Team Coordination Research Articles

A Delphi-based exploration of factors impacting blood loss and operative time in robotic prostatectomy.

This study aims to investigate factors influencing the implementation of robotic-assisted radical surgery, with a specific focus on their effects on blood loss and operative time. Radical prostatectomy was chosen as the case study due to its complexity and diverse surgical activities. The study employed a three-round Delphi approach involving 25 surgeons from three countries: UK, Australia, and China. The collected data were analysed using non-parametric tests. The Delphi study showed significant correlations between the degree of difficulty and blood loss (Z = 2.698, ρ < 0.007), as well as between team coordination and blood loss (Z = 3.499, ρ < 0.0001). However, no significant relationship was found between operative time and blood loss. Surgeons reported that neurovascular bundle (NVB) release and pelvic lymph node dissection require high team coordination. NVB release is particularly challenging and poses a higher risk of blood loss. Additionally, a large prostate increases the difficulty of prostate dissection, prolongs operative time for bladder neck and NVB dissection, and leads to a considerable overall increase in operative time. The manuscript shows that effective team coordination plays a crucial role in reducing blood loss and operative time during surgical activities. When the team coordinates well, clear and efficient verbal communication suffices, reducing the need for physical proximity during robotic-assisted surgeries.

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.

Centralization or decentralization? Power allocation in team innovation management.

Power disparity, as an important form of internal team hierarchy, presents a "double-edged sword effect". To reconcile the inconsistent effects and systematically explore the different mechanisms of power disparity, this study constructs a comprehensive theoretical model based on power functionalism and power conflict theory, with team coordination and team conflict as dual mediators, and power legitimacy as moderator. By collecting valid questionnaires from 76 teams across 27 different types of companies in various regions, statistical analysis and hypothesis testing were conducted on the data. The results conclude that power disparity positively influences team innovation performance through the team coordination path and negatively affects it through the team conflict path. However, under the moderating effect of power legitimacy, the negative effect of the team conflict path is suppressed, and the positive effect of the team coordination path is strengthened, thus ensuring that power disparity has a positive effect on team innovation performance. This study provides a useful reference for designing the power hierarchy within enterprises, and offers profound insights into effective organizational structure and decision-making processes.

Joint Action JACARDI: a context analysis on CVDs and diabetes policies and practices

Abstract Issue/problem Non-communicable diseases are the leading cause of death and disability in Europe, with 63 million people living with cardiovascular diseases (CVDs) and 32 million with diabetes (DM) in 2019. The EU-co-funded Joint Action on CVDs and diabetes (JACARDI), with 76 partners from 21 countries, aims to reduce CVDs and DM burden at European level through 142 pilot projects. Description of the problem For an effective and tailored pilots’ implementation, a preliminary step is to assess the current state of strategies and services for CVDs and DM prevention and management in Europe. We adopt the Gap Analysis methodology aiming to evaluate the gap between the current and the ideal state, the latter defined according to scientific evidence, best-practices, guidelines, and expert’s opinions. For this purpose, 12 questionnaires, one for CVDs and one for DM for six different thematic areas, were developed through a participatory approach that fostered the collaboration between the scientific coordination team and the project members. Results Questionnaires were sent to National Focal Points for health covering 29 European countries. We anticipate receiving responses from each country covering aspects related to the legal and strategic framework, the intersectoral and equity-oriented approaches, the funding and the service delivery and capacity for CVDs and DM. This information will be collected across each of the six thematic areas corresponding to six technical Work Packages (WP): health literacy, data, screening, integrated-care pathways, patients self-management, labour participation. The survey will be completed by June 2024, and results by WP and country will be presented. Lessons The context analysis, based on the Gap Analysis methodology, allows to identify gaps between the current and ideal state in CVDs and DM prevention and management. This will guide JACARDI’s pilots to address gaps and serve as a roadmap to inform European policy-makers. Key messages • The context analysis will provide an invaluable overview of the current European state of CVDs and DM prevention and management. • The context analysis will support JACARDI’s pilots in addressing identified gaps and policy-makers in shaping public health responses.

Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients.

The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care. Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling. The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.

