Care Teams Perform Well When Members Accurately Know Each Other’s Expertise

									Charlie Plain |
																			August 7, 2018

Interdisciplinary care teams (ICTs) are increasingly used to care for very complex individuals, such as those with significant mental health and behavioral challenges. These mental health teams incorporate professionals from psychiatry, nursing, social work, supported employment, supported housing, and substance abuse treatment. To help ICTs function at their best, a recent joint study by the University of Minnesota and University of Iowa Schools of Public Health revealed some teamwork factors in groups producing high-quality care.

Douglas Wholey smiling.
Professor Emeritus Douglas Wholey.

The study, co-authored by Associate Professor Xi Zhu from the University of Iowa and Professor Emeritus Douglas Wholey from the University of Minnesota, was published in Health Services Research.

The study examined a type of ICTs for clients with severe mental illness, known as Assertive Community Treatment teams. In particular, the study looked at how their performance is influenced by two main factors: expertise redundancy and what’s known as transactive memory accuracy. Expertise redundancy — the extent to which team members possess highly overlapping knowledge — can complicate a team’s knowledge structure because it reduces role clarity. Transactive memory accuracy is the extent to which team members accurately recognize experts in relevant knowledge domains. It helps team members get assistance from team members who have needed expertise, which leads to better quality decision making, task performance, and care.

The effects of expertise redundancy and transactive memory on ICTs performance were measured by examining their effect on the hospitalization of clients for mental illness.

Overall, teams with low expertise redundancy and the ability to accurately recognize who was an expert in areas had fewer mental health-related hospitalizations. Further, the study showed that transactive memory accuracy had a stronger positive relationship with team performance when expertise redundancy was higher, indicating that it could serve as a cognitive tool for mitigating the negative effect of a group’s complex knowledge structure.

“The study shows that explicit team design is critical for delivering high-quality care,” says Wholey. “Without effective coordination, more expertise is not always beneficial. For ICTs, it is important to specify team knowledge structure as clearly as possible. Specification can help ICTs minimize unnecessary expertise redundancy, and facilitate training and coordination mechanisms to assure accurate recognition of a team member’s expertise.”

Zhu and Wholey are continuing their research on mental health ICTs to examine how team design and leadership affects transactive memory accuracy and how information exchange processes affect team member outcomes, such as individual performance, satisfaction, and team identification.

The study was funded by the National Science Foundation.

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