D577 Task 1 Team Dynamics Analysis Example

Trays Coming Back to the Operating Room Incomplete: A Team Dynamics Analysis of a Composite Hospital Sterile Processing Evening Shift Divided Between Veterans and New Hires

Student Name

Leavitt School of Health, Western Governors University

D577: Team Dynamics, Task 1

Course Instructor

Month Day, Year

Trays Coming Back to the Operating Room Incomplete: A Team Dynamics Analysis of a Composite Hospital Sterile Processing Evening Shift Divided Between Veterans and New Hires

Introduction

Teams rarely fail because their members lack skill. More often they fail because of how members communicate, what they assume about each other and whether they feel safe raising problems. This paper analyzes the evening shift of a composite hospital sterile processing department, where instrument trays sent to the operating rooms have started to arrive incomplete. It describes the team and the problem, analyzes the team's dynamics using stages of group development, roles, conflict research and psychological safety, and recommends strategies to improve cohesion, communication and outcomes.

The Team and the Problem

The sterile processing department of a 350-bed hospital in Louisville, Kentucky, cleans, inspects, assembles and sterilizes surgical instruments. The evening shift, 3 p.m. to 11:30 p.m., has nine technicians and a lead. Four are veterans with 8 to 22 years in the department. Five were hired in the past eight months after a wave of retirements; all are certified but have less experience with the hospital's 2,400 tray configurations.

In the last quarter, the operating rooms reported 41 incomplete or incorrect trays from the evening shift, up from 12 in the same quarter a year earlier. Each error can delay a surgery. The lead has noticed a pattern: veterans assemble the most complex orthopedic and neurosurgery trays and rarely ask for help, while new technicians work on simpler sets and avoid asking veterans questions. Two veterans have complained in the break room that the new hires do not know the trays. One new technician told the lead that when she asked a veteran about a missing retractor, he said, If you have to ask, you should not be on this shift. Since then, new staff check the count sheet alone and send trays up when they think they are right.

Stage of Group Development

Tuckman (1965) described a sequence through which small groups develop: forming, as members get their bearings; storming, as friction and pushback surface; norming, as the group settles on shared standards; and performing, as it finally does its best work. Although the veterans had long ago reached performing together, the arrival of five new members effectively returned the shift to an earlier stage. The pattern of complaints, avoidance and a clear split between two subgroups fits storming. The team has not moved to norming because no shared standards for asking questions or checking work have been established for the new, larger group.

Roles and Subgroups

Roles on the shift have formed along tenure rather than task needs. Veterans hold an informal expert role and control the most complex work, which protects quality on those trays but concentrates knowledge. New technicians have been placed in a peripheral role. Without a formal mentoring role, the knowledge that veterans hold is not being transferred, and the team's capacity depends on who is on shift. The lead has acted mostly as a scheduler rather than as a facilitator who connects the subgroups.

Conflict: Task and Relationship

Researchers distinguish task conflict, disagreement about the work, from relationship conflict, interpersonal tension and dislike. A meta-analysis found that both types were negatively related to team performance and member satisfaction, with relationship conflict showing a stronger negative relationship with satisfaction (De Dreu & Weingart, 2003). On this shift, what began as a task issue, differences in tray knowledge, has become relationship conflict: veterans see new hires as careless, and new hires see veterans as hostile. Once conflict becomes personal, members stop sharing the task information that would resolve it.

Psychological Safety

The most important factor in this case is psychological safety, the belief, held across a team, that a person can ask a question or own up to an error without being made to pay for it. In a study of work teams, Edmondson (1999) found that psychological safety was associated with learning behavior, such as requesting input and raising errors in the open, and teams that learned this way performed better. The comment about asking questions sent a clear signal that asking was dangerous. The result was predictable: new technicians stopped asking and began sending trays they were unsure about. The rise in incomplete trays is, in large part, a psychological safety problem that shows up as a quality problem.

Strategies to Improve Team Dynamics

First, reset norms openly. The lead should hold a 30-minute shift meeting to share the error data without blame and ask the team to agree on three norms, for example: questions about trays are expected, any technician may stop a tray for a second check, and feedback is about the tray, not the person. Writing the norms down and revisiting them monthly moves the team toward norming.

Second, pair technicians. Each veteran is paired with one or two new technicians for six weeks, assembling complex trays together at a shared station. Formalizing a mentor role gives veterans recognition for their expertise and turns passing on know-how into an expected duty instead of a personal kindness.

Third, change how errors are reviewed. Returned trays are reviewed at the start of each shift as a team, focusing on what in the process allowed the error. When leaders respond to mistakes with curiosity rather than blame, members are more willing to report them.

Fourth, the lead should model the behavior. When the lead asks veterans for help in front of the team and thanks new staff for catching problems, the message that asking is safe becomes visible.

Fifth, measure progress. The team will track incomplete trays monthly and complete a four-question anonymous survey on whether members feel comfortable asking questions, reviewing both at the monthly norms meeting.

Conclusion

The evening shift's rising error rate reflects a team that returned to storming when new members arrived, formed subgroups by tenure, let task differences turn personal and lost the psychological safety that learning requires. Resetting norms, pairing veterans with new staff, reviewing errors without blame and modeling help-seeking address those dynamics directly, with measures to show whether they work.

References

De Dreu, C. K. W., & Weingart, L. R. (2003). Task versus relationship conflict, team performance, and team member satisfaction: A meta-analysis. Journal of Applied Psychology, 88(4), 741-749. https://doi.org/10.1037/0021-9010.88.4.741

Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. https://doi.org/10.2307/2666999

Tuckman, B. W. (1965). Developmental sequence in small groups. Psychological Bulletin, 63(6), 384-399. https://doi.org/10.1037/h0022100