Teamwork: it’s way more than just playing along

June 26, 2019 Jane Coutts

Try this simple test: What would you rather hear yourself say: “I’m being looked after by a group,” or “I’m being looked after by a team”?

The answer is easy.

What’s not easy is turning a group into a team — even when they work for the same organization and are all there to care for patients. As a paper by David P. Baker puts it, “Simply installing a team structure in an organization does not automatically result in effective teamwork… [that] requires team members to develop a shared awareness of one another's roles and abilities.  Without this awareness, serious but avoidable adverse outcomes may result from a series of seemingly trivial errors that effective teamwork would have prevented.”

It’s because of the way trivial mistakes can cascade into catastrophe that good teamwork is essential in health care. The World Health Organization’s Patient Safety Curriculum Guide says there is a clear  link between “non-technical skills such as teamwork” and patient safety; one pediatric study found that poor teamwork and communication in neonatal intensive care were implicated in 72 per cent of perinatal deaths and injuries.

The WHO curriculum says teams differ from small groups because while members of both have specific roles and specialized knowledge and skills, a team’s work is interdependent and must be collective. It also quotes the David P. Baker paper [above] — that training health professionals as teams “constitutes a pragmatic, effective strategy for enhancing patient safety and reducing medical errors.”

Few people already working in health care have had team training as part of their educations. However, there are a lot of resources to help health care organizations create teams, give advice on leading teams, or even describe how to be a good team member.

The WHO curriculum lists six characteristics of successful teams: common purpose, measurable goals, effective leadership, effective communication, good cohesion (team spirit) and mutual respect. Other writers agree, usually ranking good communication first, with a common, clear purpose and strong leadership coming close behind.

In “Teams, tribes and patient safety”, three New Zealand researchers list several actions for overcoming barriers to communication, among them: teaching communication strategies, training teams together and creating democratic teams — because junior team members are often afraid to speak up at crucial moments.

In “Effective Leadership of Surgical Teams”, researchers identified characteristics of surgeon-leaders; those rated best by their teams did more to engage colleagues, asking about concerns and inviting collaboration. The tone a leader set also had a strong influence on their teams — those who made the workplace more negative were poorly rated.

Perhaps the most important message out of all the research is that effective teams can (and should) be created, not left to evolve. In today’s high-pressure workplaces, there just isn’t time, and the stakes — harm to patients, burned-out health care workers and wasted human and financial resources  — are far too high.

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This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.  Feel passionate about physician-led innovation? Please connect with us at jouleinquiries@cma.ca.

About the author

Jane Coutts is an Ottawa-based writer and editor who specializes in healthcare issues. She worked as a journalist for 15 years, mainly at The Globe and Mail, where she was the health policy reporter for five years. Since she founded Coutts Communicates in 2002, Jane’s work has focused on making healthcare policy and research more readable and relevant. Jane also leads workshops plain-language writing.

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