CommentaryImproving teamwork and safety: Toward a practical systems approach, a commentary on Deneckere et al.
Section snippets
Teamwork relies on competencies: communication, coordination, and cooperation
Teamwork is not just a concern for healthcare. Many industries have recognized the critical role teamwork plays in effective operations, particularly those industries dealing with high risk, safety-critical environments and tasks such as aviation, the military, and power generation. These practical needs have driven a large body of rigorous research on the nature of effective teams (Kozlowski & Ilgen, 2006). Three key themes from this research are highlighted below, specifically, the
These teamwork competencies can be systematically improved through training
In addition to the identification of teamwork processes that reliably lead to improved outcomes and the competencies that underlie those processes, the science clearly demonstrates that team performance can be systematically improved with training. Good teamwork is not a trait that teams either do or do not posses, but a set of skills that can be developed over time through structured learning opportunities. Team training is a set of theoretically based strategies and methods for developing the
Context, constraints, and conditions moderate teamwork: tasks, tools, and organizational factors matter
As described above, teamwork depends on the competencies of team members: on what they know, feel, and do. However, the members of a team are situated within complex organizations and features of the organizational context, work processes and tasks, and information technology and tools can all support or hinder various aspects of teamwork. Specifically, the science indicates that teams perform better when their tasks are designed to promote higher levels of autonomy and task meaningfulness
Teamwork is not just about standardization; teamwork is about adaptation
Much of the teamwork and communication improvement efforts in healthcare have emphasized standardized communication protocols for critical interactions such as checklists for pre-procedure briefings and debriefings, and handoffs. This is appears to be the logic behind why care pathways would lead to improved communication and teamwork. However, this is only one aspect of teamwork, and increasingly, teamwork is required for catching and correcting non-routine events and solving novel problems.
Change and improvement requires a long-term vision and vigilance
Improving teamwork involves changing patterns of social interaction among care providers. These types of behavior are rooted in social norms, professional role identities, and local history. Consequently, improving teamwork is a cultural intervention, and culture can be resistant to change. This challenge is not unique to teamwork training interventions. Even the adoption of simple evidence based clinical guidelines is driven by local organizational culture. Ultimately, the success of care
Change requires leadership at all levels
A long-term strategy that engages key personnel from all levels of the organization is required, particularly leaders from the frontline to the executive offices. Leadership is a shared process. At some time, most staff members fulfill some type of leadership role. From a change management perspective, leaders are critical as they not only help with gaining resources needed for an implementation, but for communicating the values of the organization. Members of an organization take their cues
From programs to systems: a comprehensive approach will address people, tasks, and tools concurrently
In sum, clinical pathway interventions are one of multiple strategies available for improving teamwork and safety. Teamwork training can produce better team performance processes as well as important safety and clinical outcomes. Additionally, tasks and work processes can be redesigned to support better teamwork and more reliable care delivery processes, and well-designed information systems are required to manage patient information across care settings and time. However, it is uncommon for
References (18)
- et al.
Interventions to improve team effectiveness: a systematic review
Health Policy
(2010) - et al.
Care pathways lead to better teamwork: Results of a systematic review
Social Science & Medicine
(2012) - et al.
Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training
American Journal of Surgery
(2009) - et al.
Communicating, coordinating, and cooperating when lives depend on it: tips for teamwork
Joint Commission Journal on Quality and Patient Safety
(2008) - et al.
Reducing medical errors and adverse events
Annual Review of Medicine
(2012) - et al.
Toward an understanding of macrocognition in teams: predicting processes in complex collaborative contexts
Human Factors
(2010) - et al.
Teams in organizations: from input-process-output models to IMOI models
Annual Review of Psychology
(2005) - et al.
Enhancing the effectiveness of work groups and teams
Psychological Science in the Public Interest
(2006) - et al.
A meta-analysis of teamwork processes: tests of a multidimensional model and relationships with team effectiveness criteria
Personnel Psychology
(2008)
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