26 Culturally informed developmental paediatric care: A qualitative study

Abstract Background Paediatricians provide developmental care through developmental surveillance, identification and management of specific developmental disorders, and health advocacy. Despite being one of the most common reasons to visit a paediatrician, the provision of care in this field is challenging as it intersects with medical, mental health, and educational systems. Additionally, the rise of international migration, inequities in health systems, and unique culturally based concepts of child development require paediatricians to have unique skills for culturally informed care provision in this area. Objectives A qualitative study was conducted to describe the perceptions of paediatricians on providing culturally informed developmental paediatric care to diverse populations. Design/Methods Semi-structured interviews were completed with paediatricians who primarily provide developmental care to understand the challenges, opportunities, and potential educational enhancements to improve culturally informed care for developmental paediatrics. Thematic analysis was used to analyze the transcribed interviews using inductive and deductive approaches. Results Three major themes emerged from 18 individual semi-structured interviews. The first theme, “cultural translation,” described language differences, interpretation, and trust-building between discordant physician/family dyads. The second theme, “inequity,” described systemic barriers that diverse populations experience, power distance in healthcare relationships, and pandemic-related amplifications of inequity. The third theme, “educational opportunities,” highlighted reflective practice opportunities, immersive experiences in diverse settings, and building a community of practice for paediatricians to build their knowledge base. Paediatricians practicing developmental paediatric care highlighted unique elements to the practice which may benefit from practice changes and curricular reform. Integration of meaningful training in the use of interpretation services, multicultural health brokers, and care coordination teams is a recommended intervention which is transferable to many disciplines. Peer-mentorship from colleagues of differing cultural backgrounds may help reduce race-based stereotypes and enhance perspective taking. Conclusion Paediatricians had a variety of perspectives on the provision of developmental paediatric care to diverse populations within Canada. There were a range of perceived opportunities for improvements in care noted on individual and systems levels. The development of infrastructure to build capacity in culturally informed developmental paediatric care to reduce culturally based health gaps is a needed future direction for developmental paediatrics.

GESTÃO ESCOLAR E AS TECNOLOGIAS

This article is part of the research line of the Master's program in Emerging Technologies in Education at MUST UNIVERSITY and addresses the importance of educational management for innovative projects and their implementation. The article aims to reason the processes of deployment and implementation and the authors involved. The methodology used for the work is qualitative research to gather important information about the significance of the project coordination team, strategies, and their utilization. Therefore, at the end of the research, it is clear that the educational coordination team is essential for the effectiveness of the projects.

Bringing team science to the ambulatory diagnostic process: how do patients and clinicians develop shared mental models?

The ambulatory diagnostic process is potentially complex, resulting in faulty communication, lost information, and a lack of team coordination. Patients and families have a unique position in the ambulatory diagnostic team, holding privileged information about their clinical conditions and serving as the connecting thread across multiple healthcare encounters. While experts advocate for engaging patients as diagnostic team members, operationalizing patient engagement has been challenging. The team science literature links improved team performance with shared mental models, a concept reflecting the team's commonly held knowledge about the tasks to be done and the expertise of each team member. Despite their proven potential to improve team performance and outcomes in other settings, shared mental models remain underexplored in healthcare. In this manuscript, we review the literature on shared mental models, applying that knowledge to the ambulatory diagnostic process. We consider the role of patients in the diagnostic team and adapt the five-factor model of shared mental models to develop a framework for patient-clinician diagnostic shared mental models. We conclude with research priorities. Development, maintenance, and use of shared mental models of the diagnostic process amongst patients, families, and clinicians may increase patient/family engagement, improve diagnostic team performance, and promote diagnostic safety.

Cluster randomized trial of a team communication training implementation strategy for depression screening in a pediatric healthcare system: a study protocol

