Learning to Work Together

Abstract

We study whether teams’ productivity improves as they gain experience working together. We leverage unique clinical data to observe team experience and individual physician and staff experience in coronary catheterization laboratories. Teams are composed of cardiologists, nurses, and technicians who work together synchronistically. We observe teams and individuals at hospitals across the United States from 2001 to 2009, including the rate at which they gain experience using drug-eluting stents (DES) from their introduction in the US in 2003 onward. We estimate models of productivity and clinical outcomes that account for team experience, physician experience, and staff experience conditional on each other and on time-invariant physician and staff characteristics, hospital-specific monthly effects, and an extensive set of patient-level clinical factors. Greater experience performing DES cases together improves teams’ productivity, lowering total case time, procedure time, and non-physician labor costs while leaving clinical outcomes unchanged. In contrast, physicians’ and staffs’ individual experience with DES does not improve productivity conditional on other factors. The effects of team experience with DES appears generalized, with gains from experience with competitor brands of DES about as large as those from the specific brand of DES being used for a given case.