Team Workload Research Articles

The Impact of Role Authority and Communication Initiative on HAT Outcomes

Theobjective ofthisstudy wasto understand howrole authority and communication initiative of autonomous agents impact Human-Autonomy Team (HAT) performance, trust, workload, and cohesion. The study employed a 2 (role authority: peer vs.subordinate) x 2 (communication initiative: proactive vs.reactive robot communication) mixed factorial design.Participantsworkedcollaboratively with Boston Dynamic’s Spot robotto conductanin-person search and rescue taskin afield environment.The study revealedthe subordinate role authority condition, where therobot-is-subordinate tothehuman, imposed a higher workload thanthe peer condition, where the robot-is-peertothe human.

Community-Engaged Research on Social Capital and Older Adults’ Health: Lessons Learned

Most adults in the United States prefer to age in their own homes and communities. However, many ageing-in-place models rely on expensive external services, negatively affecting access by lower socioeconomic status (SES) and other vulnerable groups. This article documents two pilot projects conducted by a community-academic partnership that examined associations between social capital, ageing in community, and health among older adults. The first project explored the association between social capital and health across community SES levels. The second project explored one type of social capital, timebanking, and its association with health. We highlight here our lessons learned from these community-engaged research (CER) projects: (1) Our partnership needed to improve our study design and data collection by enhancing our recruitment strategies, community site partnerships, survey instrument and data matching, and research team workload allocation issues. (2) We should have validated our instruments for use with older adults who had mild cognitive and visual impairments, acknowledged how community SES differences influenced our data collection, and included more research assistant support during our community meetings. (3) We would have benefited from protocol development for recording and responding to issues raised by participants. Our projects also led us to relational insights, such as reinforcing the need to foster clear communication across team members, involving community advisory boards earlier in the CER process, seeking network input on research strategies to meet older adults’ needs, and developing plans to sustain long-term relationships. We hope these lessons learned are useful to other community-engaged researchers.

Pediatric Consultation-Liaison Psychology: Insights and Lessons Learned During the COVID-19 Pandemic.

COVID-19 has presented a variety of challenges to the provision of psychology services. In the first month of the pandemic, pediatric consultation–liaison (CL) psychologists reported significant changes in methodology of service delivery (Steinberg et al. in Clin Pract Pediatr Psychol 9:1, 2020). To better understand how and if these changes persisted, as well as other emerging trends, a follow-up study examined changes and challenges six months into the pandemic. An anonymous questionnaire assessed topics related to pediatric CL psychology including practice changes, perception of changes, and institutional support. The questionnaire was sent to the APA Society of Pediatric Society’s special interest group listservs. Thirty responses were analyzed. Quantitative results showed participants’ beliefs that telemedicine is equally efficacious to in-person services for outpatient psychological care, but less effective for inpatient care. Participants reported their perception of how institutions supported their safety, psychology trainee safety and training goals, and patient care. Qualitative results demonstrated that most psychologists experienced changes related to their dynamics with medical teams, which included changes in team efficiency, workload, transition, and team collaboration.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10880-022-09887-4.

Association Between Operating Room Noise and Team Cognitive Workload in Cardiac Surgery.

Excessive intra-operative noise in cardiac surgery has the potential to serve as source of distraction and additional cognitive workload for the surgical team, and may interfere with optimal performance. The separation from bypass phase is a technically complex phase of surgery, making it highly susceptible to communication breakdowns due to high cognitive demands and requiring tightly coupled team coordination. The objective of this study was to investigate team cognitive workload levels and communication in relation to intra-operative time periods representative of infrequent vs. frequent peaks in ambient noise. Compared to 5-minute segments with no peaks in noise at all, segments with the highest percentage of noise peaks (≥10%) were significantly associated with higher team members' heart rate before, during, and after noise segments analyzed. These noisier segments were also associated with a significantly higher level of case-irrelevant communication events. These data suggest that case-irrelevant conversations associated with a greater degree of excessive peaks in noise may be associated with team workload levels, warranting further investigation into efforts to standardize communication during critical surgical phases.

The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study.

Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined by the team or tutor or left open). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not affect hands-on time (91% [87–93] vs. 92% [88–94] for “withdrawn” and 92 [88–93] for “agitated” relatives; p = 0.15). The teams interacted significantly less with a “withdrawn” than with an “agitated” relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an “agitated” relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all <0.05 compared to control); in addition, an “agitated” relative increased mental demands and total task load (both p < 0.05 compared to “withdrawn” and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an “agitated” relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761).

Multi-objective complex product assembly scheduling problem considering parallel team and worker skills

The flow shop scheduling problem (FSP) is a classic shop scheduling problem with a strong engineering background. As an extension of FSP, the hybrid flow shop scheduling problem (HFSP) involves parallel machine scheduling, and the worker assignment problem on assembly lines (WAPAL) involves worker allocation. Parallel machine scheduling and multi-skilled and multilevel worker allocation are both involved in the actual assembly lines of complex products, but few studies have investigated them simultaneously. This work studies a complex product assembly line scheduling problem considering multi-skilled worker assignment and parallel team scheduling and takes the maximum completion time and the imbalance degree of team workload as the optimization objective. An integer programming model is proposed, and a hybrid coding method considers the worker assignment and task order. Three improved strategies based on a multiple objective evolutionary algorithm (MOEA) are proposed in the local search. Finally, 20 test instances are generated based on actual enterprise labor data, and the results based on the three strategies are compared with six MOEAs. The results show that the three strategies are superior in terms of the quality and distribution of solutions. The inverted generational distance (IGD) index value is increased by 49.97%, 47.89%, 47.08% respectively and the hypervolume (HV) index value is increased by 39.76%, 38.19%, 38.15% respectively.

Team boundary work and team workload demands: Their interactive effect on team vigor and team effectiveness

AbstractDrawing from team‐level job demands‐resources theory, we hypothesize that team workload demands moderate the positive link between team boundary work (i.e., boundary spanning and boundary buffering) and team effectiveness (i.e., team innovation and team performance), such that boundary work is more beneficial for team effectiveness when teams face higher team workload demands. Furthermore, we predict that this interaction occurs through increased team vigor, where team vigor is defined as an affective emergent state characterized by positive valences and high activation levels experienced by team members. We largely find support for our model across two field studies: a cross‐sectional survey using three independent data sources (89 automotive research and development teams, including 724 team members, 89 team leaders and 18 managers) and a time‐lagged survey using two independent data sources (139 teams working in a Chinese utility company, including 640 team members and 139 team leaders). Our article contributes to team research by broadening our understanding of when and how team boundary work is associated with greater team effectiveness.

Telephone Access Management in Primary Care: Cross-Case Analysis of High-Performing Primary Care Access Sites

ABSTRACTBackgroundPrimary care telephone access has been associated with patient satisfaction and emergency department utilization even after accounting for objective appointment wait times. However, relatively little is known about how to best structure and manage telephone access in primary care.ObjectiveAssess how primary care telephone access is structured and managed and explore how variation in telephone management may affect primary care teams and patients.DesignWe used 2016 administrative and patient survey data to select six Veterans Administration medical centers (VAMCs) with above-average primary care access (time to third next available appointment) but variable patient-reported access, geographic region, and urbanicity. Semi-structured interviews were conducted August –October 2017.ParticipantsForty-three key stakeholders knowledgeable about primary care, telephone management, and operational priorities nationally and/or within each VAMC.Key ResultsTelephone access was organized and managed differently across sites. Regional call centers were perceived as more efficient but less flexible in tailoring processes to meet local needs. Patient preferences for speaking with their own care teams were cited as a reason to manage telephone access locally rather than regionally, particularly in rural sites. Sites with high patient-rated access described call center functions as well-integrated with primary care team workflow, while those with low patient-rated access perceived telephone management practices as negatively affecting primary care team workload. Call center understaffing was a major barrier to optimal telephone access in all six sites, though rural sites reported greater challenges with provider recruitment and retention.ConclusionsIn VA, efforts to improve telephone access have focused on centralizing call center operations but current call center performance metrics do not account for the extent to which call center functions are integrated with primary care workflows or may impact patient experience. Efforts to improve primary care access should carefully consider impact of telephone management practices on providers and patients.

