The truth is, teams are often disbanded before they have a chance to gel, as individual members are delegated to new projects—and therefore new teams—on a hectic as-needed basis. Teaming, she says, is essential to organizational learning. Intense competition, rampant unpredictability, and a constant need for innovation are giving rise to even greater interdependence and thus demand even greater levels of collaboration and communication than ever before. Teaming is a verb Sports teams and musical groups are both bounded, static collections of individuals. Like most work teams in the past, they are physically located in the same place while practicing or performing together. Members of these teams learn how to interact.

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Edmondson Amy C. She is an expert on organizational behavior and has written extensively on the effectiveness of teamwork in health care, notably in a book titled, "Teaming: How Organizations Innovate, Learn, and Compete in the Knowledge Economy. We do see teams like this in health care doing important work; for example, teams that are formed to work on quality improvement projects.

There is a real value and use for formal teams that work together over some period of time. What does that mean in a health care delivery environment? Read More down-arrow Amy Edmondson: Experiencing psychological safety means that I will not hesitate to ask a question, or to ask for help, or to point to something I think might be an error, or to flag a problem in any aspect of the work environment.

First, because of the high stakes. My failure to ask a question could lead to a poor outcome, to an error, or even to a fatality. Second, psychological safety is particularly important in health care because of the nature of the work.

Specifically, a great deal of what happens in health care delivery involves uncertainty or novelty. Psychological safety is a more important determinant of performance when the work is more uncertain or novel. In contrast, in a fluid environment, psychological safety profoundly affects the quality of the work. In a nutshell, speaking up is essential to achieving high performance when there is uncertainty or interdependence. Can you explain them and talk a little about what might make them challenging for people to do?

Amy Edmondson: First, the leader has to set the stage. This can be challenging simply because we forget that we need to do this. We assume everyone is on the same page. So this step really matters. The second role is inviting input. This is really important as well. Doing so invites every member of the team to speak up; it helps to alleviate fear that people naturally have of bringing up a concern or question. This can be hard for high achieving professionals to do for two main reasons.

Perhaps more importantly, displays of humility are not always rewarded in our culture. Nor in the culture of medicine! The last one is to respond productively to input, which can also be hard. When someone points to a problem, displeasure may show up spontaneously on my face. I have to learn to overcome that. To learn to deliberately, actively, respond appreciatively to input. The focus must be on the work — on the nature of the work.

Psychological safety is not a luxury. Betsy Lehman Center: In your personal experience, have you see examples of strong teamwork or teamwork that could really use improvement? But the way people are socialized in medicine, the way the working environment is organized, and the way clinicians can be overwhelmed with what the system demands of them, are all three powerful contributors to teaming breakdowns. The purpose of thinking differently about how the work is organized is a real opportunity for better patient care that will also positively affect the working environment.

Betsy Lehman Center: What motivated you to do this work and what is next for you? Amy Edmondson: I went to graduate school interested in figuring out what makes it so hard for organizations to learn, especially in a fast changing world.

They need to engage in continuous learning — improvement and innovation — to succeed in a changing world. Ultimately, I came to see that teams were where the crucial organizational learning takes place. I was invited to study the relationship between team attributes and error rates in hospitals. Doing this in a health care environment seemed like a wonderful opportunity to learn, and indeed, I really learned a lot.

And it changed my perspective on teams — leading me to think a great deal more about teaming, rather than about teams. We need to do this well to tackle some of our larger challenges. Population health. The opioid epidemic. Clinicians and others in hospitals and clinics must work with community organizations, government agencies, companies, and more.


The Importance of Teaming

But, in my experience, in the most innovative companies, teaming is the culture. Teaming is about identifying essential collaborators and quickly getting up to speed on what they know so you can work together to get things done. This more flexible teamwork in contrast to stable teams is on the rise in many industries because the work — be it patient care, product development, customized software, or strategic decision-making — increasingly presents complicated interdependencies that have to be managed on the fly. The time between an issue arising and when it must be resolved is shrinking fast. Stepping back to select, build, and prepare the ideal team to handle fast-moving issues is not always practical.


The Three Pillars of a Teaming Culture


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