Kitzmiller Rebecca R, McDaniel Reuben R, Johnson Constance M, Lind E Allan, Anderson Ruth A
Adv Health Care Manag. 2013;14:119-44. doi: 10.1108/s1474-8231(2013)00000140010.
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project.
DESIGN/METHODOLOGY/APPROACH: Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens.
We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger.
Leaders must enact voice-promoting behaviors and use them throughout a team's engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation.
Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking.
Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes.
VALUE/ORIGINALITY: We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders' behaviors might facilitate or impeded speaking up among project teams in health care settings.
我们研究在一个基于医院的健康信息技术（HIT）实施项目中，人际行为和社会互动如何影响团队意义建构及后续的团队行动。
设计/方法/途径：在18个月的时间里，我们运用意义建构的视角直接观察了HIT实施团队的人际互动。
我们识别出团队领导者实施的三种促进表达的策略，这些策略促进了团队成员的表达和意义建构；传达愿景；将目标与团队成员的价值观联系起来；以及寻求团队成员的意见。然而，领导者偶尔表现出的愤怒会迅速破坏团队的意义建构，使解决问题所必需的对话陷入停滞。通过征求团队成员的意见，团队领导者克服了愤怒的负面影响。
领导者必须实施促进表达的行为，并在团队参与过程中始终使用这些行为。此外，培训团队如何利用冲突实现更大的创新，可能会改善对减轻项目风险至关重要的意义建构。
医疗工作流程复杂；参与实施改进的团队必须准备好应对变革过程中出现的相互冲突、有争议的问题。因此，团队冲突培训对于维持意义建构可能至关重要。
未来的研究应致力于识别促进意义建构的团队互动，尤其是当话题困难或不受欢迎时，然后确定员工意义建构与对HIT实施结果的影响之间的关联。
价值/原创性：我们是首批关注负责HIT实施的项目团队的研究之一。这项研究扩展了我们对领导者行为如何促进或阻碍医疗环境中项目团队表达意见的理解。
