24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations

Abstract

Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork.

Keywords:

• Real team membership
• Co-acting group membership
• Teamwork
• Healthcare management
• Patient mortality
• Sickness absence

Notes

¹ We use the term group to refer to a psychological group. That is “one that is psychologically significant for the members, to which they relate themselves subjectively for social comparison and the acquisition of norms and values, … that they privately accept membership in, and which influences their attitudes and behavior” (Turner, Hogg, Oakes, Reicher, & Wetherell, 1987, pp. 1–2). We return to the definitional issues surrounding the term “team” later in the article.

² This question ensured that real team membership captured an individual’s perception of a working group rather than an entire NHS department/hospital ward. Indeed, it is widely argued that a team is a relatively small collection of people (e.g., Katzenbach & Smith, 1998; Sundstrom et al., 1990), which, in the practice of acute healthcare, is likely to be no more than around 15 members (West, 2012).

³ As no quadratic effects were found in our analyses, we have not reported these findings.

⁴ We thank one of the anonymous reviewers for this suggestion.