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Health care multidisciplinary teams: The sociotechnical approach for an integrated system-wide perspective
Marta Marsilio1, Aleksandra Torbica, Stefano Villa
1Marta Marsilio, PhD, is Assistant Professor, University of Milan, Italy, and Centre for Research in Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy. Aleksandra Torbica, PhD, is Assistant Professor, Centre for Research in Health and Social Care Management (CERGAS), Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy. E-mail: aleksandra.torbica@unibocconi.it. Stefano Villa, PhD, is Associate Professor, Department of Management, Catholic University, Rome, Italy, and Coordinator of field research projects at CERISMAS (Research Centre in Health Care Management), Catholic University of Milano, Italy. This material is based on research supported by the European Health Technology Institute for Socio Economic Research (EHTI) through an unrestricted grant awarded to the Centre for Research in Health and Social Care Management (CERGAS). During the project execution, all authors were affiliated with CERGAS, Bocconi University.
Background:
The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another.
Purpose:
Drawing on a system perspective of organizations, the authors analyze the organizational patterns that promote and support multidisciplinary teams and how they interrelate and interact to enforce the organization work system.
Methodology/Approach:
The authors develop a modified sociotechnical system (STS) model to understand how the two dimensions of technical (devices/tools, layout/organization of space, core process standardization) and social (organizational structure, management of human resources and operations) can facilitate the implementation of multidisciplinary teams in health care. The study conducts an empirical analysis based on a sample of hospital adopters of transcatheter aortic valve implantation using the revised STS model.
Findings:
The modified STS model applied to the case studies improves our understanding of the critical implementation factors of a multidisciplinary approach and the importance of coordinating radical changes in the technical and the social subsystems of health care organizations. The analysis informs that the multidisciplinary effort is not a sequential process and that the interplay between the two subsystems needs to be managed efficaciously as an integrated organizational whole to deliver the goals set.
Practice Implications:
Hospital managers must place equal focus on the closely interrelated technical and social dimensions by investing in (a) shared layouts and spaces that cross the boundaries of the specialized health care units, (b) standardization of the core processes through the implementation of local clinical pathways,
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