Failure or success of self-organizing teams in long-term care organizations: an integrative systematic literature review on the role of the organization structure.

backgroundThe number of self-organizing teams is increasing in long-term care organizations. These teams have been implemented for various reasons among which improving the quality of care and the quality of working life. However, self-organizing teams are not always delivering these favorable outcomes. To evaluate the success of self-organizing teams, it is important to understand the reasons for their varying levels of success in long-term care organizations. In the long-term care context, little is known about the role of the organization structure in self-organizing team success, while organization theory indicates that this factor strongly affects their outcomes.

methodsAn integrative systematic review was conducted across four electronic databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete, and Web of Science, from inception until May 2023. Reference lists of the included studies were screened to identify other relevant studies. Quality appraisal was undertaken using MMAT for empirical studies and JBI checklists for systematic reviews, and text and opinion. Thematic analysis was conducted to synthesize the findings.

resultsForty-one articles were included. Findings were categorized based on structure characteristics that we extracted from organization theory: centralization, specialization, formalization, and functional concentration. We found different forms of each structure characteristic and their influence on self-organizing teams. A higher degree of these structure characteristics generally hinders self-organizing team success, meaning lower quality of care and lower quality of working life. Conversely, a lower degree of these characteristics generally facilitates self-organizing team success, meaning higher quality of care and higher quality of working life. However, the findings also highlight that structure characteristics can reach detrimentally low degrees when too many tasks and responsibilities are allocated to the teams, diminishing self-organizing team success.

conclusionsWhile self-organizing teams hold promise for enhancing the quality of care and improving the quality of working life, they are not always successful in practice. This integrative systematic review highlights the importance of organization structure characteristics for self-organizing team success in long-term care organizations. REGISTRATION: This review was registered with the PROSPERO International prospective register of systematic reviews (CRD42023418288).