Team working in intensive care:current evidence and future endeavors

Purpose of review: It has recently been argued that the future of intensive care medicine will rely on high quality management and teamwork. Therefore, this review takes an organizational psychology perspective to examine the most recent research on the relationship between teamwork, care processes, and patient outcomes in intensive care. Recent findings: Interdisciplinary communication within a team is crucial for the development of negotiated shared treatment goals and short-team patient outcomes. Interventions for maximizing team communication have received substantial interest in recent literature. Intensive care coordination is not a linear process, and intensive care teams often fail to discuss how to implement goals, trigger and align activities, or reflect on their performance. Despite a move toward interdisciplinary team working, clinical decision-making is still problematic and continues to be perceived as a top-down and authoritative process. The topic of team leadership in intensive care is underexplored and requires further research. Summary: Based on findings from the most recent research evidence in medicine and management, four principles are identified for improving the effectiveness of team working in intensive care: engender professional efficacy, create stable teams and leaders, develop trust and participative safety, and enable frequent team reflexivity.

From words to action:visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital

Purpose: The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. Design/methodology/approach: A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Findings: Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. Research limitations/implications: The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. Practical implications: The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Social implications: Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. Originality/value: The authors draw on solid theoretical frameworks - the complexity theory, team effectiveness model and the social identity theory - to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level. © Emerald Group Publishing Limited.

The importance of team-working in knowledge transfer partnerships

Research capacity can be built by collaboration between industry and universities, and Knowledge Transfer Partnerships (KTPs) are an ideal way to do this. While good collaboration and team-work has been recognised as crucial for success, projects tend to be evaluated on outcomes and not collaboration effectiveness. This paper discusses best practice for how a KTP project team might work together effectively.

Perceptions of a changing world induce hope and promote peace in intractable conflicts

The importance of hope in promoting conciliatory attitudes has been asserted in the field of conflict resolution. However, little is known about conditions inducing hope, especially in intractable conflicts, where reference to the outgroup may backfire. In the current research, five studies yielded convergent support for the hypothesis that hope for peace stems from a general perception of the world as changing. In Study 1, coders observed associations between belief in a changing world, hope regarding peace, and support for concessions. Study 2 revealed the hypothesized relations using self-reported measures. Studies 3 and 4 established causality by instilling a perception of the world as changing (vs. unchanging) using narrative and drawing manipulations. Study 5 compared the changing world message with a control condition during conflict escalation. Across studies, although the specific context was not referred to, the belief in a changing world increased support for concessions through hope for peace.

Women and peace in a divided society:peace-building potentials of feminist advocacy and reform in Bosnia and Herzegovina

Despite an improving international rhetoric highlighting the necessity of women’s participation in postwar settings, women still tend to be disadvantaged in peace-building processes (Chinkin and Charlesworth, 2006; United Nations, 2002). This chapter argues that women’s struggles for rights entail important potentials for peace-building in divided postwar societies. Women frequently are among the first who cooperate across ethnic divisions established and hardened during ethno-political wars. Feminist policy reforms often strengthen common state structures and their legitimacy, contributing to the overcoming of ethnic divisions. Women’s participation and contributions should, therefore, be much more recognized and promoted in peace-building processes. However, it is feminist advocacy that is key, not women’s participation per se. Women have often promoted nationalistic and violent agendas; yet, only if they champion the rights of women independent of their ethnic and political differences can peace-building potentials come into effect.

Create, Establish, Maintain: Comparing Zones of Peace in the Nordic Area and the Southern Cone

In the wake of the Cold War, regional organizations have proliferated and are now a dominant theme in global politics. This study tests whether explanations for the Nordic peace can help to understand or construct other zones of peace in these increasingly important regional settings. With that in mind, this study compares the Nordic area of Denmark, Finland, Iceland, Norway, and Sweden with the Southern Cone region–here defined as Argentina, Chile, Paraguay, and Uruguay–and both are treated as regional, subsystemic zones of peace. Its significance lies in analysis of two developmentally disparate regions not yet compared in zones of peace literature. Using structured, focused comparison, this study is guided by fundamental questions about each region that assess the relationship between explanations for regional peace and their respective historical records. Understanding the conditions that permit the endurance of peace in today’s global context has far-reaching empirical and theoretical implications.

