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GroupThink as an Impediment Toward Team Decision Making

Published March 6, 2008 2:40 PM by Brian Garavaglia

Health care administration is not an easy job. Decisions have to be made and often these decisions rely on more than just one person. In the long-term care environment many decisions are made within a team framework. The administrator, along with the director of nursing, rehabilitation director, dietary and activities directors, maintenance supervisor as well as many other important administrative team players hold important positions in the decision making process. 


However, there are times when decisions become compromised within group situations.  Teams can be an incredible asset to assist in making important decisions, but also the important significance of bringing people together into a team situation can also lead to problems. One of the major issues that can compromise decision making in teams within the long-term care health setting in what is referred to as Groupthink. 


Groupthink, a concept that was developing by Irving Janis (1982), is the propensity for group decision making to become hindered within decision making groups, regardless of whether they are in health care settings, large fortune 500 corporations, or even in Presidential cabinets. It does not just happen to people that are of modest intellect, but also among the brightest individuals as well.


For instance, groupthink has been implicated in such large-scale events as the Bay of Pigs invasion, the entry and escalation into Vietnam, as well as even our decisions to enter into our country’s current Iraq war. In all these cases there were reservations about the final decisions that were made that were never raised, acknowledged and properly evaluated. If decisions of such magnitude, affecting our nation on such a large scale, made by individuals who are intelligent and knowledgeable in their respective areas can become compromised, one can only guess how often it happens daily in more common situations. Although no exact number can be given, it can be stated that groupthink is quite pervasive, happening in most, if not all, organizations daily. 


What are the symptoms of groupthink? Two key symptoms are an assumed consensus and a feeling of group unanimity. What this means is that often many individuals will not say anything or express their opinion because they feel that everyone else is in consensus with the group. Since they feel that everyone else is on the same page and share a consensual opinion, many will fear speaking about any reservations they may have with a particular idea or plan. If team members feel that they should express themselves on a particular issue, but feel that there is a unanimous opinion and shared consensus among the other group members, that is often enough to inhibit them from getting involved in expressing important opinions. 


To prevent this it is important for the administrative staff to know about these endemic group forces that can lead to an inhibition toward full-team participation. Furthermore, the administrator should often encourage other group members to express their opinions, reservations and even possible dissenting opinions. Once the administrator becomes aware that individuals within the team meetings appear to be “shutting down,” it is at this point that the administrator should ask for opinions and even dissenting opinions. This may sound problematic since most administrators do not what to hear dissenting opinions. This does not mean they should encourage contention, but healthy disquisition on what other views may exist and what weaknesses may appear in the existing plans and ideas that have been presented to the team.         


There are other important characteristics of groupthink. For instance, placing pressure on team dissenters is often a problem that is faced with groupthink. Since dissenters may be viewed as problem individuals that are failing to be cooperative team members, individuals will often not want to raise a dissenting opinion. There is often a misconception about the group or team. Many individuals feel that if dissenters exist they are not good team players and anything they say should not be given any weight and disregarded. Unfortunately, this often leads to the glossing over of many important opinions and views that are raised. Moreover, if individuals feel that they will be looked at in a negative light and that their opinions will not be given any credence, this will lead to pressure for them to not raise any dissenting opinions.


What is also important to mention is that many team members often fear dissent due to group norms that develop dealing with not questioning the leaders or by leaders, such as the administrator or director of nursing shutting down any conversation or differences in opinion. It is not uncommon for leaders to nurture a view of themselves as an omniscient individual that is the prevailing expert in what they do. Soliciting opinion is often viewed as a weakness due to a perceived lack of knowledge. With this comes the intolerance toward opinions that differ from their own. 


Therefore leaders, especially those that are easily threatened due to feeling insecure in their position or with their knowledge, attempt to minimize dissent. In so doing they delude themselves toward thinking they have enhanced the solidarity of the group as well as protected their status as the undeniable expert for the facility. Ultimately, attempting to enhance their power and control by shutting down or disregarding opinions from other team members enhances the likelihood for groupthink to insulate itself into the team decision-making process.                        


What is interesting about groupthink is that it is a ubiquitous component of groups and teams at all levels. Unfortunately many individuals think that they would never act or behave in such a manner and that they are too much of an individual to be influenced by such group forces. Only individuals that are easily led can fall prey to such a problem.  However, as has already been stated, no one is necessarily immune to groupthink and the problems that it brings. It has been shown that even bright individuals, involved in extremely important decisions that involve the national welfare of our country can fall prey to groupthink.


However, possibly the greater sin in not necessarily falling prey to groupthink, but denying its existence or its ability to effect you and your decisions. In fact, groupthink often breeds feelings of invulnerability by the group members and it is often these same feelings of invulnerability that lead individuals to be quite insidiously influenced by this prominent group force that can lead to potentially destructive team decisions (DeLamater & Meyers, 2007).     


Although team decisions are important within any organization, and long-term care team decisions are no different, one has to recognize that team decisions can also go awry. In long-term care groups or teams, decisions are often part of the daily culture of the organization. Although many individuals have increasingly encouraged teams and team building as an important and effective part of long-term care management, one has to also realize that the team in itself does not work automatically. Team administrative management is an important factor for good long-term care administration.


However, teams have to be used effectively to maximize the decision-making process.  As is evident, being aware how the decision making process can be thwarted through groupthink will become an important administrative skill toward preventing this type of process from leading to potentially destructive team decisions. Realizing that no individual or team is absolved from groupthink’s influence will help administrators make better use of the team and the potential that teams hold for making very sound and informative decisions.    





DeLamater, J.D., & Myers, D.J. (2007).  Social psychology. Belmont, Wadsworth. 


Janis, I.L.(1982) Groupthink. Boston, Houghton Mifflin.


Excellent Article!

Lisa, LTC - MDS Coordinator April 28, 2008 4:29 AM
Bridgeport CT

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About this Blog

    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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