Team Outcomes Research Articles

Task interdependence and shared leadership: A structural perspective on the distribution of leadership in teams

Shared leadership has consistently been shown to predict team effectiveness. However, research also indicates that different teams may require different configurations of shared leadership, and achieving maximum sharedness in leadership does not always guarantee superior team outcomes. This reality underscores the need for a normative theory of shared leadership that can extend our understanding of the construct and facilitate its adoption in organizations. Despite the significance of such a theory, little attention has been given to its development and our understanding of how shared leadership should be distributed across different teams remains quite limited. In this article, we adopt a structural perspective to propose that the task interdependence network can serve as a robust foundation for devising effective shared leadership strategies. Our conceptual framework outlines the nuanced implications of the task interdependence network—from determining the optimal level of shared leadership necessary for performance to identifying potential members for shared leadership responsibilities. In doing so, we emphasize that the specific implications of the task interdependence network may vary, rather than remain uniform, across different dimensions of shared leadership.

Conceptualising Centres of Clinical Excellence: A Scoping Review

ObjectivesCentres of clinical excellence (CoCE) are healthcare facilities that provide excellent healthcare. However, despite their increasing prevalence, it is unclear how CoCE are identified and monitored. This paper explores how...

Perceived Individual Team Member Value Creation in In-Class Permanent Teams. Analysis of evidence from individual peer reviews in a Team-Lecture Hybrid instructional strategy.

This study analyzes individual peer review assessment data in order to understand the following: contributions of individual team members to in-class permanent team outcomes; social loafing and loss of social interdependence among team members; and the achievement of the Team Lecture Hybrid(TLH) instructional strategy learning outcomes in a team learning environment. A value creation theoretical framework was used to assess perceived value creation in 952 statements recorded in 341 intra-group assessment narratives from 127 students in 28 in-class permanent teams across 11 courses. Participants were drawn from public affairs, leadership, and healthcare administration courses, in two US institutions of higher learning from January 2012 to May 2016. Fifteen emerging themes organized under four predetermined domains including preparednesss (14.3%), contribution to productivity (53.4%), respect for others (13.8%), and flexibility (18.1%; and one emergent domain including teacher contribution (1.15%); revealed the following about individual performance: 1. either added to, or subtracted from collective team performance; 2. were empirically aligned with four value creation cycles in the value creation conceptual framework; and 3. advanced four expected student learning outcomes. Social loafing and loss of social interdependence was identified in team member interactions and they interfere with student learning outcomes. Permanent team members desired and expected the following five attributes from their team members: 1. to be prepared for project activities; 2. to contribute substantially or intangibly to team productivity by sharing knowledge, having good work habits, improving the team product, and helping with leadership and coordination; 3. to be respectful of others;4. to seek consensus and comprise; and 5. to show flexibility in their interaction with others They also see their teacher as an intangible resource in the permanent team who provides knowledge, moral leadership, structure, and mentoring. Instructors and student should consider these findings when they participate or facilitate learning activities in in-class permanent teams.

Unveiling the mechanisms between project manager leadership competencies and team performance: an empirical study

Purpose This study aims to explore the influence of construction project manager competencies on team performance, using structural equation modeling (SEM) within the framework of social information processing theory. It investigates the multidimensional nature of project manager competencies and their impact on team processes and outcomes. Additionally, the study examines the mediating role of team processes in the relationship between competencies and team performance. Design/methodology/approach Drawing on data collected from 483 construction professionals in China, this study uses SEM to analyze the relationships among project manager competencies, team processes and team performance. Findings The results demonstrate a significant and positive effect of competencies on team performance. Specifically, task-related competencies directly contribute to performance, while people-related competencies enhance leader-member relations, and self-related competencies exert a gradual, cumulative influence. Moreover, the research confirms a three-factor competency structure and elucidates the nuanced mediating roles of team learning, monitoring and climate in the competency-performance relationship, shedding light on how specific competencies affect different stages of team development. Originality/value This study contributes to project management literature by applying social information processing theory to elucidate how project managers influence team cognition through competencies. From a practical standpoint, it advocates for a competency-based approach to project manager selection and training, aiming to enhance team performance. Overall, this research advances the understanding of the intricate interplay between project manager competencies and team performance, using SEM and a theoretical perspective rooted in social information processing theory.

