Teams in Crisis: Team Familiarity and Performance During COVID-19

Abstract

Research on fluid teams has consistently found positive effects of team familiarity on performance in a variety of settings. Conventional wisdom suggests that during times of crisis, when stress and uncertainty are likely to disrupt team function, familiarity would be especially important to performance. However, there is little empirical research investigating the relationship between familiarity and performance during crisis. To study this, we collected patient and provider data from the emergency department (ED) of a large hospital from January 2018 through November 2020. We then used the provider data to create care teams for each patient in our data. In general, team familiarity was significantly associated with patients spending less time in the ED, a key metric of ED performance. However, team familiarity was less important during COVID-19 than during more routine periods. We further explored this using a second type of crisis – times of high acuity – and found that crisis not only decreased the importance of familiarity but might even render it disadvantageous. Based on these findings, we suggest team familiarity is not as important to performance during a crisis as it is during routine times. Analysis of qualitative interviews with providers suggested two potential explanations: (1) the pandemic created an overarching sense of camaraderie among providers that existed regardless of past relationships, and (2) the fact that ED providers have experience working in crisis situations, rendering them uniquely able to handle them, even in the absence of a shared history with teammates.