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.

A systematic review of respect between acute care nurses and physicians.

BACKGROUND: Interprofessional collaboration between nurses and physicians has become an essential part of patient care, which, when lacking, can lead to well-known challenges. One possible explanation for ineffective nurse-physician collaboration is a lack of respect. PURPOSE: This review aims to enhance our understanding of the role of respect in work between nurses and physicians by synthesizing evidence about the conceptualization of respect, its mechanisms and outcomes, and its origins. METHODS: We performed a PRISMA-guided systematic literature review across five databases and reviewed 28 empirical studies about respect between nurses and physicians in acute care settings. FINDINGS: Research about respect between nurses and physicians varied in its conceptualization of respect in terms of its nature (as an attitude or behavior), its target (respect for individuals or groups), and its object (respect for task-relevant capabilities or human rights). The greatest convergence was on respect's object; the majority of studies focused on respect for task-relevant capabilities. The work reviewed offered insights into respect's potential mechanisms (attention and civility), outcomes (e.g., collaboration, patient outcomes, and provider outcomes such as job satisfaction), and origins (e.g., professional status and competence)-the latter suggesting how respect might be generated, developed, and maintained. PRACTICE IMPLICATIONS: Our review highlights a need to appreciate how respect for task-relevant capabilities relates to respect for human rights and what fosters each to avoid rewarding only one while hoping for both, allowing leaders to cultivate more effective nurse-physician collaborations and better patient and provider outcomes.

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication.

Teams offer the potential to achieve more than any person could achieve working alone; yet, particularly in teams that span professional boundaries, it is critical to capitalize on the variety of knowledge, skills, and abilities available. This article reviews research from the field of organizational behavior to shed light on what makes for a collectively intelligent team. In doing so, we highlight the importance of moving beyond simply including smart people on a team to thinking about how those people can effectively coordinate and collaborate. In particular, we review the importance of two communication processes: ensuring that team members with relevant knowledge (1) speak up when one's expertise can be helpful and (2) influence the team's work so that the team does its collective best for the patient.