BackgroundPediatric depression is a global concern that has fueled efforts for enhanced detection and treatment engagement. As one example, the US Preventive Services Task Force recommends depression screening for adolescents ages 12–18 years. While many health systems have implemented components of depression screening protocols, there is limited evidence of effective follow-up for pediatric depression. A key barrier is timely team communication and coordination across clinicians and staff within and across service areas for prompt service linkage. However, team effectiveness interventions have been shown to improve team processes and outcomes and can be applied in healthcare settings.MethodsThis project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The team will be defined as part of the study but is expected to include medical assistants, nurses, physicians, and behavioral health clinicians within and across departments. The implementation strategy will target team mechanisms at the team-level (i.e., intra-organizational alignment and implementation climate) and team member-level (i.e., communication, coordination, psychological safety, and shared cognition). First, the project will use mixed methods to refine the team training strategy to fit the organizational context and workflows. Next, a hybrid type 3 implementation-effectiveness pilot trial will assess the initial effectiveness of the team communication training (implementation strategy) paired with the current universal depression screening protocol (clinical intervention) on implementation outcomes (i.e., feasibility, acceptability, appropriateness, workflow efficiency) and clinical/services outcomes (increased frequency of needed screening and reduced time to service linkage). Finally, the study will assess mechanisms at the team and team member levels that may affect implementation outcomes.DiscussionTeam communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the compliance with depression screening and timely service linkage. Findings are expected to yield better understanding and examples of how to optimize team communication to improve efficiency and effectiveness in the pediatric depression screening-to-treatment cascade. This should also culminate in improved implementation outcomes including patient engagement critical to address the youth mental health crisis.Trial registrationNCT06527196.Trial Sponsor: University of California San Diego.

Middle Leadership in Educational Teams: Practices and Effects on the Development of Learning Communities

In a new context of management and teaching action, framed by the organisation of the school into educational teams, middle leaders can play a key role in promoting learning communities, teacher development and improving teaching. Therefore, it seems relevant to understand the practices of these leaders that make their leadership effective. To this end, we adopted a qualitative research paradigm, operationalised through a case study, combining a quantitative and qualitative approach. Thus, we articulated data analysis processes based on descriptive statistics, which we subjected to structural and semantic analysis and interpretation, with a qualitative approach, essentially based on content analysis, to delve into some unique contexts and the perspective of individual actors. After analysing the data, we conclude that educational team coordinators play a fundamental role in facilitating the interpersonal characteristics of learning communities, involving teachers in a more collaborative and collegial working environment. However, their role in facilitating teacher learning is weaker, which hinders their contribution to deepening teacher learning and changing classroom practices.

Coordination in Dynamic Teams: Investigating a Learning–Productivity Trade-Off

The rapid growth in the use of teams and multiple team membership has led more organizations to structure work around dynamic teams, characterized by short lifespans and fluid membership boundaries. This approach to organizing work makes it difficult for teams to work efficiently or to support the learning and growth of members. Given the importance of productivity and learning, we ask how these processes can be supported in dynamic teams. We do so in a randomized controlled field experiment conducted with 91 teams in a teaching hospital, a context in which physician trainees must learn while providing patient care in dynamic teams of care providers. We randomly assigned physician teams, or “core” teams, to launch their work with an intervention focused either on internal coordination among the core team members or on external coordination with a changing cast of external contributors such as nurses and specialists. We measured resulting levels of internal and external coordination over teams’ week-long lifespans and observed that external coordination was associated with improved team efficiency, whereas internal coordination was associated with improved individual learning. Post hoc exploratory analysis suggested that individual learning was highest when teams achieved high levels of both internal and external coordination, and it was positively correlated with improvement in the team’s patients’ average length of hospital stay. We discuss the implications of the demonstrated causal effects of team launches, along with our exploratory findings, for the management of dynamic teams and the opportunities to mitigate potential trade-offs between learning and productivity. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2022.16729 .

Organizational readiness to implement bundled interventions to increase HIV linkage and retention in care and treatment: results from the Black Women First (BWF) initiative

