Efficient and Effective Teamwork in Healthcare

Healthcare teams operate in complex and dynamic environments that are characterized by multi-component decisions, rapidly evolving and ambiguous situations, information overload, severe time pressure, and severe consequences for error.

With respect to effective teamwork, teams must exhibit a sense of collective efficacy and dedication to patient safety.

Effective, high-performing teams are dynamic out of necessity. A Team is defined as a collection of people, built primarily on the technical capabilities of its members, working in pursuit of a common mission or goal.

They have been each assigned a specific function to perform.Team members recognize that they are dependent upon each other and believe that, working together, they can solve complex problems. They optimize their resources, engage in self-correction, compensate for each other by providing back-up behaviors, and reallocate functions as necessary. Because they can often coordinate without communicating overtly, effective teams can respond efficiently in high-stress, time-restricted environments. Effective teams recognize potential problems or dangerous circumstances and adjust their strategies accordingly.

Threat and Error Management

In aviation, teamwork-related behaviors are called “threat and error management behaviors” because they have been shown to help manage threats and errors in commercial aviation cockpits. In healthcare, the term “behavioral markers” has been employed. Behavioral markers are observable, non-technical behaviors that contribute to performance within a work environment.

 

 

In general, teamwork consists of: (1) attitudes; (2) knowledge; and (3) skills; therefore, developing sustainable efforts to improve teamwork requires thoughtful planning, execution and sustainability efforts. Implementation programs focused on changing the behavior of team members must first take into account individual attitudes. Subsequently, skills and knowledge are assessed, and a training program can be designed to improve teamwork with all factors equally considered. The benefits of improved teamwork are well documented in the literature. In general, teamwork results in enhanced effectiveness, more successful patient outcomes, fewer and shorter delays, improved morale and job satisfaction, increased efficiency, lower stress, and improved patient satisfaction (Firth-Cozens, 2001; Majzun, 1998; Sexton, Thomas, & Helmreich, 2000).

Standardized Processes

Fewer errors occur in clinical settings when teamwork is effective because processes are standardized and improved through constant monitoring and measurement. Each member of an effective and efficient team knows his/her own responsibilities as well as those of their fellow team members. Another trait ofa successful team is that members look out for each other and collectively anticipate errors before they happen. Furthermore, team members in high reliability settings trust one another’s judgements, speak up for patients and attend to one another’s safety concerns (IOM, 1999).

Addressing the need for formal teamwork training for clinicians is imperative. Unlike other high-risk industries, healthcare has made little progress in developing standard methods for communicating critical information among team members. This lack of clarity, in combination with individual differences in communication styles, can damage professional relationships and respect for one another. Additionally, the risk of potential patient errors increases with ineffective communication. Patient error data reveals that many of the care team situations that lead to errors are the result of poor teamwork among staff across disciplines and position hierarchies. Examples of team-related communication behaviors that increase risk of patient care errors include: failure to inform team members of a patient’s problems; failure to discuss alternative procedures; failure to plan for and communicate contingencies; failure to monitor situations and other team members’ activities; and overt hostility and frustration which may result from fatigue, complexity, and workload.

Teamwork is a human factors skill that must be taught and developed through constant practice. This essential skill is a hallmark of Safer Healthcare's CRM workshops and team training sessions.

Safer Healthcare's award-winning Crew Resource Management in Healthcare Workshop teaches teams the fundamental concepts and elements that are instrumental in achieving world-class safety and quality through effective teamwork.

Learn more about Crew Resource Management and High Reliability Topics in Healthcare

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