Managing a Distracted Modern Workforce: Applying Research Insights to Foster Focus and Productivity

Managing workplace distraction has become a pressing challenge in our digital era. Constant notifications, alerts and competing online options introduce cognitive overload that undermines employee focus and productivity. This practitioner research brief examines what current studies tell us about the cognitive and social factors driving distraction. Drawing from these insights, it proposes organizational strategies and tactics for cultivating a supportive environment where employees can focus their energy on meaningful work. Specific examples from the author's management consulting experience bring these strategies to life. By addressing distraction's root causes with compassion rather than punishment, and empowering employees within a focus-supporting context, organizations can apply a research-grounded approach to gradually shift social norms and behaviors in a way that optimizes individual and team outcomes.

The Female Advantage in Team Dynamics: The role of Genuine Emotional Displays

While the "female advantage" is a well-studied phenomenon, its incidence and effects remain a focus of much debate. In particular, with the growing relevance of teamwork and genuine affective exchange processes in team dynamics, a better understanding of multilevel effects of gender in team processes and outcomes is needed. Drawing from research in team configurations and dynamics explaining how inputs (e.g., team composition) can influence team processes (e.g., emotional exchange) that subsequently affect team outcomes (e.g., performance), we examine mediating effects of deep acting as a gendered group emotional mechanism, assuming it is more prevalent in female-dominated teams. 437 employees working in 92 teams responded to measures of emotional labor and performance. Employees were nested in teams, and data were analyzed using multilevel structural equation modelling. Mediation analyses showed that proportions of women are associated with higher team-level deep acting and subsequent team performance. Findings are discussed in terms of how organization theories could be strengthened by making visible gendered dynamics of shared emotional exchange processes and their effects in team performance, liberating genuine emotional responses among all team members.

Difficult Airway Response Team Outcomes in an Academic Emergency Department: A Prospective, Multidisciplinary Airway Management Cohort Study

Background Successful first-attempt intubation minimizes the risk of hypoxemia, hypoventilation, and hypoperfusion. However, few data exist on outcomes of team-based difficult airway management in the Emergency Department (ED) for patients with deteriorating respiratory status. Objective To investigate the outcomes of an ED Difficult Airway Response Team (DART) program. Methods A prospective observational cohort study of DART implementation was conducted in the ED of an academic, tertiary care institution over a five-year period. An activation protocol was established, and the DART team included emergency physicians, other physicians (anesthesiologists, otolaryngologists, and trauma surgeons), respiratory therapists, nurses, and staff. Patients 18 years or older managed by the DART in the ED were included. Outcome measures included first-attempt intubation success, intubation techniques, and need for surgical airway. Results Across 98 DART activations, 73 patients were managed in ED, nine patients were transported directly to the operating room, and 16 were transported to the operating room after an unsuccessful attempt at airway securement. Advanced airway techniques (fiberoptic bronchoscopy or videolaryngoscopy) accounted for 76% of first-attempt success with airway securement versus 24% for direct laryngoscopy (p<.01). Difficulty with bag-mask ventilation, need for cardiopulmonary resuscitation, and underlying illness predicted lower first attempt success rates (all p <.01). Surgical interventions were required in 17 patients, and 6 patients underwent cricothyroidotomy. There were no airway-related mortalities. Airway anatomy, difficult airway history, and context were associated with equipment selection, transport to operating room, and need for surgical airway. Conclusion In this DART implementation, the first attempt intubation success was associated with use of advanced airway techniques and favorable patient characteristics.

Multicenter Analysis of the Relationship Between Operative Team Familiarity and Safety and Efficiency Outcomes in Cardiac Surgery.