Real-Time Team Performance and Workload Prediction From Voice Communications

Automatic prediction of team performance and workload plays a crucial role in team selection, training, evaluation, and re-training processes. This study investigated the potential of using voice analysis of team-based communication for predicting team workload (TW) and team performance (TP). Both the TW and TP categories were labeled objectively. Ten teams of three participants were tasked with completing a computer-based command-and-control simulation that required communication of task-specific information to each team member. Recordings of each participant&#x2019;s voice communications were used to train Convolution Neural Network (CNN) models for each team separately. It was hypothesized that integrating TW and TP information into the prediction process would support the prediction of both TW and TP categories. Two experiments were conducted. In the first experiment, the TP prediction networks were fine-tuned to predict TW, and conversely, the TW prediction networks were fine-tuned to predict TP. In the second experiment, the TP or TW prediction based on the assembly of interconnected TP and TW classifiers was tested. Both experiments confirmed the hypothesis. It was shown that task-related pre-requisite knowledge embedded into the neural network reduced neural network model training time and improved performance without the need to increase the training data size. Predictions based on combined TW and TP classification outcomes - using either separate or interconnected TW or TP classifiers - outperformed the baseline method using a single CNN model trained to predict either TW or TP alone. The classification accuracy was consistent with previously reported cognitive load prediction based on objective measures.

Creating a Model to Predict Time Intervals From Induction of Labor to Induction of Anesthesia and Delivery to Coordinate Workload

(Int J Obstet Anesth. 2021;45:115–123) Recent evidence and guidelines supports offering induction of labor (IOL) to low-risk nulliparous women at 39 weeks’ gestation to reduce risk of cesarean delivery (CD) or adverse neonatal outcomes. Surgical patient outcomes can be impacted by timing of surgery and this may translate to risk of maternal and neonatal outcomes depending on timing of delivery and care team staffing levels and availability. This study aimed to create a model to predict timing from IOL to request for anesthesia and subsequent delivery in order to optimize anesthesia and obstetric team workload during the most well-staffed hours.

Evaluation of Performance Characteristics and Internal and External Training Loads in Female Collegiate Beach Volleyball Players.

Bozzini, BN, McFadden, BA, Scruggs, SK, and Arent, SM. Evaluation of performance characteristics and internal and external training loads in female collegiate beach volleyball players. J Strength Cond Res 35(6): 1559-1567, 2021-Although women's beach volleyball is the fastest growing collegiate sport, the training demands and performance characteristics have yet to be determined. The purpose of this study was to evaluate internal and external training loads throughout a competitive season and to quantify the performance characteristics of National Collegiate Athletic Association Division I women's beach volleyball players. Female beach volleyball players (N = 20) were monitored throughout the 6-week competitive season (T1-T6) using integrative global positioning systems (GPS) and heart rate (HR)-monitoring technology, which was individualized based on preseason testing, for the determination of workload metrics. In addition to team data, all variables were analyzed between travel (n = 11, regular match participation) and non-travel (n = 7) squad athletes (p < 0.05). Team performance metrics demonstrated the explosive power emphasis of the sport, with travel squad players exhibiting significantly greater vertical jump and jump velocity abilities than their non-travel counterparts (p < 0.05). Although few time main effects from T1 to T6 were observed for team workload metrics, follow-ups revealed significant time × group interactions for training load (TL), exercise energy expenditure (EEE), total distance covered, and minutes spent in HR zones (HRZ1-Z5) over the season (p < 0.05). Finally, although average workloads were greater in practices than in matches, when accounting for pre-match warm-ups, competition load was greater than practice (p < 0.05). National Collegiate Athletic Association Division I women's beach volleyball is a demanding, explosive power sport characterized by overall large TL and EEE, particularly in-season when athletes compete in 4 matches per weekend. The workloads observed point to the need to assess and manage training loads and fueling requirements to optimize performance and decrease injury risk.

The COVID-19 Army: Experiences From the Deployment of Non-Hospitalist Physician Volunteers During the COVID-19 Pandemic.

New York City was the epicenter of the outbreak of the 2019 coronavirus disease (COVID-19) pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a "COVID Army," consisting of non-hospitalist physicians, to meet the needs of the patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. To assess the experiences and perceived readiness of these physicians (n = 183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined to develop results. Responses highlighted varying experiences and attitudes of our frontline physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to (1) provide orientations, (2) clarify roles/workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Lessons from our deployment and assessment are scalable at other institutions.

