Table 3.

Summary of Key Findings According to Design and Teamwork Model.

Teamwork Aspects	Association with Design Attributes
Communication
Face-to-face communication frequency	Communication perception scores (from Team Development Survey) of providers in Clinic A and LPNs in Clinic B significantly lowered post-pandemic. In Clinic B, staffers’ Communication Frequency perception statistically lowered in 2021 from 2017. Staffers stated that physical distance has made communication more difficult, resulting in less verbal face-to-face communication, which might delay care and cause more work for everyone.
Quick and timely communication	Staffers stated that separation and the physical distance between them made it difficult to locate other staffers to quickly run something by them.
Informal communication	Staffers stated that physical distance resulted in more formal electronic communication and less informal face-to-face communication. This made it difficult for staff members to have collective awareness of the patients’ status and context.
Group meetings	A lack of large space for group meetings (with reasonable distance) disabled regular huddles and group meetings. Staffers mentioned the importance of group meetings for teamwork.
Situational Awareness
Awareness of the locations of other individuals	Social distancing and working outside of the team room made it hard to have awareness of other individuals’ presence and locations, making it more effort to find them.
Awareness of the status of other individuals	A lack of visibility due to the physical distance and separation made it hard to know whether others were available for interruption and conversation.
Heads-Down Work
	Staffers, especially providers and RNs, mentioned that separation (working off-site or outside of the team rooms) increased their productivity for the heads-down solitary work.
Teamness
	Team Cohesion (from Team Development Survey) and Teamwork perception scores of Clinic B were statistically lower in 2021 compared to pre-pandemic years. Staffers mentioned that physical distance and separation made them feel isolated and separated from each other.
Social support and activities
Social support of team members	Staffers mentioned that they miss seeing each other, and the lack of social interactions decreased their joy at work. Physical distance and lack of visual connection among staff members made it difficult to have social support as a team.
Social activities	Pandemic restrictions and physical distancing made it hard for staffers to gather for treats, lunches, or lunch meetings. Staffers stated that this made it hard to bounce ideas off each other and decreased joy at work.
Asynchronous information exchange
Asynchronous electronic communication	Staff members mentioned that electronic communication made it more difficult to quickly gather and synthesize information in the way that a brief verbal discussion with a team member might.
Accessibility and persistence of information	Staffers noted that the lack of accessibility and persistence of information created inconsistency and a lack of shared awareness. Communication artifacts, such as vertical surfaces or papers, can affect communication efficiency by regulating the accessibility and persistence of information.