BackgroundEvidence-based and evidence-informed interventions designed to address gaps in the HIV care continuum have the potential to improve HIV care and treatment. However, inadequate organizational readiness can derail intervention uptake, prevent the integration of interventions, and contribute to suboptimal HIV treatment outcomes. This study sought to understand organizational readiness to implement bundled interventions for Black women with HIV and inform facilitators and barriers to implementation.MethodsWe conducted a mixed methods readiness assessment across 12 sites participating in the Black Women First (BWF) initiative to gauge preparedness to implement bundled interventions. Readiness was assessed using the organizational readiness for implementing change (ORIC) scale, and two open-ended questions examined facilitators and barriers. Associations between participant and organizational level factors were evaluated using linear models with clustering by site at baseline, 6- and 12-months. Pre-implementation interviews were conducted with staff virtually and transcripts were managed in NVivo. Directed content analysis was used to explore implementation barriers and facilitators.FindingsSites demonstrated high levels of organizational readiness at baseline; overall organizational readiness for implementing change (ORIC) (mean 56.4, median 59, interquartile range [IQR] 5) and subscales of the ORIC change efficacy (mean 32.4, median 35, IQR 4), change commitment (mean 24, median 25, IQR 1), which is consistent with willingness and capability to implement bundled interventions for Black women with HIV. Organizational readiness remained high at 6- and 12-month follow-up periods. Staff role was significantly associated with organizational readiness (p = 0.007), change efficacy (p = 0.006), and change commitment (p = 0.020) at 6 months. Qualitative analysis indicated strategic planning and assessment (e.g., team coordination and the development of workflows to support implementation); organizational change through network weaving across silos within the organization, and communications systems that engage external partners, as well as resources available for hiring and training, supported readiness. Collaborative leadership and organizational buy-in, staff motivation, and partnerships facilitated implementation processes.ConclusionsOrganizations in the BWF initiative have high levels of organizational readiness reflecting willingness and capability to implement bundled interventions for Black women with HIV. Future research should examine the relationship between readiness and clinical outcomes.

Learning to Move Like Professional Counter‐Strike Players

AbstractIn multiplayer, first‐person shooter games like Counter‐Strike: Global Offensive (CS:GO), coordinated movement is a critical component of high‐level strategic play. However, the complexity of team coordination and the variety of conditions present in popular game maps make it impractical to author hand‐crafted movement policies for every scenario. We show that it is possible to take a data‐driven approach to creating human‐like movement controllers for CS:GO. We curate a team movement dataset comprising 123 hours of professional game play traces, and use this dataset to train a transformer‐based movement model that generates human‐like team movement for all players in a “Retakes” round of the game. Importantly, the movement prediction model is efficient. Performing inference for all players takes less than 0.5 ms per game step (amortized cost) on a single CPU core, making it plausible for use in commercial games today. Human evaluators assess that our model behaves more like humans than both commercially‐available bots and procedural movement controllers scripted by experts (16% to 59% higher by TrueSkill rating of “human‐like”). Using experiments involving in‐game bot vs. bot self‐play, we demonstrate that our model performs simple forms of teamwork, makes fewer common movement mistakes, and yields movement distributions, player lifetimes, and kill locations similar to those observed in professional CS:GO match play.

Requesting Relatives' Consent for Intensive Care for Organ Donation: An Empirical Analysis of Spanish Transplant Coordinators' Practices.

Intensive care to facilitate organ donation (ICOD) involves the initiation or continuation of intensive care for patients with devastating brain injury for donation purposes. In the Spanish system, relatives undergo an early interview to request consent for this procedure. If they consent, a waiting time is agreed upon in the expectation that death by neurological criteria occurs and donation after brain death takes place. Otherwise, relatives can decide on donation after circulatory determination of death or withdrawal of life support. This study analyzes how Spanish transplant coordinators interact with relatives in early interviews and follow-ups on potential donation pathways. Semistructured interviews were conducted with a random stratified sample of 23 Spanish transplant coordination teams to explore strategies, practices, and perceptions of ICOD consent requests. The interviews were recorded, transcribed, and analyzed using content analysis. Previous coordination with other units and information retrieval regarding patient and relatives' situations is crucial. The development of early interviews includes an introduction to the family, identification of decision makers, empathizing with relatives and offering condolences, reaffirming the fatal prognosis, explaining the possibility of donating based on the patient's will, confirming the family's understanding and resolving doubts, and ensuring comfort and assessing family needs. Approaching families to obtain ICOD consent is a regular practice for Spanish coordination teams. It involves a highly professional and diversified set of strategies based on establishing a support relationship for relatives. Our study provides strategies that serve as a reference for obtaining ICOD consent from families in other settings.

