Can Teamwork Enhance Patient Safety?

 Teamwork is a set of interrelated behaviors, cognitions and attitudes that combine to facilitate coordinated, adaptive performance.  Skills + Knowledge + Attitude = Competence  Effective teams have members who anticipate each other’s needs; they can coordinate without the need to communicate overtly.

 High-performing teams develop a sense of collective efficacy and “teamness.”  Optimize resources – know each other’s strengths  Self-Correcting – compensate for each other  The individual members recognize their interdependence and believe in the ability of the team to solve complex problems  Know how things are supposed to go, but adapt when they don’t go as planned

 Teamwork depends on a willingness to cooperate for a shared goal  Team work does require you to like or “feel close” to your team members  Teamwork does not require you to work with team members on a permanent basis.  Teamwork is sustained by a shared set of teamwork skills rather than a permanent assignment  Teamwork is as imperative in daily routines as it is in emergencies

 Teamwork requires KSA  Knowledge  Skills  Attitude

 Knowledge – what do we need to know?  Strengths and weakness of each other  Goal, objectives, resources, and norms  Roles and Responsibilities  By understanding the unique roles and responsibilities of an interdependent health care team, even newly formed team members can quickly realize shared team models in a dynamic environment

 Skills – what do we need to do?  Proactively and reactively adapt to changing circumstances  Use clear and concise closed-loop communication  Provide Back-Up Behavior  Know each role’s responsibilities  Monitor each other for the safety of the patient  Make informed decisions  Prevent task fixation and maintain situational awarenesssituational awareness

 Attitude – What do we need to feel?  A shared vision – AKA - Shared Mental Model  Sense of cohesion and mutual trust  Motivation to achieve collective mission, objectives and tasks  “Character trumps Competence every time”  Dr. Tim Irwin, “Derailed”

 Depends upon the ability of each member  Anticipate the needs of others  Adjust to each other’s actions in a dynamic environment  Have shared understanding of how a procedure should happen in order to identify when errors are occurring, have a potential to occur, and how to correct those errors