"Four minutes," a triumphant Amy C. Edmondson exclaims as she arrives at her Harvard Business School office, clutching a bike helmet and explaining that her commute is 10 minutes faster by bicycle than by car. Edmondson, the Novartis Professor of Leadership and Management at HBS, knows a thing or two about efficiency.
But it's one thing to make yourself more efficient, quite another to make a team more efficient, and still another when that team's membership is in constant flux. With short-term teams assembled on the fly becoming increasingly common in today's workplaces, Edmondson and a colleague set out to investigate how fluid teams can work better.
In their paper Team Scaffolds: How Mesolevel Structures Enable Role-Based Coordination in Temporary Groups, Edmondson and lead author Melissa A. Valentine show how a very minimal structure can lead to greater collaboration and efficiency on a temporary team. What they call a team scaffold is fixed while individual team members flow through the structure.
“The big 'aha' was how very little structure this is”
The paper, published in the March-April 2015 edition of Organization Science, focuses on the redesign of a city hospital's emergency department around temporary teams called pods. The low-cost redesign led to dramatic improvements, both qualitatively and quantitatively, including a 40 percent reduction in how long a patient would remain in the ED before being discharged or admitted. The hospital, located in the southeastern United States, was an early adopter of a team-focused structure that many emergency departments are now implementing.
The research showed that temporary teams mimic the behaviors of more permanent teams, which have definitive boundaries around a group of roles, a clear goal, interdependent tasks, and stable, appropriate composition, Edmondson says. "Here we say we've got only the minimal version of those four factors-just a whisper of those things-and yet we get an awful lot of benefit."
Prior research makes clear the importance of team stability, yet that's not always possible when an organization must work around the clock with overlapping shifts.
Given more and more dynamism in the modern workplace, "my interest started to be, how do you have effective teamwork when you can't have the traditional structural features of effective teams, [and so] I shifted my emphasis from teams to 'teaming,'" Edmondson says.
Valentine shared that interest in "messy" teams, making it the focus of her dissertation for the Health Policy (Management) doctoral program at HBS. (Edmondson chaired her dissertation committee.)
Prior to the redesign, the hospital used ad hoc groupings in the emergency department—any available nurse would triage a patient, then return the patient's chart for any available resident, who would then leave the chart for any available attending physician. The nurses did not know which doctor was working on which patient, and vice versa, which led to inefficiencies and a lack of accountability to one another. Schisms between the professional groups also hampered communication.
The redesign divided the ED into four pods, which were essentially bays with the necessary equipment to treat any type of patient. One senior or attending physician, one or two residents, and three nurses were assigned randomly to a pod at the start of their shifts. Patients were assigned consecutively to the four pods, with each pod having ultimate responsibility for its queue of patients. Because of the staggered and differing shifts, the entire team membership could changeover in as little as five hours.
The qualitative data showed better coordination between the pod members because they were co-located, making it easy to know who was on the team. It increased communication, follow-up, and the setting of mutual priorities, especially since the pod members were collectively responsible for getting the patients through the ED.
"The big 'aha' was how very little structure this is," Edmondson says. "We still have no assigned membership to specific teams over time. I think it speaks to the subtle interpersonal challenges we face trying to catch and work with relative strangers, and that even those small moments of hesitation or miscommunication matter."
While the scaffolds helped break down barriers between professional groups, they created new, albeit temporary, affinity groups to some extent, triggering competition between the teams, which the staff referred to as "the pod wars." No one wanted to be stuck in the slowest pod, and other pods didn't tend to help you out if yours was bogged down, the staff interviews revealed. "People were only affiliated with their pod for four or eight hours, and despite how temporary their team memberships were, they were still competitive with one another," says Valentine, who after earning her PhD from Harvard in 2013 joined Stanford University as an assistant professor of management science and engineering.
Valentine says one caveat of the quantitative improvement is that the hospital was not performing as well as its peers before the redesign. Although not every workplace will see such dramatic improvement, the research shows how powerful a tool grouping people deliberately, even if temporary, can be for managers. In other research, Valentine studied four other hospitals that implemented team scaffolds in their emergency departments with less success, which is the basis for an upcoming paper. The city hospital in the joint research with Edmondson had a robust change process, getting a lot of input from staff and buy-in, and used a pilot pod to train staff. One other hospital had a decent change process and bounded groups, but did not assign the pod ultimate responsibility for the patient flow, which hampered the pod acting as a team, Valentine says.
While a hospital may be a natural setting for team scaffolds, Edmondson and Valentine see other applicable sites.
Many large, global companies are trying to enable better lateral coordination to solve client issues more efficiently. "Just the designation that you're part of this temporary group can eliminate some of those bureaucratic layers where the coordination between people laterally is harder than it needs to be," Edmondson says.
Valentine was one of the authors of a Stanford paper on crowdsourcing teams to handle more complex projects, applying many of the ideas of team scaffolds. She has also incorporated the research into one of her courses, with students creating e-books in 48 hours through crowdsourcing on a team scaffold platform. While the hospital's pod members were physically in the same area, Valentine notes that co-location can be virtual in the case of crowdsourcing, using chat rooms, shared folders, or shared websites.
"There's more complex work that really requires this teaming on the fly, and the social technologies make it more possible to find and coordinate with each other," Edmondson says.