Rebecca Mitchell, PhD, is Senior Lecturer, University of Newcastle, New South Wales, Australia. E-mail:
Health Care Manage Rev. 2014 Jan-Mar;39(1):1-9. doi: 10.1097/HCM.0b013e3182766504.
Interprofessional teams form the basis of many health care problem-solving and decision-making mechanisms. However, more than 70% of medical errors are attributable to dysfunctional team dynamics. The recent suggestion that health care teams are more complex than nonmedical teams suggests that we require more sophisticated knowledge of team dynamics and processes.
The mechanisms of dysfunctional interprofessional teams focusing on affective, behavioral, and cognitive effects are explored. We argue that interprofessional composition impacts team dynamics by increasing the likelihood of affective conflict, which mediates a decrease in elaborative behaviors and open-mindedness.
The hypotheses are investigated using a cross-sectional, correlational design. Survey data received from 218 members of 47 interprofessional teams employed in an acute care setting, representing a 39% response rate, is used to investigate two moderated mediation pathways.
Analysis supports a significant relationship between interprofessional composition and affective conflict but only when team rate highly for professional identification. Results also support a dual moderated mediation pathway through which professional diversity has a dysfunctional effect on debate and open-mindedness.
A range of strategies emerge from the findings to minimize dysfunctional interprofessional team dynamics. These include the use of leadership strategies, such as transformational styles, reinforcement of shared values such as patient-centeredness, and development of a shared group identity.
多专业团队是许多医疗保健问题解决和决策机制的基础。然而，超过 70%的医疗错误归因于功能失调的团队动态。最近有观点认为，医疗保健团队比非医疗团队更复杂，这表明我们需要更复杂的团队动态和流程知识。
探讨以情感、行为和认知影响为重点的功能失调的多专业团队的机制。我们认为，跨专业组成会通过增加情感冲突的可能性来影响团队动态，而情感冲突会影响详尽行为和开放性的减少。
采用横断面相关设计来检验假设。研究数据来自于在急症护理环境中工作的 47 个多专业团队的 218 名成员（回应率为 39%），用于调查两个具有调节作用的中介途径。
分析支持跨专业组成与情感冲突之间存在显著关系，但只有当团队对专业认同度高时才会如此。结果还支持一个双重调节中介途径，即专业多样性对辩论和开放性具有功能失调的影响。
研究结果提出了一系列策略来最小化功能失调的多专业团队动态。这些策略包括使用领导策略，如变革型风格，加强以患者为中心等共同价值观，以及发展共同的群体认同。