Measurements of team workload: A time pressure and scenario complexity study for maritime operation tasks

Workload is a critical factor influencing team performance in complex systems. There remains no consensus on the selection of team workload measures. Through an experiment based on simulated maritime operation tasks, team workload was manipulated by time pressure and scenario complexity to investigate the responses of three categories (subjective, performance-based, and physiological) of potential team workload measurements. The results show that time pressure had significant effects on all the three categories of measurements, especially on subjective indicators, miss rate, completion rate, operation accuracy, and eye movements. Significant main effects of scenario complexity on subjective team workload and the selected team performance measurements were also found, such as response latent time, miss rate, completion rate, and operation accuracy. Physiological measurements may not be sensitive for measuring team workload when scenario complexity serves as a major influencing factor of team workload.

P0676 / #912: RAPID CYCLE DELIBERATE PRACTICE FOR INTER PROFESSIONAL EDUCATION IN A NON TRAINEE STAFFED PEDIATRIC INTENSIVE CARE UNIT

Aims & Objectives: Rapid Cycle Deliberate Practice (RCDP) is a simulation debriefing methodology that has been compared to post simulation debriefing (PsD) in simulation based medical education (SBME) studies, mostly focused on resuscitations and procedure skills. The aim of this study is to compare the RCDP versus PsD training as methods for experiential learning in the pediatric intensive care unit (PICU) interprofessional SBME sessions. We also measure PICU team workload perception during the simulation scenario using the National Aeronautics and Space Administration Task Load Index (NASA TLX) questionnaire. We hypothesize the RCDP will be more effective than PsD in improving team performance and minimizing cognitive load of learners and facilitators. Methods: Pediatric Critical Care attending physicians, Nurses, Pharmacists and Respiratory Therapists will participate in a 3-hour simulation workshop. Workshops are being conducted from October 2019 - March 2020, and include 5 workshops covering two medical sepsis scenarios. Each session will schedule 1 physician, 2-3 nurses, 1 pharmacist and 1 RT. The first part of the SBME workshop will be PsD and the second half will be RCDP with hard stops and soft stops. The learners complete pre and post-test crew resource knowledge assessments and cognitive load assessments (NASA Task Load Index). Facilitators complete the validated teamwork assessment tool (TEAM Assessment) andNASA Task Index. Results: Raw scores of crew resource knowledge test, TEAM Assessment and NASA Task Load Index between the two studies will be examined. Conclusions: RCDP during interporfessional SBME is feasible and needs to be designed differently in a trainee versus non trainee environment.

Evaluating an emergency department‐based mental health liaison nurse service: A multi‐site translational research project

We aimed to translate and evaluate a model of mental health liaison nursing (MHLN) care that was embedded within EDs. The 12 month mixed-methods translational research study incorporated descriptive data on ED presentations, waiting times for MHLN intervention, time spent in ED and discharge arrangements across three EDs in New South Wales. The study involved an inner-city ED (where the model was first established) and two rural sites. Surveys were conducted on a subset of ED patients (n = 58), and emergency and psychiatry staff (n = 52). Triage category 3 presentations accounted for 49% of the MHLN team workload. Response times and ED length of stay varied between city and rural sites, with rural sites demonstrating prompt response times and reduced ED length of stay. The model was strongly endorsed by patients and staff, with 95% of staff and 85% of patients across the three sites recommending the model be implemented in other emergency settings. The need for adequate resources to maintain designated levels of staffing and sustain this model of care was highlighted. Findings from the present study indicate that a model of ED-based MHLN care developed in a metropolitan setting was successfully translated to two rural sites. However, the model needs to adhere to certain key principles, and be adequately resourced in order to be sustainable and improve outcomes for ED patients and access to community care.

