Date of Conferral

2021

Degree

Ph.D.

School

Health Services

Advisor

Denise Rizzolo

Abstract

Medical errors in emergency departments (EDs) have been researched extensively but people who use EDs have continued to be at risk. A gap in knowledge existed as to what the relationship is between interprofessional (IP) team membership stability (TMS), work experience, collective competence, and ED patient outcomes. Guided by the collective competence theory, this quantitative correlational study sampled three rural EDs, a 33% response rate. IP participants rated collective competence as high. Using regression analysis and 3 months of existing data, IP ED core teams showed low temporal stability and the relationship between TMS and medical errors was not statistically significant, but work experience was related to a decrease in time to physician and length of stay. TMS and work experience correlated positively (r = .42) and moderating effects were tested. TMS had a negative moderating effect on work experience. Also, neither TMS nor work experience were statistically significant when patient volumes and levels of acuity were controlled. In contrast, when team size was controlled, TMS had a large effect size on time to physician. Conclusion: (a) structured organizational processes were present to buffer low TMS; (b) high team cohesiveness existed within the low TMS and groupthink may have been present; and (c) determining the ceiling effect for optimal team size was needed. These results may benefit ED patients, point of care providers, administrators, and funders to strengthen collective knowledge at the organizational level by using standardized processes to buffer low TMS, implement strategies to mitigate groupthink to prevent collective failures, and consider team size for effecting a responsive and effective healthcare system to improve the quality of ED patient care.

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