A configurational approach to the relationship between ethnic diversity, leadership, and performance in health care teams

Background Health care services are increasingly delivered by ethnically diverse teams. Understanding how these teams function and should be managed to improve clinical performance is critical to improving the quality and safety of care. Purpose The aim of this study was to identify configurations of conditions that enable ethnically diverse health care teams to improve their clinical performance. Methodology/Approach This study uses video data from 59 simulations collected at a simulation center in southern Sweden in October 2022 and December 2023, supplemented by survey data. The simulations include 28 observations of CEPS (Concept for Patient Simulation) and 31 observations of PROBE (Practical Obstetric Team-Training). Fuzzy-set qualitative comparative analysis was used to explore combinations of conditions that lead to high performance. Results A laissez-faire leadership style does not enable high performance in either ethnically homogeneous or heterogeneous teams. Ethnically diverse health care teams excel with shared leadership, especially when these teams are larger and less experienced. In addition, small and experienced teams perform well with shared leadership, regardless of ethnic diversity. Autocratic leadership is ineffective in ethnically diverse teams and effective only in small, ethnically homogeneous teams. Practice Implications The study highlights the importance of active leadership for optimal performance in health care teams, regardless of ethnic diversity. These findings provide valuable guidance for managers and practitioners responsible for staffing or leading diverse teams in hospitals.