Safety in cardiac surgical procedures is predicated on effective team dynamics. This study associated operative team familiarity (ie, the extent of clinical collaboration among surgical team members) with procedural efficiency and Society of Thoracic Surgeons (STS) adjudicated patient outcomes. Institutional STS adult cardiac surgery registry and electronic health record data from 2014 to 2021 were evaluated across 3 quaternary hospitals. Team familiarity was defined as the mean number of cardiac operations performed by surgeon-anesthesiologist, surgeon-perfusionist, and anesthesiologist-perfusionist dyads within 1 year of the operation. The primary outcomes were (1) safety, measured by the STS' composite major morbidity and operative mortality measure, and (2) procedural efficiency, assessed by cardiopulmonary bypass duration. Team familiarity was stratified by terciles (low, moderate, and high) for crude analyses and analyzed continuously for adjusted analyses. Multivariable logistic and linear regression models were used to assess the association between team familiarity and outcomes. Team familiarity was calculated for 13 581 operations. The median (interquartile range) patient age was 64 (55-72) years, and 31.9% (4328/13 581) were women. Terciles of team familiarity were defined as low (<6.00 average shared operations), moderate (6.00-9.67), and high (>9.67). Teams in lower terciles had higher observed STS morbidity and mortality rates (low, 17.9%; moderate, 18.0%; high, 16.0%; P=0.02) and longer median cardiopulmonary bypass duration (low, 137 minutes; moderate, 131 minutes; high, 118 minutes; P<0.001). After risk adjustment, team familiarity was not significantly associated with STS morbidity and mortality (estimate, -0.001 [95% CI, -0.998 to 0.997]) but was inversely associated with cardiopulmonary bypass duration (estimate, -2.02 minutes per 1 unit increase in team familiarity [95% CI, -2.30 to -1.75]). Increased team familiarity was not associated with STS morbidity and mortality but was inversely correlated with cardiopulmonary bypass duration, demonstrating potential benefit. Interventions aimed at improving team familiarity among operative teams may increase procedural efficiency.

Bullying, Harassment, and Undermining Behaviour in Cardiothoracic Surgery in the United Kingdom and Ireland.

Bullying, harassment, and undermining behaviour has a profound detrimental effect on the multi-professional team, patient safety, and clinical outcomes. Bullying creates a poor working and training environment , increasing stress, damaging confidence, and impairing wellbeing. We sought to characterize the prevalence and nature of bullying, harassment and undermining within cardiothoracic surgery in the United Kingdom and Republic of Ireland. A 21-question survey was sent to all members of the Society for Cardiothoracic Surgery (SCTS) in Great Britain & Ireland. Participants were asked about baseline demographics and their experience of bullying as victim or witness. The survey was sent to 1,326 SCTS members and there were 278 responses (21.0%). Most respondents were physicians (75.2%, n = 209) and most were male (58.3%, n = 162). The majority (79.1%, n = 220) had experienced or witnessed bullying in some form within the last three years (or appointment as a professional). This was experienced directly the majority of respondents (62%, n=136) and a large minority (23.6%, n = 52) had witnessed it in their workplace CONCLUSIONS: Bullying is observed or experienced by a concerning proportion of healthcare professionals working in cardiothoracic surgery. Ongoing initiatives to reduce this within British and Irish healthcare need to be strengthened to improve prevention, reporting and investigation, and support for victims and perpetrators to keep workplaces safe for teams and individuals and to facilitate the delivery of the best possible patient care.

Rudeness and team performance: Adverse effects via member social value orientation and coordinative team processes.

A growing body of research shows that rudeness negatively affects individual functioning and performance. Considerably less is known about how rudeness affects team processes and outcomes. In a series of five studies aimed at extending theories of the social-cognitive implications of rudeness to the team level, we show that rudeness is detrimental to team functioning. Using an experimental design, Study 1 shows that teams encountering rudeness perform worse than other teams. Study 2, a medical simulation study, explains this effect by showing that medical teams exposed to rudeness are less likely than other teams to share information and workload and, in turn, execute a variety of medical procedures less well. Studies 3a and 3b highlight the mediating role played by social value orientation (SVO), demonstrating that rudeness elicits these effects by diminishing members' SVO (i.e., making team members less prosocial and more pro-self). In turn, Study 4 shows that rudeness-diminished SVO explains reduced information sharing in teams. Finally, Study 5, a laboratory study, tests a full serial mediation model, demonstrating that rudeness decreases team members' SVO, which in turn reduces team information sharing and, as a result, encumbers team performance. Overall, these findings show that rudeness can have severe implications for team functioning and may even have life-threatening consequences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The development and effects of a social constructivist approach in an interprofessional discomfort care online education program

BackgroundThe importance of interprofessional education (IPE) programs is increasing due to the complexity and multidimensional aspects of discomfort in long-term care facilities (LTCFs). The social constructivist approach, which is helpful in IPE, has received considerable attention in education. This study aimed to develop and identify the effects of an interprofessional discomfort management online education program using a social constructivist approach.MethodsUsing the Network-Based Instructional System Design model, five steps were employed for online educational program development: analysis, design, production, implementation, and evaluation. We modified the framework of interprofessional discomfort care and a C3 (case-based, collaborative, and contextual learning) instructional model to construct the program. The study used a non-equivalent control group pre-post-test design with 54 interprofessional participants from four LTCFs.ResultsThe pre-post outcomes were statistically significant for proactivity in problem-solving (t = − 2.244, p = 0.030), team outcomes (t = − 2.457, p = 0.017), and transactive memory system (t = − 3.229, p = 0.002). The results of the learners’ educational program-related satisfaction were as follows: overall degree of satisfaction, 3.67 ± 0.67; difficulty, 3.56 ± 0.82; suitability for practice, 3.83 ± 0.64, content, 3.69 ± 0.75; and educational method, 3.46 ± 0.86.ConclusionsThese findings support the effectiveness of the social constructivist approach education program for the awareness of discomfort care in LTCF healthcare professionals and can contribute to the improvement of IPE.