Impact of the complexity of surgical procedures and intraoperative interruptions on neurosurgical team workload

BackgroundNeurosurgical teams are exposed to various stressors: complexity of surgical procedures, environment, time pressure and interruptions contribute to increasing the perceived workload. ObjectiveThis study aimed to evaluate the impact of interruptions and surgical complexity on neurosurgical team workload. MethodsA prospective observational study was conducted on thirty surgical procedures of graduated complexity recorded in our Department of Neurosurgery. A scale was created and used by neurosurgeons to evaluate the perceived complexity of the surgical procedure. Interruptions and severity of interruptions were noted. The workloads of the neurosurgeon, surgical assistant, scrub nurse and circulating nurse were measured on the Surgery Task Load Index (SURG-TLX) at the end of the procedure. ResultsA mean 24.6 interruptions per hour were recorded. The mean interference level of the interruptions was 3.5/7. Mean surgical complexity was 4.3/10. Mean sterile team workload was 43.4/100. The multiple linear regression model showed that sterile team workload increased with surgical complexity (β=6.692, P=.0002) but decreased in spite of increases in the number of interruptions per hour (β=−0.855, P=.027). Neurosurgeon and surgical assistant workload increased with surgical complexity (β=11.53, P<0.0001 and β=7.42, P=0.0007, respectively). Scrub nurse workload decreased in spite of increases in the number of interruptions per hour (β=−1.11, P=.026). ConclusionOur study suggests positive effects of some interruptions during elective neurosurgical procedures with strong team familiarity.

Implementation of individual placement and support in a first‐episode psychosis unit: A new way of working

AbstractThe aim of this study is to explore the IPS implementation process in a first‐episode psychosis (FEP) mental health service team in Sweden. More specifically, the study explores how integration processes and critical situations are perceived over time by team members who originated from two diverse welfare organizations. A serial interview design was used (initially, at 6 and 12 months) to describe experiences of 16 team members. Material was analyzed using a constant comparison grounded theory approach. Team members dealt with the ambivalence of sharing mental health information, and whether the new way of working was a risk or benefit for users. They gradually learned new perspectives and knowledge, built trust and shared common views. After a year, the team workload perceived reduced and became person‐centred. Some members described remaining unclear roles and requested further support. Negotiated goals for integration and early knowledge transfer are critical. Organizational change and trusting team relationships have to be facilitated. Anticipated gains of integration should be clearly described and discussed early on, and continuous support for sustainability should be considered. This study confirmed the importance and potential of integrating IPS into FEP teams.

Violence-related knife injuries in a UK city; epidemiology and impact on secondary care resources

BackgroundThe incidence of knife-related injuries is rising across the UK. This study aimed to determine the spectrum of knife-related injuries in a major UK city, with regards to patient and injury characteristics. A secondary aim was to quantify their impact on secondary care resources. MethodsObservational study of patients aged 16+ years admitted to a major trauma centre following knife-related injuries resulting from interpersonal violence (May 2015 to April 2018). Patients were identified using Emergency Department and discharge coding, blood bank and UK national Trauma Audit and Research prospective registries. Patient and injury characteristics, outcome and resource utilisation were collected from ambulance and hospital records. Findings532 patients were identified; 93% male, median age 26 years (IQR 20–35). Median injury severity score was 9 (IQR 3–13). 346 (65%) underwent surgery; 133 (25%) required intensive care; 95 (17·9%) received blood transfusion. Median length of stay was 3·3 days (IQR 1·7–6·0). In-hospital mortality was 10/532 (1·9%). 98 patients (18·5%) had previous attendance with violence-related injuries. 24/37 females (64·9%) were injured in a domestic setting. Intoxication with alcohol (19·2%) and illicit drugs (17·6%) was common. Causative weapon was household knife in 9%, knife (other/unspecified) in 38·0%, machete in 13·9%, small folding blade (2·8%) and, unrecorded in 36·3%. InterpretationKnife injuries constitute 12·9% of trauma team workload. Violence recidivism and intoxication are common, and females are predominantly injured in a domestic setting, presenting opportunities for targeted violence reduction interventions. 13·9% of injuries involved machetes, with implications for law enforcement strategies.

