The Functions of Team Monitoring and ‘Talking to the Room’ for Performance in Anesthesia Teams

We explored the functions of team monitoring and talking to the room (undirected talk to relay relevant information or comment on the performance of real-time self behavior) for effects on team interaction and performance in 27 anesthesia teams in the clinical setting. Immediate reactions to team monitoring and talking to the room were investigated by means of lag sequential analysis. As expected, we found that in high performing teams, immediate consequences of team monitoring were speaking-up and providing unsolicited assistance. Talking to the room led to further talking to the room and substituted explicit coordination. The results highlight the relevance of team monitoring and talking to the room for team coordination and performance in dynamic healthcare environments.

[1]  Frances J. Milliken,et al.  Organizational Silence: A Barrier to Change and Development in a Pluralistic World , 2000 .

[2]  Henrik Artman,et al.  Distributed Cognition in an Emergency Co-ordination Center , 1999, Cognition, Technology & Work.

[3]  E. Dayton,et al.  Organizational silence and hidden threats to patient safety. , 2006, Health services research.

[4]  A. Edmondson.  Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams , 2003 .

[5]  Viva J. Siddall,et al.  Development of an Objective Scoring System for Measurement of Resident Performance on the Human Patient Simulator , 2006, Anesthesiology.

[6]  Mary J . Waller and Sjir Uitdewilligen.  Talking to the room: Collective sensemaking during crisis situations , 2008 .

[7]  Eduardo Salas,et al.  Making decisions under stress: Implications for individual and team training. , 1998 .

[8]  Amy C. Edmondson,et al.  Why Employees Are Afraid to Speak Up , 2007 .

[9]  E. Salas,et al.  Cross-training and team performance. , 1998 .

[10]  W. Nixon,et al.  Using aviation safety measures to enhance patient outcomes. , 2003, AORN journal.

[11]  F C Forrest,et al.  Use of a high-fidelity simulator to develop testing of the technical performance of novice anaesthetists. , 2002, British journal of anaesthesia.

[12]  J. Beaubien,et al.  Medical Team Training Programs in Health Care , 2005 .

[13]  Christopher O. L. H. Porter,et al.  When Does Teamwork Translate Into Improved Team Performance? A Resource Allocation Perspective , 2010 .

[14]  L. V. Dyne,et al.  Conceptualizing Employee Silence and Employee Voice as Multidimensional Constructs , 2003 .

[15]  J. Sexton,et al.  Error, stress, and teamwork in medicine and aviation: cross sectional surveys , 2000, BMJ : British Medical Journal.

[16]  D. S. Derue,et al.  Leadership in Teams: A Functional Approach to Understanding Leadership Structures and Processes , 2010 .

[17]  D. P. Baker,et al.  Teamwork as an essential component of high-reliability organizations. , 2006, Health services research.

[18]  G. Grote,et al.  Substitutes for leadership in anaesthesia teams and their impact on leadership effectiveness , 2010 .

[19]  Daniel R. Ilgen,et al.  Backing up behaviors in teams: the role of personality and legitimacy of need. , 2003, The Journal of applied psychology.

[20]  R. Mcintyre,et al.  A Conceptual Framework for Teamwork Measurement , 1997 .

[21]  Eduardo Salas,et al.  TRAINING TEAM PERFORMANCE‐RELATED ASSERTIVENESS , 1996 .

[22]  Dana E. Sims,et al.  Is there a “Big Five” in Teamwork? , 2005 .

[23]  John E. Mathieu,et al.  A Temporally Based Framework and Taxonomy of Team Processes , 2001 .

[24]  David M Gaba,et al.  Adaptive coordination in cardiac anaesthesia: a study of situational changes in coordination patterns using a new observation system , 2008, Ergonomics.

[25]  Norbert K. Semmer,et al.  Explicit Reasoning, Confirmation Bias, and Illusory Transactive Memory , 2009 .

[26]  Philip Smith.  Roger Bakeman John M. Gottman , 1987, Animal Behaviour.

[27]  Anna Borg,et al.  Principles of Regulating Interaction in Teams Practicing Face-To-Face Communication Versus Teams Practicing Computer-Mediated Communication , 2005 .

[28]  E. Sundstrom,et al.  Work teams: Applications and effectiveness. , 1990 .

[29]  T. Manser,et al.  The Role of Coordination in Preventing Harm in Healthcare Groups: Research Examples from Anaesthesia and an Integrated Model of Coordination for Action Teams in Health Care , 2011 .

[30]  G Grote,et al.  The influence of standardisation and task load on team coordination patterns during anaesthesia inductions , 2009, Quality & Safety in Health Care.

[31]  Christopher M. Barnes,et al.  Harmful help: the costs of backing-up behavior in teams. , 2008, The Journal of applied psychology.

[32]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[33]  M. Marks,et al.  The Influence of Team Monitoring on Team Processes and Performance , 2004 .