The role of transactive memory systems, psychological safety and interpersonal conflict in hospital team performance

Abstract

Safe patient care in hospitals relies on teamwork. Transactive Memory Systems (TMS), are shared cognitive systems that have been linked to team performance in other domains, but have received limited attention in healthcare. This study investigated the role of TMS, psychological safety and interpersonal conflict in predicting team performance in hospital ward teams where team membership is dynamic and often loosely defined. Hospital staff (n = 106) in four wards completed a battery of instruments assessing team performance, TMS, psychological safety and interpersonal conflict. TMS was a weak predictor of team performance, but the relationship was mediated by psychological safety. Overall, team performance was predicted by high psychological safety, low interpersonal conflict and low reliance on team members’ knowledge (i.e. TMS credibility). These findings suggest that, in hospital teams, TMS is not a strong predictor of team performance but team culture is critical to ensure the quality and safety of patient care.

Practitioner summary: This study investigated the role of Transactive Memory Systems (TMS) and cultural factors in hospital team performance. Team performance was predicted by psychological safety, low interpersonal conflict and low reliance on team members’ untested knowledge. This highlights the importance of a supportive and psychologically safe team culture for safe care in hospitals.

Abbreviations: TMS: transactive memory systems; HCA: health care assistant

Keywords:

• Patient safety
• teamwork
• transactive memory systems
• psychological safety
• interpersonal conflict

Acknowledgements

ML, and this study, were supported by the NIHR Imperial Patient Safety Translational Research Centre (PSTRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Infrastructure support for this research was also provided by the NIHR Imperial Biomedical Research Centre (BRC). The team would like to sincerely thank Lily Roberts and Annaliza Sevillano for their support with data collection on this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by NIHR Imperial Patient Safety Translational Research Centre (PSTRC) [PSTRC-2016-004].