Team and Organizational Dynamics in the Healthcare Industry
Date of Award
Spring 2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Management
First Advisor
King, Marissa
Abstract
The United States healthcare landscape is increasingly complex, with medical professionals and healthcare organizations facing a myriad of challenges, including the global COVID-19 pandemic, continually rising costs, increasing levels of consolidation, and concerns about provider shortages. Despite the growing body of work on healthcare providers, teams, and organizations, there is still much to be learned from applying an organizational lens to the behavior and performance of medical providers and healthcare organizations. In my dissertation, I explore how healthcare organizations – such as independent physician practices – and the actors within them – such as physicians, residents, and nurses – respond to the variety of intra- and extra-organizational pressures faced by healthcare providers today.
In the first chapter, I use patient and provider data from a large emergency department to investigate the effect of team familiarity on fluid teams’ performance during crisis situations. Using data from the COVID-19 pandemic and times the department experienced an increase in high acuity patients, I explore how the nature of a crisis can change the well-documented benefits of team familiarity in fluid teams. In the second chapter, I use data from the same emergency department to understand how team familiarity and team member expertise interact to affect teamwork. By differentiating familiarity based on team members’ roles, I also explore how certain roles’ familiarity matter more or less for the overall team’s performance. Finally, the third chapter investigates whether physician groups in certain regions are more or less likely to experience consolidation events and how prices change after they do. Using data on physician group mergers and acquisitions, I examine how a region’s demographic composition changes the likelihood of consolidation.
This dissertation draws on and contributes to research on team familiarity and performance in fluid teams, teams’ responses to crisis situations, and the antecedents and consequences of healthcare consolidation. The first and second chapters build on existing research on fluid teams by providing information about circumstances in which team familiarity is more or less important to performance. The first chapter also contributes to the literature on how teams respond to crisis situations. Finally, the third chapter contributes to the literature on healthcare consolidation by examining smaller cases of consolidation and exploring where consolidation is most likely to occur.
Recommended Citation
Bray, Alexandr, "Team and Organizational Dynamics in the Healthcare Industry" (2023). Yale Graduate School of Arts and Sciences Dissertations. 1069.
https://elischolar.library.yale.edu/gsas_dissertations/1069
