Building Perspective‐Taking as an Organizational Capability: An Exploratory Study

Abstract

Research ObjectivePerspective‐taking, or understanding the viewpoints of others, is associated with greater trust, cooperation, and creative problem‐solving within high‐functioning teams. High‐functioning teams have been associated with a range of positive quality, safety, and clinical outcomes. Perspective‐taking has largely been understood as an individual and interpersonal phenomenon, primarily based on laboratory studies outside of health care. Despite its potential for improving outcomes in health care, little is known about whether and how perspective‐taking might build from the interpersonal to a wider, shared capability within and across organizations. We present novel empirical data to describe perspective‐taking across teams and organizations and suggest hypothesis for future exploration.Study DesignLeadership Saves Lives was a 2‐year, mixed‐methods intervention study in 10 U.S. hospitals to achieve reductions in AMI mortality by supporting the implementation of evidence‐based strategies and fostering improvements in domains of organizational culture related to hospital performance. The qualitative component included in‐depth interviews at baseline, 6, and 18 months (n = 393 interviews with 197 staff) and observations (56 hours). We performed a secondary exploratory analysis of the longitudinal qualitative data using the constant comparative method, focusing on selected codes most potentially relevant to perspective‐taking.Population StudiedParticipants included members of the guiding coalitions in 10 hospitals in the Mayo Clinic Care Network. Coalitions included approximately 15 key staff involved in care of patients with AMI, from multiple departments (ie, cardiology, emergency medicine, pharmacy, quality improvement, cardiac rehabilitation), professions (ie, physicians, nurses, technologists, administrators), and levels of the organization (ie, senior executives to front‐line staff).Principal FindingsStaff described improved collective perspective‐taking at both the group and system levels over the intervention period. Perspective‐taking behaviors were reported by members from diverse departments, professions, and levels of the organization. Behaviors were apparent in each of the core dimensions of perspective‐taking: 1) affective empathic concern (eg, bonding over a common purpose, solidarity, 2) cognitive attributional understanding (eg, concrete, specific insights and knowledge about facts, roles, processes, and 3) motivational efforts to improve understanding (eg, structural conditions, psychological safety of the perspectives inherent to other organizational targets). Participants described these behaviors as new and attributed them to structural and cultural changes developed through the intervention.ConclusionsThe LSL intervention included training for intentionally diverse teams in engaging conflict productively, using levels of analysis to diagnose organizational challenges, fostering psychological safety, ensuring role clarity, and working with power and hierarchy. Organizations may foster perspective‐taking by building ecological structures and processes that build team capacity in these areas.Implications for Policy or PracticePerspective‐taking has implications for productively spanning boundaries and distances across teams and organizations. Such boundary spanning is becoming increasingly important given contemporary efforts to integrate health and social care.Primary Funding SourceThe medicines company.