Managing Job-Related Diversity Processes in High-Reliability Teams in the Emergency Department

We examine how high-reliability teams (HRTs) manage job-related diversity, which refers to differences among team members in skills and experiences relevant to work tasks. Managing job-related diversity is important in HRTs because of the need for consistent performance in time-pressured situations with serious consequences for error. In a qualitative study, we observe and interview members of HRTs in a public hospital emergency department in Australia. Our findings reveal a set of six strategies that HRTs in emergency departments use to manage different types of job-related diversity. Strategies of active explanations and experience-based task assignment manage educational diversity within HRT team processes. Strategies of deferring to a single leader and balancing delegation and participative leadership manage power diversity. Finally, strategies of sequential specialist involvement and a co-production mindset manage functional diversity. Our theoretical model of these strategies and their implications for team processes deepen understanding of job-related diversity in HRTs. Our study contributes to the literature by (1) shining light on managing the double-edged sword of job-related diversity in HRTs; (2) opening up insight into differences in diversity management processes between HRTs and traditional teams; and (3) informing debate in the broader teams literature about specific versus generic processes for managing diversity.