Academic journal article The Journal of Business Communication

Democracy, Performance, and Outcomes in Interdisciplinary Health Care Teams

Academic journal article The Journal of Business Communication

Democracy, Performance, and Outcomes in Interdisciplinary Health Care Teams

Article excerpt

Central to hospice care is the interdisciplinary team. Such health care teams are by definition democratic, self-managing teams. Fifty-two team members on seven hospice teams in three hospice organizations participated in the study. Hospice team members perceived the teams to be not as democratic as might be expected, One dimension of team democracy, perceived involvement of all members in team decisions, was positively and significantly associated with perceived team cohesiveness, productiveness, satisfaction with the team, satisfaction with team communication, and desire to stay with the team. Perception of team productiveness was a mediating variable between team involvement and job satisfaction. This study adds to empirical research on teamwork and participation in organizations by identifying the importance of a specific dimension of participation, involvement in decision making. The findings suggest the necessity of training team members in developing strategies to encourage involvement in decision maki ng. However, practitioners are also cautioned against viewing involvement in team decision making as the answer to all teamwork ills.

Keywords: Teamwork, Democracy, Participation, Decision Making, Health Care

Teamwork is central to the postmodern organization (Hartley, 1997; Pinchot & Pinchot, 1993; Savoie, 1998; Shulman, 1996). With roots in the human relations movement and post World War II Japanese management approaches, teams in the United States are viewed as the basis of better corporate performance in the form of increased productivity and profits (Pinchot & Pinchot, 1993; Seibold, 1995; Shank, 1992). Barney and Hesterly (1996) observe: "Team production typically involves gains from cooperation where complex production processes are involved. The members of the team can produce more working cooperatively with one another than separately" (p. 116). Moreover, in this time of "postbureaucratic organizations, teams form the basic unit of empowerment, small enough for efficient high involvement and large enough for the collective strength and the synergy generated by diverse talents" (Pinchot & Pinchot, 1993, p. 194). Stohl (1995) suggests that the move toward team-based organizations is a result of an overall s ocial movement toward decentralized decision making and power in institutions instigated by the emergence of a global information society. In a recent survey of 80 randomly selected U.S. organizations, 48% reported regularly using teams to accomplish organizational tasks (Devine, Clayton, Philips, Dunford, & Melner, 1999).

Although teams are typically associated with traditional business corporations, they have been a mainstay in the health care industry for many years (Julia & Thompson, 1994a). Recently, the emphasis on teams and teamwork in health care organizations has increased. There are several reasons for this heightened attention to health care teams. First, as the health care industry has become more specialized, sophisticated, complex, and technical, the numerous disciplines involved in the delivery of health care have become increasingly interdependent (Northouse & Northouse, 1998; O'Connor, Hallberg, & Myles, 1999; Sullivan, 1998). The very nature of health care is bringing providers from numerous disciplines together to address health care problems. Second, team-based health care organizations are considered more effective, efficient, and adaptive than bureaucratic, hierarchically structured ones (Becker-Reems & Garrett, 1998; Manion, Lorimer, & Leander, 1996). "Teams are a way ... to release potential for improve d productivity, better decisions, and process innovation" (Manion et al., 1996, p. 4). Thus, teams are seen as "critical to sustainability in health care" organizations and "the basic unit of work" (Porter-O'Grady & Wilson, 1998, p. vii). Third, health care organizations take a team-based approach for philosophical reasons. …

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