Necessary skills and practices required for effective participation in high bandwidth design team activities

Technology is continually changing, and evolving, throughout the entire construction industry; and particularly in the design process. One of the principal manifestations of this is a move away from team working in a shared work space to team working in a virtual space, using increasingly sophisticated electronic media. Due to the significant operating differences when working in shared and virtual spaces adjustments to generic skills utilised by members is a necessity when moving between the two conditions. This paper reports an aspect of a CRC-CI research project based on research of ‘generic skills’ used by individuals and teams when engaging with high bandwidth information and communication technologies (ICT). It aligns with the project’s other two aspects of collaboration in virtual environments: ‘processes’ and ‘models’. The entire project focuses on the early stages of a project (i.e. design) in which models for the project are being developed and revised. The paper summarises the first stage of the research project which reviews literature to identify factors of virtual teaming which may affect team member skills. It concludes that design team participants require ‘appropriate skills’ to function efficiently and effectively, and that the introduction of high band-width technologies reinforces the need for skills mapping and measurement.

The relationship between communication and team performance : testing moderators and identifying communication profiles in established work teams

Communication is one team process factor that has received considerable research attention in the team literature. This literature provides equivocal evidence regarding the role of communication in team performance and yet, does not provide any evidence for when communication becomes important for team performance. This research program sought to address this evidence gap by a) testing task complexity and team member diversity (race diversity, gender diversity and work value diversity) as moderators of the team communication — performance relationship; and b) testing a team communication — performance model using established teams across two different task types. The functional perspective was used as the theoretical framework for operationalizing team communication activity. The research program utilised a quasi-experimental research design with participants from a large multi-national information technology company whose Head Office was based in Sydney, Australia. Participants voluntarily completed two team building exercises (a decision making and production task), and completed two online questionnaires. In total, data were collected from 1039 individuals who constituted 203 work teams. Analysis of the data revealed a small number of significant moderation effects, not all in the expected direction. However, an interesting and unexpected finding also emerged from Study One. Large and significant correlations between communication activity ratings were found across tasks, but not within tasks. This finding suggested that teams were displaying very similar profiles of communication on each task, despite the tasks having different communication requirements. Given this finding, Study Two sought to a) determine the relative importance of task versus team effects in explaining variance in team communication measures for established teams; b) determine if established teams had reliable and discernable team communication profiles and if so, c) investigate whether team communication profiles related to task performance. Multi-level modeling and repeated measures analysis of variance (ANOVA) revealed that task type did not have an effect on team communication ratings. However, teams accounted for 24% of the total variance in communication measures. Through cluster analysis, five reliable and distinct team communication profiles were identified. Consistent with the findings of the multi-level analysis and repeated measures ANOVA, teams’ profiles were virtually identical across the decision making and production tasks. A relationship between communication profile and performance was identified for the production task, although not for the decision making task. This research responds to calls in the literature for a better understanding of when communication becomes important for team performance. The moderators tested in this research were not found to have a substantive or reliable effect on the relationship between communication and performance. However, the consistency in team communication activity suggests that established teams can be characterized by their communication profiles and further, that these communication profiles may have implications for team performance. The findings of this research provide theoretical support for the functional perspective in terms of the communication – performance relationship and further support the team development literature as an explanation for the stability in team communication profiles. This research can also assist organizations to better understand the specific types of communication activity and profiles of communication that could offer teams a performance advantage.

