Teams in Crisis: The Effect of Team Familiarity on Performance Under Conditions of Crisis and Uncertainty

Research on fluid teams has consistently found a positive relationship between team familiarity and performance, but little empirical research has investigated whether these benefits of familiarity extend to times of crisis and uncertainty. This study examines how team familiarity influences provider decision times in the emergency department, focusing on how its effects vary across different crisis and uncertainty contexts. Using patient and provider assignment data from a large, multisite emergency department, we construct care team familiarity networks and analyze familiarity’s impact on decision-making speed during both low-uncertainty crises (high-acuity patient surges) and high-uncertainty crises (early COVID-19 pandemic), as well as under conditions of patient-level task uncertainty. We find that team familiarity consistently reduces provider decision times; familiarity is particularly beneficial during crises. However, across both crisis and noncrisis situations, we find that the positive effects of familiarity are significantly weakened under conditions of high uncertainty. These findings underscore the conditional nature of familiarity’s benefits, suggesting that in highly uncertain or novel situations, teams cannot rely solely on past shared experience to maintain performance. Implications for staffing strategies in healthcare and other high-stakes environments highlight the need for organizations to balance the benefits of familiarity with adaptability in the face of uncertainty. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2025.20912 .