Indexing dynamic collective constructs using computer-aided text analysis: Construct validity evidence and illustrations featuring team processes.

Organizational processes have been widely recognized as both multilevel and dynamic, yet traditional methods of measurements limit our ability to model and understand such phenomena. Featuring a popular model of team processes advanced by Marks et al. (2001), we illustrate a method to use individuals' communications as construct valid unobtrusive measures of collective constructs occurring over time. Thus, the purpose of this investigation is to develop computer-aided text analysis (CATA) techniques that can score members' communications into valid team process measures. We apply a deductive content validity-based method to construct CATA dictionaries for Marks et al.'s dimensions. We then demonstrate their convergent validity with subject matter experts' (SMEs) hand-coded team communications and different SMEs' behaviorally anchored rating scales based on video recordings of team interactions, using multitrait-multimethod analyses in two samples. Using a third sample of paramedics performing a high-fidelity mass casualty incident exercise, we further demonstrate the convergent validity of the CATA and SME scorings of communications. We then model the relationships among processes across episodes using all three samples. Next, we test criterion-related validity using a longitudinal dual-discontinuous change growth modeling design featuring the paramedic CATA-scored team processes as related to a dynamic performance criterion. Finally, we integrate behavioral data from wearable sensor badges to illustrate how CATA can be scored at the individual level and then leveraged to model dynamic networks of team interactions. Implications, limitations, directions for the future research, and guidelines for the application of these techniques to other collective constructs are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Scaling an Enhanced Recovery Program to an Institution-Wide Initiative: It Takes a Village.

BACKGROUND AND OBJECTIVE: With the inclusion of Enhanced Recovery Programs (ERPs) into routine clinical practice, scaling programs across an institution is important to drive sustainable change in a patient-centric care delivery paradigm. A review of ERP implementation within a large institution was performed to understand key components that hinder or facilitate success of scaling an ERP. METHODS: From January 2018 to March 2018, a needs assessment was completed to review implementation of enhanced recovery across the institution. Implementation progress was categorized into one of 5 phases including Define, Implement, Measure, Analyze, and Optimize. RESULTS: Only 25% of service line ERPs reached the optimization phase within 5 years. One hundred percent of respondents reported more strengths (n = 41) and opportunities (n = 41) than weaknesses or threats (n = 25 and 14, respectively). Commonly identified strengths included established enhanced recovery pathways, functional team databases, and effective provider education. Weaknesses identified were inconsistencies in data quality/collection and a lack of key personnel participation including buy-in and time availability. Respondents perceived the need for data standardization to be an opportunity, while personnel factors were viewed as key threats. CONCLUSION: Identification of strengths, weaknesses, opportunities, and threats could prove beneficial in helping scale an ERP across an institution. Successful optimization and expansion of ERPs require robust data management for continuous quality improvement efforts among clinicians, administrators, executives, and patients.

The room where it happens: The impact of core and non-core roles on surgical team performance.

Research on team roles has demonstrated that the strategic core has a larger influence on team performance than non-core roles. Drawing on theories of shared cognition and the strategic core approach, we posit that not all shared experience within a team is equally impactful and examine how dyadic experience with the strategic core facilitates team performance. We further examine the extent to which task complexity and presence of the strategic core further influence this relationship. In this study, we examine surgical teams in which the surgeon occupies the core role. We analyze archival surgical data from 7,070 team performance episodes (i.e., surgeries) conducted at a large community hospital in the United States. We hypothesize and find that dyadic experience between core and non-core roles has a positive effect on team performance, which is stronger for less complex tasks. We then examine the assumption that the continuous presence of the strategic core is a necessary condition for team performance. We find support for a three-way interaction in which the positive effect of dyadic experience between core and non-core roles on team performance is weaker when task complexity is relatively higher and core presence is relatively lower. Our study highlights the importance of dyadic experience between core and non-core roles, especially for less complex tasks. Furthermore, our findings indicate that for more complex tasks, a team's core should be present. Additional implications and future directions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Enhanced recovery program implementation: an evidence-based review of the art and the science.

BACKGROUND: The benefits of enhanced recovery program (ERP) implementation include patient engagement, improved patient outcomes and satisfaction, better team relationships, lower per episode costs of care, lower public consumption of narcotic prescription pills, and the promise of greater access to quality surgical care. Despite these positive attributes, vast numbers of surgical patients are not treated on ERPs, and many of those considered "on pathway" are unlikely to be exposed to a majority of recommended ERP elements. METHODS: To explain the gap between ERP knowledge and action, this manuscript reviewed formal implementation strategies, proposed a novel change adoption model and focused on common barriers (and corollary solutions) that are encountered during the journey to a fully implemented and successful ERP. Given the nature of this review, IRB approval was not required/obtained. RESULTS: The information reviewed indicates that implementation of best practice is both a science and an art. What many surgeons have learned is that the "soft" skills of emotional intelligence, leadership, team dynamics, culture, buy-in, motivation, and sustainability are central to a successful ERP implementation. CONCLUSIONS: To lead teams toward achievement of pervasive and sustained adherence to best practices, surgeons need to learn new strategies, techniques, and skills.

Modeling time-lagged reciprocal psychological empowerment-performance relationships.

Employee psychological empowerment is widely accepted as a means for organizations to compete in increasingly dynamic environments. Previous empirical research and meta-analyses have demonstrated that employee psychological empowerment is positively related to several attitudinal and behavioral outcomes including job performance. While this research positions psychological empowerment as an antecedent influencing such outcomes, a close examination of the literature reveals that this relationship is primarily based on cross-sectional research. Notably, evidence supporting the presumed benefits of empowerment has failed to account for potential reciprocal relationships and endogeneity effects. Accordingly, using a multiwave, time-lagged design, we model reciprocal relationships between psychological empowerment and job performance using a sample of 441 nurses from 5 hospitals. Incorporating temporal effects in a staggered research design and using structural equation modeling techniques, our findings provide support for the conventional positive correlation between empowerment and subsequent performance. Moreover, accounting for the temporal stability of variables over time, we found support for empowerment levels as positive influences on subsequent changes in performance. Finally, we also found support for the reciprocal relationship, as performance levels were shown to relate positively to changes in empowerment over time. Theoretical and practical implications of the reciprocal psychological empowerment-performance relationships are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Leading multiple teams: average and relative external leadership influences on team empowerment and effectiveness.

External leaders continue to be an important source of influence even when teams are empowered, but it is not always clear how they do so. Extending research on structurally empowered teams, we recognize that teams' external leaders are often responsible for multiple teams. We adopt a multilevel approach to model external leader influences at both the team level and the external leader level of analysis. In doing so, we distinguish the influence of general external leader behaviors (i.e., average external leadership) from those that are directed differently toward the teams that they lead (i.e., relative external leadership). Analysis of data collected from 451 individuals, in 101 teams, reporting to 25 external leaders, revealed that both relative and average external leadership related positively to team empowerment. In turn, team empowerment related positively to team performance and member job satisfaction. However, while the indirect effects were all positive, we found that relative external leadership was not directly related to team performance, and average external leadership evidenced a significant negative direct influence. Additionally, relative external leadership exhibited a significant direct positive influence on member job satisfaction as anticipated, whereas average external leadership did not. These findings attest to the value in distinguishing external leaders' behaviors that are exhibited consistently versus differentially across empowered teams. Implications and future directions for the study and management of external leaders overseeing multiple teams are discussed.