for practicing nurses, educators, and researchers to be able to identify and report the contributions of nurses to team performance and care outcomes to prepare students for high-performance teamwork to improve practice and influence healthcare policy. Currently, the work of many nurses and other team members is not discoverable in electronic health records. Methods used to identify all members of the healthcare team may not be aligned with theories and definitions of teamwork embedded in emerging nursing and interprofessional accreditation guidelines.

PURPOSE

This paper describes a promising new, theoretically grounded approach to identify team members, including nurses, in electronic health records.

METHODS

Using operational constructs from a common team definition, grounded in theory, primary care teams were data mined from EHR data to find the hidden members of the team.

DISCUSSION/CONCLUSION

Further testing and use of this approach have the potential to provide a robust strategy to identify and distinguish each team member's contributions to clinical outcomes while laying the foundation for a meaningful study of teams in large data sets like the electronic health record.

CLINICAL RELEVANCE

New strategies to study nursing and team member contributions utilizing EHR data may lead to improved clinical outcomes. A better understanding of how teams are structured may enhance the understanding of each team member's contribution to outcomes and lead to more equitable recognition and reimbursement for all team members.

Managing Organizational Constraints in Innovation Teams: A Qualitative Study Across Four Health Systems

Though increasingly useful for developing complex healthcare innovations, interdisciplinary teams are prone to resistance and other organizational challenges. However, how teams are affected by and manage external constraints over the lifecycle of their innovation project is not well understood. We used a multimethod qualitative approach consisting of over 3 years of participant observation data to analyze how four interdisciplinary teams across different health systems experienced and managed constraints as they pursued process innovations. Specifically, we derived the constraint management process, which demonstrates how teams address constraints at different stages of innovation by applying various tactics. Our findings point to several practical implications concerning innovation processes in healthcare: (a) how conditions in the organizational context, or constraints, can impede team progress at different stages of innovation; and (2) the collective efforts, or tactics, teams use to manage or work around these constraints to further progress on their innovations.

Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

BACKGROUND

Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings.

METHODS

We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis.

DISCUSSION

Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020220168.

Exploring the root causes of servitization challenges: an organisational boundary perspective

Purpose

This paper explains how servitization disrupts long-established internal and external boundaries of product-focused manufacturers and investigates the root causes of servitization challenges.

Design/methodology/approach

The authors draw from the collective experiences of 20 senior executives from ten multinational manufacturers involved in servitization, using a multiple case study approach, and employ a codebook thematic analysis technique.

Findings

The authors develop an integrative framework based on the theoretical notions of power, competency and identity boundaries to offer insights into the root causes of various servitization-related challenges.

Research limitations/implications

Although the extant literature discusses servitization challenges, it does not examine the underlying root causes that create them in the first place. This study contributes to the extant research by establishing rational links between organisational boundaries (internal and external) and servitization challenges in the interest of building a coherent and systematically integrated body of theory that can be successfully applied and built upon by future research.

Practical implications

This study provides a foundation for managers to recognise, anticipate and systematically manage various boundary-related challenges triggered by servitization.

Originality/value

It is one of the first studies to employ the concept of organisational boundary to understand the challenges created by servitization and to account for both internal (between different functions of the same organisation) and external boundaries (between an organisation and its external stakeholders) to establish a holistic understanding of the impacts of servitization on manufacturers.

Examining the average scores of nursing teamwork subscales in an acute private medical ward

BACKGROUND

Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and ultimately patient care.

METHODS

This study used a descriptive survey research method to measure nursing teamwork in a clinical environment. The Nursing Teamwork Survey (NTS) measures the levels of nursing teamwork in acute healthcare facilities. Items for the NTS were generated on theoretical grounds, based on teamwork behaviours, offering a practical explanation of teamwork dynamics.

RESULTS

The survey incorporated five subscales. The response rate to the survey was 90 % (n = 45) with an overall average result on the survey being (m = 2.97) on a 0-4 Likert scale. The validated NTS has provided participants the opportunity to consider nursing teamwork with regards to their position and perceived responsibilities towards patients and team members.

CONCLUSION

The findings highlight areas for consolidation and improvement in teamwork. Introducing teambuilding strategies and acting on results of this survey may support enhanced communication and teamwork influencing nursing care and patient outcomes. Findings recommend that activities to improve teamwork and ensuring teambuilding strategies are implemented to improve effective communication in an acute medical care setting would have significant impacts on staff satisfaction.

