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The purpose of this chapter is to highlight some of the critical multiteam system (MTS) issues that are faced in healthcare by utilizing case studies that illustrate the transition of a patient through the healthcare system and suggest a possible approach to studying these issues.

The approach taken by the authors is a case study approach, which is used to illustrate the transition of a patient through several venues in a healthcare system. This approach elucidates the MTS nature of healthcare. Moreover, a methodological explanation, social network analysis (SNA), for exploring the description and analysis of MTSs in healthcare is provided.

The case study approach provides concrete examples of the complex relationship between providers caring for a single patient. The case study describes the range of shared practice in healthcare, from collaborative care within each setting to the less obvious interdependence between teams across settings. This interdependence is necessary to deliver complex care but is also a source of potential errors during care. SNA is one tool to quantify these relationships, link them to outcomes, and establish areas for future research and quality improvement efforts.

This chapter offers a unique holistic view of the transition of a patient through a healthcare system and the interdependency of care necessary to deliver care. The authors show a methodology for assessing MTSs with a discussion of utilizing SNA. This foundation may offer promise to better understand care delivery and shape programs that can lead to improvement in care.

Extending a model of how teams learn, this paper aims to present a model of multiteam system (MTS) learning, comparing similarities and differences between how MTSs learn and how component teams learn. The paper describes the value of adaptive, generative and transformative learning for increasing MTS development over time.

The model proposes that environmental demands trigger adaptive, generative and transformative MTS learning, which is further increased by the MTS’s readiness to learn. Learning can happen during performance episodes and during hiatus periods between performance episodes.

Learning triggers coupled with readiness to learn and the cycle and phase of MTS process influence the learning process (adaptive, generative or transformative), which in turn influences the learning outcomes.

The study offers a number of research propositions with the idea that the model and propositions will stimulate research in this area.

This model allows MTS and component team leaders and facilitators to recognize that MTS learning is a process that is needed to help component teams work together and help the MTS as a whole perform in current and future situations, thereby improving MTS effectiveness.

Little attention has been given to the notion that MTSs learn and develop. This manuscript is the first to emphasize that MTSs learn and identify processes that can improve learning. Adaptive, generative and transformative processes describe how MTSs learn and produce changes in MTS structure and actions.

To present a case study of coordination mechanisms employed by a multiteam system (MTS) charged in an international oil and gas company.

Qualitative method with longitudinal observation and interviewing.

The MTS, and particularly its coordination mechanism of a regular collaboration meeting, provided multiple benefits, such as access to diverse competences, capabilities for solving problems crossing team boundaries, and opportunities for developing relationships between the different teams involved. There were also observed challenges: a lack of shared understanding between the participants concerning the purpose of the main collaboration session of the MTS, different levels of insight into each other’s areas of competence, information sharing, shifting team membership, multiteam membership, time pressure, and technology-mediated communication.

Providing an illustration of the MTS concept in a real organizational setting and the role of a regular collaboration meeting as a coordination mechanism for the MTS.

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

This chapter describes the complexity of large-scale disaster recovery programs in the United States, the challenges faced by these programs, and the importance of multiteam systems in overcoming these challenges.

This chapter is a case study based on the experience of the authors in hurricane recovery programs.

Multiteam systems provide the range of expertise and experience needed to implement complex large-scale disaster recovery programs. For such disasters, responsibility for recovery work needs to be divided among specialized teams with unique expertise, some of which act as checks and balances for others. Challenges facing these teams include ensuring compliance with multiple Federal and state requirements, providing sufficient training to program staff, modifying procedures in response to changing program policies, and communicating changes for all pressure to move quickly, while at the same time facing intense pressure to process applications for assistance as rapidly as possible.

This chapter provides organizations responsible for disaster recovery important information about the scope of work and challenges they are likely to face following a large-scale disaster.

Spaceflight presents a unique environment in which multiteam coordination is often required for mission success. This chapter will explore the topic of multiteam systems (MTSs) and their functioning in this environment.

This chapter describes the MTS case of human spaceflight in terms of a specific subset of the system involved in current human spaceflight missions: NASA Mission Control and the NASA astronauts aboard the International Space Station. In addition to describing the system itself, this chapter describes notable advantages and disadvantages of this particular MTS, along with potential future issues in human spaceflight and research directions for use of MTSs in spaceflight.

More than 40 years of successful human spaceflight missions have demonstrated many of the benefits and drawbacks of MTSs across some of the most challenging environments faced by any teams attempting coordination. These environmental challenges include extreme distances, limited modes of communication, complex systems, novel problems, and coordination between teams from multiple countries with differing goals and priorities. The specific advantages and drawbacks of MTSs in this environment, and the impacts of the aforementioned environmental challenges, are discussed.

This chapter examines a known operational and successful MTS that operates in an environment in which many of the standard assumptions regarding teams and MTSs may not apply.

Although existing research on cohesion provides a robust understanding of the emergent phenomenon in small groups and teams, our comprehension of cohesion at the multisystem (MTS) level is quite limited. The simultaneous within- and between-team functioning inherent in MTSs produces more intricate dynamics than those observed at the team level. This added layer of complexity requires that many familiar team constructs, including cohesion, be systematically re-conceptualized and empirically examined through the lens of MTS theory (DeChurch & Zaccaro, 2010; Hackman, 2003). The present research addresses this gap by extending the conceptualization of team cohesion to the interteam level, and empirically investigating how cohesion functions across levels in a collective network of teams. Results from preliminary research suggest that intrateam and interteam cohesion share a curvilinear relationship with one another, while simultaneously interacting to affect overall system-level outcomes. This research not only illuminates the complexities associated with emergent phenomena in MTSs, but also serves as a starting point for continued, systematic research of the multilevel cohesive bonds that characterize MTS functioning.

This inquiry aims to determine the features and mechanisms that specially enable a multiteam system (MTS) to develop ambidexterity that can deal effectively with rapid changes in dynamic environments. The MTS is an emerging organizational unit comprised of tightly integrated networks of teams that may originate from one or more firms. The inquiry also considered how an MTS can engage those features and mechanisms to maximize ambidexterity as dynamic capabilities for increased innovation and long-term adaptation under complex, volatile conditions.

This conceptual inquiry integrates the emerging research on MTSs with theory and studies relating to ambidexterity and dynamic capabilities. This inquiry focuses on the attributes and linkages that specially characterize an MTS. It analyzes these to determine the key mechanisms and interactions enabling and engaging ambidexterity at MTS unit level.

MTSs can engage powerful mechanisms for ambidexterity functioning as dynamic capabilities at meso-organizational level. The attributes and linkages that distinguish an MTS from other units enable it to deal effectively and efficiently with near-term task demands by simultaneously balancing the essential tasks of exploration and exploitation, and by being able to rapidly adapt by reconfiguring taskwork and reallocating resources as required for sustainable innovation and long-term success within a dynamic environment.

This inquiry provides valuable insights for designing MTSs that are equipped with selected teams, flexible memberships, specialized skills and permeable interfaces. Autonomy for an MTS allows the unit to span internal and external organizational boundaries to gain access to new discoveries and to exchange information and material resources for increased innovation. Ambidexterity as dynamic capabilities facilitates exploitation of current resources by efficiently reconfiguring taskwork and reallocating materials for adaptation and competitive advantage.

This inquiry appears to represent the most integrative effort to examine the underexplored potential of MTSs for developing and engaging ambidexterity functioning as dynamic capabilities. The inquiry appears to be a first effort at articulating a concept of MTS ambidexterity distinct from organizational ambidexterity. The analysis synthesizes a systems model that guides organizational leaders and opens new opportunities for future research.