Team science in interdisciplinary health professions education research: a multi-institutional case study.

The interdisciplinary nature of health professions education requires exploration of problems by interdisciplinary research teams. Drawing on the Dynamics of Cross-disciplinary Research Development conceptual framework, this study explores the processes and experiences of an interdisciplinary research team, identifying elements of successful collaboration. Case study data were collected from a team of nine researchers from six universities. Data included meeting minutes and researcher reflections. Researcher reflection and meeting minute themes converged within the framework constructs: Contexts and inputs, social learning processes, social capital outcomes, and knowledge and human capital outcomes. This study provides a blueprint for interdisciplinary researchers indicating that successful collaboration starts with transparent, distributed leadership. The convergence of data illustrates how social learning processes, social capital outcomes, and knowledge and human capital outcomes facilitate research team outcomes.

From Silos to Synergy: A Scoping Review of Team Approaches to Outpatient Eating Disorder Treatment.

This scoping review synthesizes the available evidence on team outpatient eating disorder treatment, focusing on team composition, reported health and service outcomes, and reported principles of Interprofessional Collaborative Practice (IPCP), a synergistic healthcare approach characterized by shared values and ethics, clear roles, communication, and teamwork. A comprehensive search was conducted across five databases, targeting studies published between January 2004 and August 2024 that discussed team-based outpatient eating disorder treatment. Peer-reviewed and gray literature were included if they detailed team composition, characteristics, dynamics, experiences, processes, or outcomes. Forty-five studies met the inclusion criteria; nearly half were case reports or lacked primary data. Treatment teams commonly comprised mental health professionals, dietitians, and medical practitioners. Clinical outcomes, such as body mass index and psychopathology, were the most frequently reported, while satisfaction and organizational outcomes were underrepresented. IPCP principles were inconsistently reported, with "Roles/Responsibilities" and "Communication" most frequently mentioned but often superficially addressed. The evidence base for team outpatient eating disorder treatment lacks rigor and depth. Future research should focus on refining the integration of roles across disciplines, developing comprehensive outcome measures for benchmarking, and applying IPCP principles more systematically.

Sharing a Team’s Vision: Discretionary Behavioral Expectations, Trust, and Team Autonomy, oh my!

Despite knowing that a shared vision can result in a number of positive outcomes for groups and teams, we have a very limited understanding of what potentially contributes to group and team members sharing the same vision. This study seeks to contribute to our very limited understanding of what potentially contributes to team members sharing their team’s vision by focusing on team members’ expectations of their teammates engaging in discretionary behaviors directed toward the organization, the degree to which team members trust their teammates, and the degree to which team managers provide their teams autonomy. Using 197 team members across 46 teams/team managers and 13 organizations, I find that team members’ expectations of their teammates engaging in citizenship behaviors directed toward the organization is positively associated with team members sharing their team’s vision, but I find no association for team members’ expectations of their teammates engaging in deviant behaviors directed toward the organization and sharing their team’s vision. However, I find that trust weakens and team autonomy strengthens the negative relationship between team members’ expectations of their teammates’ deviant behaviors directed toward the organization and sharing their team’s vision. I find no conditional effects of trust and team autonomy on the relationship between OCBO expectations and shared vision. These results suggest that both properties of individual team members as well as the team may play an important role in sharing a team’s vision.

Verbal vs. Visual: How Humans Perceive and Collaborate with AI Teammates Using Different Communication Modalities in Various Human-AI Team Compositions

As AI becomes more advanced in natural language processing, the research on AI's communication in teaming environments is getting more attention in CSCW/HCI. Even though AI's communication serves as an essential part of facilitating team coordination and shaping team outcomes, the impact of AI's communication modality on human-AI teamwork is still understudied. Using a mixed-design experiment and follow-up group interviews with 100 participants, we investigate the impact of AI's communication modality, one of AI's most essential communication characteristics, on team coordination and team outcomes in two different human-AI team compositions, human-human-AI teams, and human-AI-AI teams. Our findings highlight the trade-offs between AI's verbal communication and visual communication, which inspire two design recommendations on how to apply AI's verbal and visual communication to support human-AI coordination effectively. Our study generates an initial understanding of the role that AI's communication will have in ensuring team effectiveness in human-AI teams in the CSCW/HCI field.

