What impact do these stressors have on teams?

We feel that these stressors lead to both attitudinal and behavioral risk points.

Attitudes and cognitions of concern include low belief that the team can succeed (sometimes referred to as loss of collective efficacy); narrowing of attention, with excessive focus on oneself, insufficient shared mental models, such as roles and priorities, and discomfort speaking up, which creates a sense of lack of psychological safety.

Additional issues are that schisms may start to appear among team members, there may be insufficient vigilance, and people may fail to ask questions, admit concerns, or provide feedback. Perhaps most importantly, when setbacks occur, they adversely affect the next tasks, creating low team resilience.


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To mitigate these effects, our team identified 7 recommendations for organizational and team leaders as well as team members to deal with these stressors and mitigate their negative impact.

Celebrate all successes-big and small

During the pandemic, teams may be struggling to maintain collective efficacy, which is having a shared sense that you can achieve your goals. In the health care context, this means helping patients get through COVID-19 and come out alive and healthy on the other side. It’s really easy to lose collective efficacy when you are consistently confronted with failure, such as high patient mortality rates, but sharing successes boosts morale and can lend perspective.

For example, if a health care provider has had losses of patients during his or her shift but hears good news coming from other teams in the hospital about successes in treating patients, this can suggest that, although one team is experiencing discouraging results, other teams might be experiencing more successes and this can give hope that successes are happening and can happen in their team as well.

I have heard about hospitals where, if a patient with COVID-19 has recovered and is discharged, all the nurses, physicians, and patient care staff stand in the hallways to cheer them out. This is a good example of building collective efficacy and taking a moment to celebrate every victory.

Make sure team members understand their roles and priorities

“Shared mental models” (SMM) are also called “team cognitions” and refer to a team’s shared, accurate, and complementary understanding of their domain, which enables teams to adapt and coordinate together. This can be accomplished through regular huddles and debriefings, even if time is limited, as it is during the pandemic. During these often-brief meetings, roles and priorities can be clarified, and it can be determined who has the most expertise to take on a given need.

Don’t overlook anyone, including team members who work behind the scenes

Many of the health care professionals who are working with COVID-19 patients are visible and providing hands-on treatment. They are the face of the “health care heroes” and are justifiably lauded and appreciated. However, it is very easy to forget the number of people behind the scenes, including those who obtain supplies or monitor the need for supplies, those who answer phones or those who are working with patients who do not have COVID-19. In this type of setting, communicating the wins and success of all members of the practice, including those in the background, allows a sense of collegiality. Sharing the workarounds people are coming up with for problems helps improve the learning of the entire team over time.

The “schisms” I mentioned earlier refer to the sense that there is a hierarchy of importance, with those providing direct COVID-19 care more important than others in supporting roles or who are not providing care to COVID-19 patients. This can cause a sense of having people feel unappreciated. All contributions to the functioning of the health care system or practice should be regularly acknowledged and commended.

Encourage mutual team monitoring and support

A major concern that we have seen is a narrowing of attention,4 which means that people on a team can over focus on themselves and their own jobs and not take a step back and see the larger team, so mutual team monitoring is critical. Some research5 has suggested that effective teams successfully monitor the situation itself, team performance as a whole, and each of the teammates.

Team members should be encouraged to provide back up to each other if one person seems overwhelmed or fatigued. Leaders might encourage situation monitoring, for example, if an individual has an excessive case volume, or performance monitoring. More experienced team members can also lend support to less experienced team members.

This article originally appeared on MPR