Coordination, Teams and Knowledge Translation

In their column in this month’s Fast Company magazine, Dan and Chip Heath write about the importance of coordination and how it is often neglected in environments where there are multiple actors working together. They are writing primarily of business, but they might as well be writing about health care and public health. In their article, they point to the experience of the performance of the U.S.A. 4×100 men’s (and women’s) relay team in the 2008 Beijing Olympics. Both teams dropped the baton at the same point in the race.

In discussing the blown baton pass between Darvis Patton and Tyson Gay, the Heaths write:

“Team U.S.A.’s track coach, Bubba Thornton, told the media his runners had practiced baton passes ‘a million times.’ But not with their Olympic teammates. Some reporters noted that Patton and Gay’s practice together had been minimal.

Thornton’s apparent over-confidence was understandable. If you have four world-class experienced runners on your team, shouldn’t that be enough? Unfortunately, not it isn’t. The baton pass cannot be taken for granted — not on the track and not in your organization.”

It got me to thinking about how many times we speak of coordination in knowledge translation and public health practice more widely, yet how little we pay attention to it as a focus of our work. A search of Google Scholar using the terms “knowledge translation”, “team”, and “coordination” found 1400 articles that mention the terms. Yet, when we restrict this to terms in the title — presumably indicating importance and focus — we get exactly zero. Take out team and you also get zero. Take out coordination and you get two.

In all cases, the numbers are small. If putting a term in a title is a sign of importance and focus, then we have a long way to go.

Coordination is a systems problem and, as many scholars including myself have written about, we humans don’t deal with those particularly well. We don’t think about them in a manner relative to their weight, particularly when an estimated 80 to 90 per cent of change can be attributed to systems-level variables (see the work of Russell Ackoff, W. Edwards Deming and others for examples of this).

To take the U.S.A. relay team case study: here were elite athletes training for the biggest team event in their careers, yet not doing so as a team. This is a perfect example of where conventional thinking that assumes the parts equal the whole falls apart. We’ve seen this with other sports where ‘all-stars’ are put together on to a ‘team’ and yet fail to deliver. Time and again we’ve witnessed collections of athletes with superior individual talent fail when brought together to supposedly lesser teams. (Anyone watching the 2010 World Cup and the collapse of teams like France, Italy and England will find ample evidence of this – particularly with France).

If we are to take knowledge translation — undoubtedly a team process at many levels — and truly make it work, we need to make coordination and team part of the focus of much of the research and scholarship out there.

Just as there is no ‘i’ in team, there perhaps should be a silent ‘k’ and ‘t’ .

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