Implementing a clinical cutting-edge and decision-making activity: an ethnographic teamwork approach to a molecular tumorboard

Background

New technology implementation in healthcare must address important challenges such as interdisciplinary approaches. In oncology, molecular tumorboard (MTB) settings require biomedical researchers and clinical practitioners to collaborate and work together. While acknowledging that MTBs have been primarily investigated from a clinical rather than an organizational perspective, this article analyzes team processes and dynamics in a newly implemented MTB.

Methods

A systemic case study of a newly implemented MTB in a Swiss teaching hospital was conducted between July 2017 and February 2018, with in situ work observations, six exploratory interviews and six semi-structured interviews.

Results

An MTB workflow is progressively stabilized in four steps: 1) patient case submissions, 2) molecular analyses and results validation, 3) co-elaboration of therapeutic proposals, and 4) reporting during formal MTB sessions. The elaboration of a therapeutic proposal requires a framework for discussion that departs from the formality of institutional relationships, which was gradually incepted in this MTB.

Conclusions

Firstly, our research showed that an MTB organizational process requires the five teaming components that characterizes a learning organization. It showed that at the organizational level, procedures can be stabilized without limiting practice flexibility. Secondly, this research highlighted the importance of non-clinical outcomes from an MTB, e.g. an important support network for the oncologist community.

Enhanced recovery after surgical correction of adolescent idiopathic scoliosis

BACKGROUND

Few publications in the literature examine enhanced recovery after scoliosis surgery (ERAS) in children, despite significant scientific interest in adults. The objective of the current study was to describe an ERAS protocol for surgical correction of adolescent idiopathic scoliosis (AIS) and its results.

METHODS

ERAS outcomes were measured in two patient cohorts. Historical controls and ERAS groups were selected from patients managed for scoliosis surgery in 2015 and 2018, respectively. The ERAS protocol included fasting minimization, carbohydrate loading, the avoidance of background morphine infusions, perioperative opioid-sparing protocols, the use of a cooling brace, early physiotherapy, feeding and oral medications, and the early removal of urinary catheters and surgical drains. The main outcome of the study was hospital length of stay.

RESULTS

Overall, 82 controls and 81 ERAS patients were recruited. ERAS protocols were observed in over 80% of patients for almost items. Median length of hospital stay was significantly lower in the ERAS group (- 3 [95% confidence interval: -2; -4] days). Median morphine consumption was reduced by 25% and 35% on days 2 and 3, respectively. The incidence of PONV did not differ between the two groups, and the incidence of constipation decreased slightly but significantly in the ERAS group on day 2. Pain intensity at rest and movement were lower in the ERAS group at day 2 and 3.

CONCLUSIONS

The current study suggests an ERAS protocol after adolescent idiopathic scoliosis surgery is associated with reduced hospital length of stay and improved postoperative care.

Some Algorithms to Solve a Bi-Objectives Problem for Team Selection

In real life, many problems are instances of combinatorial optimization. Cross-functional team selection is one of the typical issues. The decision-maker has to select solutions among ( k h ) solutions in the decision space, where k is the number of all candidates, and h is the number of members in the selected team. This paper is our continuing work since 2018; here, we introduce the completed version of the Min Distance to the Boundary model (MDSB) that allows access to both the “deep” and “wide” aspects of the selected team. The compromise programming approach enables decision-makers to ignore the parameters in the decision-making process. Instead, they point to the one scenario they expect. The aim of model construction focuses on finding the solution that matched the most to the expectation. We develop two algorithms: one is the genetic algorithm and another based on the philosophy of DC programming (DC) and its algorithm (DCA) to find the optimal solution. We also compared the introduced algorithms with the MIQP-CPLEX search algorithm to show their effectiveness.

Innovating with Strangers; Managing Knowledge Barriers Across Distances in Cross-Industry Innovation

We explore the types of knowledge barriers that are encountered at organizational level in cross-industry innovation, what influences them and how they can be overcome. Eleven cross-industry projects were qualitatively analyzed at the individual level of activity. Innovation collaboration occurred at three levels; intra-organizational, inter-organizational, and inter-institutional. Each level exhibited added relational distances as well as semantic and pragmatic barriers, of which the latter type was the most challenging. Effort necessary to overcome knowledge barriers accumulated at each level. Knowledge barriers were increased by legitimacy differences and communicational deficiencies, and lowered by reduction of interdependencies, use of knowledge brokers, and previous cross-industry experience.