Team Learning and New Technology Implementation

July 1, 2009 / General /

By Ryan Quinn

New Video Communication TechnologyI work with an organization that recently decided to require the majority of its employees to have video cameras and a video communication system installed into their computers. The person leading this project sent an email to employees announcing this decision. Then, a few days later, I had a couple of conversations with some of the people in the Information Technology department who were responsible for implementing this new technology. One was skeptical about the entire project, citing a track record of failures for new technology implementations. The other was less skeptical, but still felt that in the end, only a handful of people in the organization would end up using the technology, and the rest of the money spent on this technology would be “lost to the ether.”

Implementation as a Learning Process

These conversations reminded me of one of my favorite research studies, conducted by Amy Edmondson, Richard Bohmer, and Gary Pisano.* Edmondson and her colleagues, rather than focus primarily on obstacles to implementation, implementation failures, and other problems with technology, focused instead on the processes that teams go through as they learn how to implement new technologies. To do this, they watched, interviewed, and studied the archives of sixteen hospitals that tried to implement MICS (minimally invasive cardiac surgery). The previous method for heart surgery, CABG (coronary artery bypass graft), involved cutting a person’s chest and breaking their rib cage in order to perform the surgery. MICS only involves small cuts between the ribs and no breaking of bones. There were obvious benefits to hospitals and their patients if their surgical teams could learn how to implement this new technology.

MICS had obvious benefits, but it required a complete re-structuring of sugical structures and routines. Surgeons who were used to giving directions and having all of the necessary information in front of them now needed to listen to feedback from other members of the team about how well the instruments had been placed, as they kept track of data on the monitors. The teams became more interdependent, procedures needed to be updated, authority structures were challenged, and the need for communication skyrocketed. Only half of the teams were able to implement the new technology successfully in their hospitals.

As Edmondson and her colleagues examined the processes that the teams used to implement these technologies, they discovered key differences in each stage of implementation: enrollment, preparation, trials, and reflection. These differences are summarized below.

Enrollment Stage

SUCCESSFUL HOSPITALS

  • Carefully select team members
  • Explain reasons for selection
  • Define clear roles and responsibilities
  • Frame the project as implementing a new technology with new procedures
  • Members listen carefully and enroll fully

UNSUCCESSFUL HOSPITALS

  • Select haphazardly
  • Give no reason for selection
  • Frame the project as “plug-in” technology

Preparation Stage

SUCCESSFUL HOSPITALS

  • Conduct a practice session first
  • Reinforce the frame for the project again
  • Have surgeons who signal openness to feedback
  • Make reasons for the changes clear

UNSUCCESSFUL HOSPITALS

  • Have surgeons who do not show up to practice sessions
  • Team members interpret this as a message that teamwork is not critical or they decide not to hold the session

Trial Stage

SUCCESSFUL HOSPITALS

Have surgeons who…

  • seek input
  • acknowledge  the need for help
  • accepts new behaviors

Have team members who…

  • take risks
  • attempt new behaviors

UNSUCCESSFUL HOSPITALS

Have surgeons who…

  • discourage input
  • exhibit laissez-faire attitudes
  • reject attempts to do things differently

Reflection Stage

SUCCESSFUL HOSPITALS

  • Follow each surgery with a debriefing where the team collects and reviews data and discusses what they should learn from the surgery

UNSUCCESSFUL HOSPITALS

  • Hold no debriefings
  • If data is analyzed at all, it is only done much later

Successful teams also iterated between trials and reflection over and over again, using their conversations as a way to learn as a team. Then, when the first team became successful, the hospital began rolling out the process to other heart surgery teams as well.

Broader Application

The implications of this study are clear for technology implementation in any organization where the technology has the potential to disrupt routines. Consider the organization with the new video technology. The full extent of implementation efforts was to send out an email letting employees know that the technology was coming, and then to send an IT employee to make sure it was installed and to answer any questions. When we compare this to the implementation approach used by the successful hospital in the study that Edmondson and her colleagues did, it is no surprise that the IT employees believe that the video communications will be another technology that sinks off into the ether.

While the study of MICS implementation does not bode well for the video communication implementation at the moment, it does provide hope for those who do want to implement a technology successfully in their organization. Hope, but also hard work. My personal experience suggests, though, that hard work can be meaningful or even fun when people know why they are doing what they are doing, learn how to do it well, and get to experience success in doing it.

* Edmondson, A. C., R. M. Bohmer, & G. P. Pisano (2001). Disrupted Routines: Team Learning and New Technology Implementation in Hospitals. Administrative Science Quarterly, 46(4): 685-716.