Swarm Teams 101: What Makes Them Different — and Why It Matters

At Mission Critical Medicine, one of our key areas of interest is understanding and improving medical swarm teams. Unlike traditional or “intact” teams, swarm teams are temporary, self-organizing, ad hoc, multidisciplinary groups formed to solve a specific problem. They are literally called into being by the problem itself—springing into action, working the problem, and dissolving once the mission is complete.

A classic example is a code blue response. The moment the code button is pressed, individuals from multiple roles—often in the middle of other work—drop what they’re doing, converge on the location, rapidly self-organize into a cardiac arrest team, and work together to restart the patient’s heart.

This post focuses on one specific type of swarm team: the cardiac arrest-style response team, and explores the features that make it fundamentally different from intact teams.

Duration and Formation

Intact teams are ongoing, stable groups capable of handling multiple missions over time. They build shared practices, a sense of identity, and institutional memory.

Swarm teams, by contrast, are temporary and exist only to solve a single problem. They don’t pre-exist the incident—they are “called into life” when the problem emerges. Once the problem is resolved, the team dissolves.

Because of their short lifespan, swarm teams rarely have time to develop dependable patterns of action, shared mental models, or deep trust. Their “culture” is a patchwork, drawn from the diverse cultures of the participants.

Cultural Composition

In a cardiac arrest swarm team, members often have never worked together before. You might have emergency physicians, ICU nurses, respiratory therapists, and others—each bringing the norms, priorities, and working styles of their home environments.

For example:

• ICU nurses may focus on precision and long-term stability.

• Emergency physicians may prioritize speed and adaptability.

One of the critical tasks for any swarm team is bridging these cultural differences—amplifying the strengths and minimizing the friction points—fast enough to operate effectively in the moment.

Hierarchy and Relationships

In intact teams, membership is usually sought-after and stable, with clearly defined hierarchy and roles. Members often have personal relationships that deepen coordination: Sally knows how John tends to act under pressure, and John knows how Sally prefers to receive information.

In swarm teams, membership is often assigned (and sometimes undesired), and hierarchy is looser. Relationships are primarily role-based rather than person-based: an ER physician may not know a particular ICU nurse personally, but both understand the general responsibilities and decision-making patterns of each other’s role in a code blue.

Why The Structure of Swarm Teams Matters

Understanding whether your team is functioning as an intact team, a swarm team, or a hybrid is the first step toward improving performance. Each has strengths and weaknesses:

• Intact teams: Benefit from shared history, stable culture, and deep trust—but may be slower to adapt to sudden, unfamiliar situations.

• Swarm teams: Can assemble rapidly and bring fresh perspectives—but must bridge differences and build trust on the fly.

In future posts, we’ll explore the different types of swarm teams in medicine, strategies for improving their performance, and how leaders can design systems that support both intact and swarm team excellence.

For now, consider this with your own team:

When the alarm sounds, are you operating as an intact team, a swarm team, or something in between?