Focus less on role-based teams to improve care coordination

Care coordination and team-based care are effective ways to ensure that patients get the best care possible, but organizations can improve teamwork with less rigid and siloed team structures.

Team “scaffolds” may help members work better together and hold each other more accountable, according to an article from Harvard Business Review. This team structure focuses less on the individual roles and skills of its members and more on a well-defined, shared goal that team members work toward. When teams use role-based approaches, its members are likely to focus too narrowly on specific tasks and less on the group’s overall goal.

The article’s authors—Melissa A. Valentine, a core faculty member of the Center for Work, Technology and Organization at Stanford, and Amy C. Edmondson, a leadership and management professor at Harvard University—teamed for a 2014 study of the scaffolding structure at a large, urban emergency department. That ED’s previous structure was regimented, and nurses and doctors were not aware of which colleagues were assigned to which patients, leading to inefficient communication and a lack of accountability in the care team.

That ED was redesigned into four pods that handled their own flow of patients. Shift changes changed the staff in each pod regularly, but clinicians were co-located, so communication and sense of accountability improved.

Valentine and Edmondson note, though, that such scaffolded teams need to be managed effectively to be successful. Hospital and health facility leaders must work together to design the teams, and they must include input from staff members on the best strategies. Training that clearly communicates goals to team members and gathers feedback is also key, according to the article.