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Contents
- Abstract
- Why Study Health Care Teams?
- The Importance of Teamwork to the Quality and Safety of Care Delivery
- Health Care as a Vehicle to Advance the Science of Teams
- Purpose of This Review
- Discovery 1: Structure and Context Matter to Understanding the Quality of Teamwork
- Structure: Team Composition and Task Interdependence
- Context: External Leadership and Culture
- Discovery 2: The Competencies Underlying Teamwork in Health Care Settings Are Identifiable
- Differentiating Technical Versus Nontechnical Skills in Health Care
- Teamwork Competencies in Nonepisodic Care Contexts
- Teamwork Competency Frameworks in Health Care Education Policy and Practice
- Teaming Over Time in Complex Delivery Systems: Teamwork and Care Coordination Models
- Discovery 3: Teamwork Processes in Health Care Include Rapid Learning, Listening Intently, Adapting, and Speaking Up Among Clearly Defined Team Members and Loose Collaborators
- Discovery 4: Team Performance Can Be Validly Measured Across Complex Settings
- Discovery 5: Health Care Team Training Competencies Can Be Systematically Improved
- Team Training
- On-the-Job Tools and Strategies
- Moderating Conditions
- Discovery 6: Teamwork Quality Impacts Patient, Staff, and Organizational Outcomes
- Teamwork and Patient Care Outcomes
- Teamwork and Health Care Worker Outcomes
- Future Directions
- Conclusions
Figures and Tables
Abstract
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue. Health care delivery systems exemplify complex organizations operating under high stakes in dynamic policy and regulatory environments. The coordination and delivery of safe, high-quality care demands reliable teamwork and collaboration within, as well as across, organizational, disciplinary, technical, and cultural boundaries. In this review, we synthesize the evidence examining teams and teamwork in health care delivery settings in order to characterize the current state of the science and to highlight gaps in which studies can further illuminate our evidence-based understanding of teamwork and collaboration. Specifically, we highlight...