Self-organization processes in field-invasion team sports

In nature, the interactions between agents in a complex system (fish schools; colonies of ants) are governed by information that is locally created. Each agent self-organizes (adjusts) its behaviour, not through a central command centre, but based on variables that emerge from the interactions with other system agents in the neighbourhood. Self-organization has been proposed as a mechanism to explain the tendencies for individual performers to interact with each other in field-invasion sports teams, displaying functional co-adaptive behaviours, without the need for central control. The relevance of self-organization as a mechanism that explains pattern-forming dynamics within attacker-defender interactions in field-invasion sports has been sustained in the literature. Nonetheless, other levels of interpersonal coordination, such as intra-team interactions, still raise important questions, particularly with reference to the role of leadership or match strategies that have been prescribed in advance by a coach. The existence of key properties of complex systems, such as system degeneracy, nonlinearity or contextual dependency, suggests that self-organization is a functional mechanism to explain the emergence of interpersonal coordination tendencies within intra-team interactions. In this opinion article we propose how leadership may act as a key constraint on the emergent, self-organizational tendencies of performers in field-invasion sports.

Value management in design planning : a systems-based framework for multi-disciplinary team involvement

This thesis investigates the Value Management processes used by construction project clients that effects project team involvement in VM workshops during the design stage of the projects. It is based on five case studies of the Malaysian international airport construction project packages. The focus of the research is on how issues related to infrastructure design that can improve construction processes on-site are being identified, analysed and resolved through multi-disciplinary team participation. The degrees of interaction, diversity of visualisation aids, certain cultural dimensions and the system thinking approach are found to have significant influence in maximizing participation among project team members during the entire VM workshop process.

Predicting transactive memory systems in multidisciplinary teams : The interplay between team and professional identities

In explaining how communication quality predicts TMS in multidisciplinary teams, we drew on the social identity approach to investigate the mediating role of team identification and the moderating role of professional identification. Recognizing that professional identification could trigger intergroup biases among professional subgroups, or alternatively, could bring resources to the team, we explored the potential moderating role of professional identification in the relationship between team identification and TMS. Using data collected from 882 healthcare personnel working in 126 multidisciplinary hospital teams, results supported our hypothesis that perceived communication quality predicted TMS through team identification. Furthermore, findings provided support for a resource view of professional subgroup identities with results indicating that high levels of professional identification compensated for low levels of team identification in predicting TMS. We provide recommendations on how social identities may be used to promote TMS in multidisciplinary teams.

Peace and Peacemaking in Paul Against the Backdrop of Greco-Roman Conceptions of Peace

Peace in the ancient world has been studied primarily from the perspective of pacifism and questions related to war and peace. This study employs a socio-historical method to determine how peace was understood in itself, not just with respect to war. It demonstrates that the Greco-Roman world viewed peace as brief periods of tranquility in an existence where conflict was the norm, while Paul regarded peace as the norm and conflict as an intrusive aberration. Through a historical and literary survey of Greco-Roman thought and culture, this study shows that myth, legend, religion, education, philosophy, and science created and perpetuated the idea that conflict was necessary for existence. Wars were fought to attain peace, which meant periods of calm, quiet, and security with respect to the gods, one's inner self, nature, others who are insiders, and others who are outsiders. Despite the desirability of peace, genuine peace was seldom experienced, and even then, only briefly, as underlying enmity persisted without resolution. While Paul supports the prevailing conception of peace as tranquility and felicity in relation to God, self, nature, and others, he differs as to the origin, attainment, and maintenance of peace. In Paul, peace originates in God and is graciously given to those who are justified and reconciled to God through Jesus Christ. God removes the enmity caused by sin and provides the indwelling Spirit to empower believers to think and behave in ways that promote and maintain peace. This study also examines how three social dynamics (honor-shame, patron-client, friendship-enmity) affect Paul's approach to conflict resolution with Philemon and Onesimus, Euodia and Syntyche, believers who are prosecuting one another in civil courts, and Peter. Rather than giving specific procedures for resolving conflict, Paul reinforces the believer's new identity in Christ and the implications of God's grace, love, and peace upon their thoughts, words, and behavior toward one another. Paul uses these three social dynamics to encourage believers in the right direction, but their ultimate accountability is to God. The study concludes with four strategic principles for educating the church and developing an atmosphere and attitude within the church for peacemaking.