How far can I trust you? Understanding the social identity perspective of trust development in global virtual teams

PurposeNew technologies, digitalization tools, and the changing world of work have created a virtual, multicultural, and crossborder environment within organizations. Consequently, a growing body of international business literature is focusing on global virtual teams. However, the research so far has focused more on work-based challenges and outcomes of global virtual teams, with limited attention to long-term trust development between members in these teams. This gap is the key focus of the present research.Design/methodology/approachIn this study, data were collected from 19 interviewees of various nationalities who were part of global virtual teams to understand trust development and identity changes. Afterwards, the NVivo software was used, and findings were generated using the “thematic analysis approach.”FindingsThe findings suggested that individuals working in global virtual teams perceived that such a work arrangement had a positive effect on their work performance; however, it had several negative consequences for their social and nonwork lives. Further, while many team members were able to develop swift and cognitive trust with their global virtual team members, the development of affective trust was less common. Also, exposure to multicultural team members, albeit remotely, resulted in most of the individuals embracing (perceived positive) changes in their behaviors and attitudes, thus reflecting a gradual move toward globalization of the workforce values, yet simultaneously creating greater uncertainty and complexity in their identity and work values.Originality/valueUsing the findings, a novel process model, i.e. “the social identity perspective of trust development in global virtual teams” has been proposed, which offers a step-wise guidance regarding how affect-based trust may be developed in global virtual teams in various stages.

Awareness support in collaborative programming tools: An evaluation based on programmer's perception and eye tracking

Groupware technology is an essential asset for organizations and a successful medium to support social meetings and teacher-learning processes when people are geographically distributed. Computer programming is a domain that can take advantage of the Collaborative Work paradigm and of this technology. However, to be truly effective, groupware systems must provide suitable awareness support, i.e., be capable of informing users of the activity taking place and of the team outcome, so that they can build a setting for their work. The study of awareness mechanisms and their influence on collaborative programming processes is an open research question. In this context, this article contributes an experimental study to evaluate the mechanisms to support coordination, communication, and awareness of COLLECE, a distributed group programming system rich in awareness support. This study brings as a novel approach the combination of subjective and objective information sources, specifically eye tracking techniques, and incorporates a heuristic evaluation of awareness support based on a well-known framework. Thanks to this experiment, we have been able to verify that this blended approach, in which users participate intensively, provides a more comprehensive and deeper assessment of awareness and other coordination and communication mechanisms, and thus a better understanding of how their use can influence the collaborative programming process and outcome (program or piece of software). The study has revealed strengths, weaknesses and opportunities for improvement of the evaluated system, and has yielded concrete results as to which are the most useful awareness components of the user interface not related to the activity supported by the system (programming), these being the traffic lights; the easiest to use, such as the session panel; or the components that impose a greater cognitive load, such as the multi-scrollbar. Regarding the relationship between the supported awareness dimensions and the quality of the collaboration outcome (computer program), the results point to the need to adequately support the What-Artifact dimension, i.e., highlighting in which part of the shared workspace (the source code) the user with floor control is working.

Diagnosing leadership – construction and validation of the leadership impact inventory

PurposeThe purpose is to examine the connection between leadership and its proximal and distal outcomes on employee, team and organization-level outcomes. As a more practical endeavor, a leadership measurement is constructed and validated.Design/methodology/approachThe study takes a quantitative approach, statistically analyzing 301 online survey responses to a survey of leader attributes and their organizational impacts.FindingsThis study shows that the impact of leadership is associated more with actionable behaviors than personality traits. More specifically, leader success leans on leader dependability, management mode, emotive skills and coaching style, which relate to organizational outcomes. Additionally, preventative conflict management belongs to immediate supervisory foci, whereas already escalated conflicts ought to be outsourced to e.g. HR. Further, the findings verify that management is even more about communication than previously understood. Interestingly, employee satisfaction does not predict willingness to stay and is therefore irrelevant as a predictor of employee retention. This verifies the role of satisfaction as a proximal outcome and a post-goal state. Finally, the role of psychological safety is incoherent and equivocal in relation to organizational outcomes.Practical implicationsAs a practical ramification, we devise an instrument, the Leadership Impact Inventory, for (1) diagnosing the quality and effect of organizational leadership in an easy-to-adopt, cost-effective and quick manner and (2) analyzing the influence of various leadership dimensions on satisfaction and goals on individual, team and organizational levels.Originality/valueThis study expands the earlier body of research on leader influence to factors promoting not only proximal outcomes that are typically post-goal states but also distal outcomes. Further, it examines outcomes on all organizational levels, as an extension to prior studies which are typically limited to the entire organization. Finally, the study does not explore leadership as a force or process separate from culture but rather appreciates their synergy through the inclusion of cultural features. This is achieved by monitoring leader success with such subjective aspects describing employee experience and organizational culture that are associated with follower performance.

