History shows us that the engine of progress runs best when people from diverse backgrounds work together to solve problems. A prominent example is how Bell Labs, considered one of the most productive R&D laboratories in history,1 operates. It organizes teams so that diverse experts across many fields work together in close proximity to easily meet and make serendipitous connections. Bell scientists have invented a large number of technologies, such as the transistor, the laser, and the UNIX operating system, technologies we still use today.
Famed sociologist, Judith Adler, described the interactions of this type of team as transdisciplinary. She noted that transdisciplinary teams integrate different methods and concepts across diverse disciplines to develop an innovative way to solve problems.2 Transdisciplinary teams may hold the key to accelerate progress and innovation in patient safety and quality improvement efforts.
ARMSTRONG INSTITUTE STRUCTURE SUPPORTING TRANSDISCIPLINARY RESEARCH
The Armstrong Institute conceptualizes transdisciplinary research as a mixing bowl of methodologies and disciplines. As a specific problem arises, the Institute brainstorms what expertise is needed to address the issue and assigns appropriate disciplines, sometimes adding disciplines as the team innovates and realizes an unmet skill is needed. Like swarming behavior, we bring together diverse teams to solve problems.3 We turn to many different disciplines in medicine, nursing, public health, and health services research, as well as specialists in human factors, systems engineering, applied physics, bioethics, and others, to solve quality of care and patient safety problems.
An example of how this worked was our collaboration with the Centers for Disease Control and Prevention (CDC) to produce an interactive Web-based training program for how to don and doff personal protective equipment when caring for patients with the Ebola virus disease. The CDC published evidence-based guidelines, but many recommendations were ambiguous and clinicians were unsure how to apply them to prevent risk of exposure. A core transdisciplinary team of about 30 people was assembled in October 2014 and included infection preventionists, doctors, nurses, human factors engineers, designers, software developers, Web-based educators, and a team of videographers and film editors. Everyone from this diverse group worked together, and we were able to ensure that all experts across these different fields were able to deliver an integrated comprehensive product for diverse audiences.
Transdisciplinary research is often complex, with a large team requiring structured project management. Thus, a Project Management Office (PMO) was formed to help establish and organize transdisciplinary research teams and ensure successful completion, whether delivery of training materials for the Ebola project or meeting a low infection rate goal. Classic management teams manage logistics and team dynamics, and our PMO goes further by focusing on team member personalities and the culture of the group. The added sociocultural focus is a critical piece because many people and disciplines have never collaborated before, and languages and concepts are unfamiliar. A good PMO supports the team's mission, beliefs, and behaviors and ensures the team delivers.
FORMING A TRANSDISCIPLINARY TEAM
When forming a transdisciplinary team, it is important that the group has a clear and compelling purpose and defined principles in line with its mission and that it is performance-focused and has disciplined project management and accountability to achieve the goal. Through our work with transdisciplinary teams, we learned that 3 ingredients are needed in that mixing bowl: the right structure, the right team members, and the right language.
The team needs a tangible structure to organize the work, such as regular meetings and, if resources are possible, a PMO. Equally important is to define the less tangible sociocultural tone of the team. Key attributes when conducting transdisciplinary research is a deep respect for and curiosity about all disciplines involved. To ensure there is respect, there should be a set of norms voiced from the beginning that members need to listen to one another and be open to their perspectives and discipline-specific methodologies. A PMO could help delineate this type of culture from the beginning, defining a safe space for open conversation and success in how the project is run. Members of the PMO not only must be selected for leadership and management skills but also have the ability to mitigate personalities and recognize and prioritize respectful behavior among the team.
In identifying the right team members, we made a grid of the different disciplines needed for the research, populating it with people to inform the work. Team members will typically have deep methodological grounding in one discipline, which could limit any in-depth conversations and collaborations, and the ability to create new research models. In thinking about these transdisciplinary teams, members will require knowledge and skills resembling a jellyfish (see the Figure), meaning they will have deep methodological grounding in one discipline (one long tentacle) and an understanding of the other disciplines (multiple short tentacles). Therefore, persons joining transdisciplinary teams must learn about the other disciplines at least at a level where they can understand the concepts and principles and how it all fits in the work.
Along these lines, it is imperative that everyone to be on the same page when starting a project by speaking a common language. We found that when assembling a transdisciplinary team, each member will speak the "language" derived through his or her training. Often, a project can get derailed by people talking about the exact same thing, being on the same page, but using different terminology.4 To mitigate this risk, team members should also learn their language and be able to translate their work into others language.
Transdisciplinary teams require respect for each discipline, knowledge from each individual, and innovative brainstorming that provides a feasible improvement solution. Creating these types of teams is complex and being able to break down silos across disciplines in reality is challenging to implement. The results we can achieve will be well worth the effort.
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