Alternative Conceptualizations of "Team" as the Unit of Analysis in Examining the Outcomes of "Team" Health Care Delivery
This paper was originally published in the Proceedings of the Thirteenth Annual Interdisciplinary Health Team Care Conference, which took place September 26-28, 1991 in Baltimore, Maryland. It is reproduced here with the permission of the author.
In my presentation I would like to talk about three alternative strategies for conceptualizing team outcome research that are emerging in recent literature. The three strategies are differentiated, in part, by how the "team" unit of analysis is conceptualized. This conceptualization has implications both for the measurement of outcomes and explanations for results of outcome studies.
The first strategy is the one we have used in our own geriatric team research program (see, for example, Feiger & Schmitt, 1979; Farrell, Heinemann & Schmitt, 1986; Farrell, Schmitt & Heinemann, 1988; Schmitt, Farrell & Heinemann, 1988). In our research, the unit of analysis is the formalized interdisciplinary team-as-a-small-group. The second is a strategy developed by Dr. Judith Baggs, a colleague in the nursing school at Rochester, who has been studying outcomes of team efforts in the ICU setting (Baggs, 1990a, 1990b; Baggs, Ryan, Phelps, Richeson & Johnson, in press). The team unit of analysis in her research is focused at the more microscopic level of the nurse-physician dyad involved in making a particular kind of ICU patient care decision for a particular patient. The third strategy is a more macroscopic strategy than the individual patient-oriented dyad, or the team-as-small-group. This is the team as a "unit" within a. larger organizational structure. A research group that typifies this approach to studying team outcomes is that of Knaus, Draper, Wagner and Zimmerman (1986) in their widely cited study of the outcomes of 13 ICU's, and, more recently, the work of Shorten, Rousseau, Gilles, Devers, and Simons (1991), who have been collaborating with Knaus and colleagues on a nationwide study of outcomes of 42 ICUs.