Team Performance in a Simulated Maritime Control Room: The Effect of Information Integration and Operator Configuration

How team cognition is conceptualized has evolved rapidly in the last decade with the emerging use of a systems approach, moving the focus from the cognition residing in the heads of individuals, to that distributed across the team. This is referred to as ‘distributed cognition’. Increasingly, network approaches are being explored in attempts to model team distributed cognition. The specific domain of interest in the present study is the sociotechnical system within a maritime control room. This comprises human, machine and software agents interacting to interpret sensor data in order to develop a timely and accurate picture of surrounding contacts at sea. To achieve the goal, information is shared or integrated across the maritime control room consoles. The aim of this study was to develop and apply a suite of workload, situation awareness and team performance measures, including network analysis techniques, to examine how the distributed cognition of a team might change as a function of console configuration and information integration within a control room, and how these changes, if any, impact overall team performance. Sixteen teams of six novices conducted two one-hour scenarios operating generic maritime control room positions. Each team completed a one-hour simulation in each of two console configuration layouts with the order counter-balanced (within-subject design). Half the teams conducted the two scenarios in a high integration condition, and half in a low integration condition (between-subjects). The human machine interface (HMI) designs for the high integration condition emerged from a series of task analyses and user-centered design workshops. The emergent cognitively –oriented HMI designs are based on the assumption that each console can freely share information with other consoles. To create an analogue of current, less-integrated, and more stove-piped systems, a low integration condition was created where not all information was shared across consoles, but instead was shared verbally by console operators. Contacts detected at sea were introduced into the simulation and the team’s task was to assess, report and derive a solution (location, course, and speed) for each detected contact. Individual situation awareness was measured through the Situation Present Assessment Method (SPAM) and individual workload through the Air Traffic Workload Indicator Task (ATWIT). Team interaction from the scenarios were video recorded and we applied the Event Analysis of Systemic Teamwork (EAST) approach to examine the task, social and information networks which emerged. Team performance was measured as the accuracy and timeliness of the solutions We found higher information integration lowered average team workload, and improved average team situation awareness and team performance (faster solutions and a more accurate tactical picture). We found no impact of console configuration on team performance or any other dependent measure. The EAST method uncovered patterns in the network analysis that are potentially explanatory for the team workload, situation awareness and performance findings as a function of the information integration manipulation. This experiment showed that there can be reductions in workload, and improvements to situation awareness and performance when information is shared between consoles in a considered design. This has implications for HMI design within a team setting. The set of diagnostic metrics developed were largely effective in examining teamwork and team performance. Acknowledgements. The authors would like to thank Justin Hill (Royal Australian Navy) for his subject matter expertise, Graeme Muller (elmTEK) for his software, technical and infrastructure support, David Munro-Ford (Total Technology Partners) for his simulation programming, Dr Aaron Roberts for his advice on general aspects of the experiment, and Professor Paul Salmon for his advice on EAST.

The Relationship Between Mindfulness, Triage Accuracy, and Patient Satisfaction in the Emergency Department: A Moderation-Mediation Model

IntroductionIndividual and collective mindfulness attracts growing research attention, yet reports of their impact on health care professionals’ work behaviors are scarce, especially in the emergency department. The aim of the current study was to explore whether the association between trait mindfulness and triage accuracy is moderated by the emergency workload environment, and whether this association promotes patient satisfaction subject to levels of collective mindfulness. MethodsA prospective consecutive nested design was conducted. Data were collected from ED teams (nurses and physicians, N = 96) on individual characteristics and trait mindfulness. Data were also collected on triage accuracy, triage team characteristics, collective mindfulness, workload, and patient satisfaction (N = 960) at a specific patient–ED team encounter. ResultsFindings indicated that ED workload environment (b = 0.24, P < 0.01), trait mindfulness (b = 1.80, P < 0.01), and their interaction (b = −0.04, P < 0.05) were associated with triage accuracy. Triage accuracy (b = 1.81, P < 0.001), collective mindfulness (b = 1.29, P < 0.001), and their interaction (b = −0.32, P < 0.001) were associated with patient satisfaction. The moderated-mediation model was significant under high, but not under extreme, levels of ED workload environment and all levels of collective mindfulness. DiscussionTrait and collective mindfulness are relevant to ED triage and patient satisfaction, but their effects are bounded by workload. The beneficial gain of nurses’ trait mindfulness on triage accuracy and collective mindfulness on patient satisfaction is demonstrated only under high-workload environments but limited under extreme-workload environments.