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Teamwork
in a Shock Trauma Unit
Reprinted from Knowledge@Wharton (http://knowledge.wharton.upenn.edu
Wharton's Katherine Klein Studies Emergency Action Teams
to Find New Lessons in Leadership
Imagine that you, as a mid-level manager in your company,
have been assigned to a six-person team asked to complete
a top-priority project on a very short deadline.
As it turns out, some of the people have never worked together
before, members of the team change every hour or so,
leadership constantly shifts between three different individuals,
and any mistake by even one person could have disastrous,
even fatal, consequences for the project's outcome.
Wharton management professor Katherine J. Klein spent
10 months studying such teams in action at the Shock Trauma
Center in Baltimore, MD, a world-renowned urban facility
that treats more than 7,000 patients each year, most of whom
arrive with severe, often life-threatening injuries. The project
and research were funded by the U.S. Army Research Institute
as part of its efforts to gather information about leadership
strategies for teams working in highly dynamic and stressful
situations. The results of this research are presented in a paper
titled, "A Leadership System for Emergency Action Teams:
Rigid Hierarchy and Dynamic Flexibility," co-authored by
Klein, Jonathan C. Ziegert, a visiting scholar at Wharton,
Andrew P. Knight, a Wharton doctoral student, and Yan Xiao,
a professor and lead researcher at the School of Medicine,
University of Maryland, Baltimore.
Klein, who began her tenure at Wharton this past fall,
has based much of her research on the intersection between
leadership and organizational psychology, with interests in
multilevel organizational theory and research, team composition
and leadership, as well as organizational innovation
processes. With previous appointments in the Psychology
Department at the University of Maryland and the Graduate
School of Business at Stamford, she has published her research
in the Journal of Applied Psychology (for which she serves as associate
editor) and has a forthcoming paper entitled "How do
they get there? An examination of the antecedents of centrality
in team networks" in the Academy of Management Journal. In
2000, she co-authored a book with S.W.J. Kozlowski entitled
Multilevel theory, research, and methods in organizations:
Foundations, extensions, and new directions (Jossey-Bass).
For "A Leadership System for Emergency Action Teams,"
Klein and her colleagues studied the trauma resuscitation
unit as a way to analyze team leadership in diverse settings.
"It is surprising that there hasn't been much research on team
leadership, because there is lots of research on teams and lots
of research on leadership," Klein says, adding that traditional
research is usually based on "dominant" or "transformational"
models which emphasize the leader's "inspirational" role
in motivating his or her followers and which assume a long-
term leader-follower relationship.
Yet in many current organizations, the researchers note in
their paper, these "emphases and assumptions appear increasingly
inapt." The tempo of work today is not only faster but
also more unpredictable, the work is more complex and there
is greater employee turnover. In addition, Klein says, recent
scholarly studies focus on the idea that errors in certain kinds
of organizations have huge consequences; think nuclear power
plants and airlines. But other organizations—from consulting
firms to fire-fighting units—struggle with these issues
as well. "There is the need to incorporate new people, bring
them up to speed quickly, and at the same time, maintain
reliability and never commit an error. These are enormous
challenges."
Instead of relying on traditional 'dominant' leadership
models, Klein and her colleagues offer a more novel, and
counter-intuitive, way of viewing leadership. They see it "as
a system or a structure—a characteristic not of individuals
but of the organization or unit as a whole." It is a different
approach to how you build leadership, says Klein. "The lesson
for a company would be not to focus only on selecting
better people or training better people; think about putting
structures and norms in place that allow leaders to be more
effective. The role should be sufficiently established, and the
norms sufficiently clear, so that whoever steps into the role
will do it effectively."
This approach, taken to its extreme, is perhaps nowhere
more evident than in a trauma unit, where terms like "life
and death decision" and "working on deadline" have an
unambiguous urgency. And while these trauma units present
a "microcosm of many of the challenges contemporary
organizations face," it wasn't initially clear to the researchers
just how the teams functioned. As Klein notes: "We walked
in there and said, 'This leadership system doesn't look like
anything we have ever heard of.'"
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