Wherever people come together, groups form. And where groups are formed, there is a risk that they will break down into small groups. Of course, this also applies to teams that care for patients in hospitals. Under certain circumstances, this can happen particularly in groups that can be described with the present word “diverse”: If members of a diverse group join together to form informal subgroups or coalitions based on characteristics such as gender or skin color, this can exacerbate conflicts and thereby ultimately endanger patients.
This is suggested by a study by scientists led by Ren Li from the Hong Kong Polytechnic University. The team evaluated data from 1,102 employees from 38 hospital teams and 4,138 patients across the United States and published the results in a specialist journal PNAS. Where strong fault lines formed along such identity characteristics, unpleasant conflicts within the teams occurred more often. And the conflicts among employees had consequences for medical quality: for every ten percent increase in conflict intensity in the groups, the mortality rate among the treated patients increased by 10.59 percent and the probability of infections in the hospital increased by 8.87 percent.
“Our results show that diversity can be a double-edged sword that has the potential to either cause harm or benefit,” write the researchers led by Li. It depends on how diversity is organized in groups. It seems clear that in a group with members with diverse identity characteristics, different perspectives do not automatically come together to form a larger, positive whole, such as scientists around Stefan Razinskas from the FU Berlin in a review article in the specialist journal Applied Psychology show.
Diversity can be a strength if the culture of conflict is right
In various groups there is a risk of so-called faultlines, as it is called in the English-language specialist literature, perhaps in German: fault lines. These form when people come together based on at least two identity characteristics – for example male and doctor or female and nurse. This is probably a primal human tendency to approach others who are similar to you. As a rule, this doesn’t even happen consciously; people are just somehow closer to each other and get together. “These are more informal subgroups that then form,” says Razinskas, who himself researches the phenomenon of faultlines.
It must be emphasized that this is not a problem per se. “Such fault lines do not always result in conflicts to the same extent,” write the researchers led by Li in PNAS. The problem only arises when identification with the subgroups is stronger than that with the entire team or the common goal being worked on. Or to put it more simply: Diversity can become a burden if differences are emphasized too strongly. According to Li’s researchers, this can become a self-reinforcing process: the deeper the fault lines within a team, the more pronounced the tendency towards social categorization.
But if there is a good culture of conflict in the groups, according to Li’s researchers, diversity can be a strength. In the hospital teams studied, social fault lines in groups were even associated with fewer arguments when conflicts in these communities were resolved respectfully and different opinions and viewpoints could be expressed without fear of consequences. On average, however, deeper rifts in the groups were associated with increased levels of rude arguments.
Li’s authors therefore advocate specifically ensuring a respectful conflict culture in various groups. Is it that easy? “Of course, that depends heavily on the respective managers,” says Razinskas. According to the economist, it is definitely helpful if there is a clear hierarchy in groups. Where this is missing, fierce competition for status quickly breaks out. And competition brings conflict – regardless of whether the members of a group differ in their identity characteristics or not. Arguments, in turn, provoke mistakes, in the hospital and elsewhere.