"It's Complicated"

The concept of workplace teams has been championed and maligned, tested and turned every which way to discover the magic formula for what and who and how many work best to make teams effective. What most can agree on is that there is no getting around the need to build and harness quality teamwork in every workplace.

This is particularly true in healthcare, where people of different shifts and specialties along various hierarchical divisions have to pass batons and communicate vital information or risk patient harm.

Numerous hospital projects focusing on teamwork show impressive results. One multi-hospital project realized a 32 percent reduction in surgical site infections. Another project reduced clinical error rates in the ER from 30.9 percent to 4.4 percent.

But here's the rub: every team is different, from type of organization and composition and function of the team. Is it an ongoing team of workers or a project-based ad hoc team? How high is turnover and how does this affect team performance? The variables are nearly endless.

Another complicating factor in teamwork studies is the Hawthorne Effect -- when employees are given positive attention, job performance rises, regardless of the nature of the changes made.

We are left with mostly intuitive conclusions about teamwork, but intuition can be a powerful advisor. Add a large dollop of industry experience, and some wisdom emerges:

1. Keep the bureaucracy to a minimum

Make the team-related reporting, approvals and metrics simple. The team that stays focused on a few clear goals has the best shot at success.

2. Beware of the democratic team

When people think of a team as a democracy where everyone should get a vote, decisions suffer. This phenomenon turns a team into a dreaded "committee" that seeks consensus. Once they discover consensus is time-consuming if not entirely elusive, more haphazard decision-making becomes the default mechanism.

3. Check your ego at the door

Hand in hand with the above, the best teams are self-aware and feel safe in acknowledging their own superior or inferior knowledge or expertise.

Scientific American reported a recent study in, "Are Two Heads Better than One?” which could be summed up as "Yes, but it's complicated." The researchers found that better decisions depend on how accurately each individual assesses her own ability and degree of confidence, and in how well she communicates that to the other. In short, good team members learn to back up their opinions and communicate these effectively.

Interestingly, this same study found that additional heads may not be better than two. The temptation to succumb to group think is significant when members feel they can escape personal responsibility by hiding behind the auspices of the team.

4. Remove fear of reprisal for expressing safety concerns

This is hard to overstate. Consider an over-scheduled operating room where a surgical tech calls a sterile field breach. Few things put the kibosh on team trust like a palpable cooling of the atmosphere and a withering look from the surgeon. Find team leaders who nurture a culture where members can blow the whistle on a (legitimate) safety breach and be supported.

5. Keep "seamlessness" front and center

Those who actively seize opportunities to share information (even at the end of a long shift) are more likely to create successful outcomes.

Psychology Today reported on a recent teamwork study that concluded, "The most important factor in determining how intelligently a group will perform has nothing to do with accumulated knowledge or skill set. Rather, it depends on how well the individual members can read the emotions of the other group members."

This social perceptiveness is tough to teach, so it should be assessed during the search process.