Developing a cross-functional team coordination framework: A model for optimizing business operations

In today's complex business environment, effective cross-functional team coordination is crucial for optimizing operations and achieving organizational goals. This study introduces a comprehensive framework designed to enhance cross-functional team coordination through structured operational management strategies. By integrating key principles of collaboration, communication, and accountability, the framework aims to bridge departmental silos and promote a culture of teamwork. The proposed model is structured around three core components: communication channels, collaborative tools, and performance metrics. First, it emphasizes the establishment of robust communication channels that facilitate real-time information sharing and feedback among team members from diverse functions. This fosters transparency and aligns objectives, ensuring that all team members are on the same page. Second, the framework advocates for the implementation of collaborative tools that streamline project management and task allocation. These tools enable team members to track progress, manage workloads, and share resources effectively, thereby enhancing overall productivity. By utilizing technology that supports remote collaboration, organizations can also adapt to the increasing trend of virtual teams, ensuring that geographical barriers do not hinder coordination. Finally, the model incorporates performance metrics that allow teams to evaluate their effectiveness and make data-driven decisions. By establishing clear key performance indicators (KPIs) related to team outcomes, organizations can continuously monitor progress and identify areas for improvement. This iterative approach not only optimizes current operations but also fosters a culture of continuous improvement within cross-functional teams. The framework is designed for applicability across various industries, demonstrating its versatility in addressing the unique challenges faced by organizations. By adopting this structured approach to cross-functional coordination, businesses can enhance their operational efficiency, reduce project delays, and improve overall team morale. This study contributes to the existing literature on operational management by providing a practical model that organizations can implement to optimize their business operations through improved cross-functional teamwork.

Clinical outcomes and outcome predictors of two-year assertive community treatment in Norway: an explorative prospective pre–post study

BackgroundAssertive Community Treatment (ACT) teams have become a part of mental health services for people with severe mental illness in many high-income countries. Studies in several countries have investigated the outcomes of ACT, and knowledge is also needed about outcomes of ACT teams in Norway. Our aims were to study clinical outcomes of ACT, how the outcomes were associated with characteristics of patients and treatment, and whether they differed across ACT teams.MethodsOur explorative, prospective, pre–post multicenter study involved 142 patients who received ACT for two years from the first 12 ACT teams established in urban and rural areas of Norway. There was no control group. The primary outcome was change in clinician-rated psychiatric symptoms. Secondary outcomes were clinician-rated change in functioning and engagement and change in community tenure compared with 2 years prior to ACT. We measured fidelity to the ACT model using the Tool for Measurement of Assertive Community Treatment. We performed linear mixed-effects modeling to analyze outcomes and their associations with characteristics of patients and treatment.ResultsAfter two years, psychiatric symptoms were significantly reduced with a small effect size. Negative symptoms, anxiety and depression, and agitation and mania had significant reductions, while positive symptoms had nonsignificant changes. Functioning, engagement, and community tenure all significantly increased with small effect sizes. Age, difficulty to engage, problematic use of alcohol, frequent previous use of inpatient services, total number of sessions, and team’s fidelity to the ACT model were associated with different groups of symptoms. Less improvement in functioning was associated with team fidelity and number of sessions. Change in engagement was not associated with any predictors. Increased community tenure was greater for younger patients and patients who were on community treatment orders at treatment start.ConclusionsACT for two years led to significant positive outcomes with small effect sizes for psychiatric symptoms, functioning, engagement, and community tenure. The outcomes were associated with some potential predictors, and some team-level variance emerged. Positive significant outcomes after two years indicate that larger improvements may be achieved from longer-term treatments by ACT teams.