Managing Diversity in High-Reliability Teams in the Emergency Department

Abstract

We examine the question of how High-Reliability Teams (HRTs) manage deep-level diversity, with a particular focus on educational diversity, power diversity and functional diversity. To investigate this question, we conduct a qualitative inductive study of a public hospital emergency department in Australia. Our findings reveal a set of six strategies that HRTs in emergency departments use to manage different types of deep-level diversity. Strategies of active explanations and experience-based task assignment manage educational diversity within HRT team processes. Strategies of deferring to a single-leader and balancing delegation and participative leadership manage power diversity. Finally, strategies of sequential specialist involvement and a co-production mindset manage functional diversity. Our theoretical model of these strategies and their implications for effective and ineffective team processes contributes to the literature by offering nuanced insight into deep-level diversity in HRTs and opens up new avenues for future process-based inquiry into HRTs.