Количественная оценка степени сформированности навыков командной деятельности

&lt;p&gt;The article presents a method for quantifying teamwork skills formation using a triangular scheme and mathematical models based on transition probability matrices. The study focuses on analyzing individual and jointly coordinated activities of participants under experimental conditions, involving working on a simulator for jointly controlling an aircraft. Markov chains are used to analyze the results, allowing for detailed analysis of task completion dynamics and identification of key aspects of participant interaction. The findings confirm the effectiveness of the proposed approach to analyzing and improving team coordination.&lt;/p&gt;

Choking under pressure in online and live esports competitions

This paper explores the phenomenon of choking under pressure within the context of esports, particularly focusing on the difference between online and live competitive settings and on high-pressure situations during overtime rounds. Employing a quasi-experimental design, the research leverages an extensive dataset covering professional CS:GO matches from 2012 to 2022 (match-level) and from 2015 to 2023 (round-level), including performance metrics such as players' ratings, headshot percentages, and teammate damage. The findings indicate a substantial decrease in the performance of esports players during overtime. This effect, however, is significantly mitigated in online competitions compared to live events. The study also reveals that while individual performance suffers under pressure, the impact on team coordination is less pronounced in online settings, suggesting that the virtual environment might offer a buffer against the negative effects of stress on team dynamics. This study enriches our understanding of performance psychology in digital settings but also opens up new avenues for research on stress, teamwork, and performance in professional and virtual environments.

Challenges With Robot-Assisted Surgery Setup for Complex Minimally Invasive Upper Gastrointestinal Surgery.

The utilization of robot-assisted approaches to surgery has increased significantly over the last two decades. This has introduced novel complexities into the operating room environment, requiring management of new challenges and workflow adaptation. This study aimed to analyze challenges in the surgical setup for complex upper gastrointestinal robot-assisted surgery (UGI-RAS) and identify opportunities for solutions. Direct observations of surgical setup processes for UGI-RAS were performed by a trained Human Factors researcher at a non-profit academic medical center in Southern California. Setup tasks were subdivided into five phases: (1) before wheels-in; (2) patient transfer and anesthesia induction; (3) patient preparation; (4) surgery preparation; and (5) robot docking. Start/end times for each phase/task were documented along with workflow disruption (FD) narratives and timestamps. Setup tasks and FDs were analyzed using descriptive statistics. Twenty UGI-RAS setup procedures were observed between May-November 2023: sleeve gastrectomy +/- hiatal hernia repair (n = 9, 45.00%); para-esophageal hernia repair +/- fundoplication (n = 8, 40.00%); revision to Roux-en-Y gastric bypass (n = 2, 10.00%); and gastric band removal (n = 1, 5.00%). Frequent FDs included planning breakdowns (n = 20, 29.85%), equipment/supply management (n = 17, 25.37%), patient care coordination (n = 8, 11.94%), and equipment challenges (n = 8, 11.94%). Eleven of 20 observations were first-start cases, of which 10 experienced delayed starts. Interventions aimed at improving workflows during UGI-RAS setup include performing pre-operative team huddles and conducting trainings aimed at team coordination and equipment challenges. These solutions could result in improved teamwork, efficiency, and communication while reducing case start delays and turnover time.

Channeling personal initiative through team coordination: A heat map analysis of soccer players’ aggregate behavioral initiative

Channeling personal initiative through team coordination: A heat map analysis of soccer players’ aggregate behavioral initiative

Distributed Space Team Coordination: An Agent-based Modeling and Simulation Approach

Distributed Space Team Coordination: An Agent-based Modeling and Simulation Approach

Enhancing Emergency Response: The Role of Collective Competence in Epidemiological Teams for Effective Laboratory Data Collection and Analysis

Background: Health systems globally face ncreasing challenges from health crises and epidemic threats, necessitating the pivotal role of epidemiological teams in emergency response. This study investigates the significance of collective competence within these teams, focusing on their ability to collect, analyze, and manage laboratory data effectively. Methods: A cross-sectional descriptive study design was used to survey epidemiological teams in Saudi Arabia. A structured questionnaire was developed based on existing literature and distributed electronically to participants. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), using descriptive and inferential statistics to summarize participant characteristics and explore associations between variables. Results: A total of 208 epidemiological teams member completed the questionnaire, yielding insights into their The Role of Collective Competence in Epidemiological Teams. The findings reveal high levels of agreement regarding the effectiveness of management approaches, knowledge sharing, and team collaboration, with the average score exceeding 4.0 on a 5-point scale. Notably, team efficacy was found to significantly enhance the efficiency of laboratory data collection and analysis, accounting for approximately 25.9% of the variance in efficacy. Discussion: These findings underscore the need to invest in developing team competencies within epidemiological teams to improve emergency response capabilities. The study provides practical insights into enhancing team collaboration and coordination, ultimately contributing to more effective public health interventions in future health crises.