Using teams to implement personalized health care across a multi-site breast cancer network.

PURPOSE: This study sought to identify the organizational factors associated with team and network effectiveness of the Athena Breast Health Network, a multi-site collaboration between five University of California health systems.

DESIGN/METHODOLOGY/APPROACH: Providers, managers, and support staff completed self-administered surveys over three years. Statistical analyses at the network and medical center levels tested hypotheses regarding the correlates of effective teams and perceived network effectiveness over time.

FINDINGS: Perceived team effectiveness was positively correlated with group culture and environments which support collaboration, negatively correlated with hierarchical culture, and negatively associated with professional tenure at year two. As measured by increasing team effectiveness scores over time and Athena's potential impact on patient care, perceived network effectiveness was positively associated with team effectiveness.

RESEARCH LIMITATIONS/IMPLICATIONS: Results do not allow us to conclude that a certain type of culture "causes" team effectiveness or that team effectiveness "causes" greater perceptions of progress over time. Subsequent studies should examine these variables simultaneously. Further research is needed to examine the role of payment incentives, internal reward systems, the use of electronic health records, public disclosure of performance data, and depth of leadership within each organization and within the network overall.

PRACTICAL IMPLICATIONS: - Focusing on group affiliation and participation may improve team member perceptions regarding effectiveness and impact on patient care.

ORIGINALITY/VALUE: Relatively little is known about the adaptive processes that occur within inter-organizational networks to achieve desired goals, and particularly the roles played by multi-disciplinary interprofessional teams. We studied a network comprising multiple campuses actively involved in better understanding, preventing, and treating a complex disease.