Teamwork as an essential component of high-reliability organizations.

Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where the consequences of errors are high, but the occurrence of error is extremely low. In this article, we argue that teamwork is an essential component of achieving high reliability particularly in health care organizations. We describe the fundamental characteristics of teams, review strategies in team training, demonstrate the criticality of teamwork in HROs and finally, identify specific challenges the health care community must address to improve teamwork and enhance reliability.

[1]  P. Barach,et al.  Trauma Team Performance , 2007 .

[2]  Adaptive Teams , 2007 .

[3]  D. P. Baker,et al.  Reducing medical error in the Military Health System: How can team training help? , 2006 .

[4]  M. Alexander.  To Err is Human. , 2006, Journal of infusion nursing : the official publication of the Infusion Nurses Society.

[5]  Dana E. Sims,et al.  Is there a “Big Five” in Teamwork? , 2005 .

[6]  B. Sachs.  A 38-year-old woman with fetal loss and hysterectomy. , 2005, JAMA.

[7]  E. Salas,et al.  Promoting health care safety through training high reliability teams , 2005, Quality and Safety in Health Care.

[8]  S Undre,et al.  Developing observational measures of performance in surgical teams , 2004, Quality and Safety in Health Care.

[9]  R. Flin,et al.  Identifying and training non-technical skills for teams in acute medicine , 2004, Quality and Safety in Health Care.

[10]  J. Sexton,et al.  Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation , 2004, Quality and Safety in Health Care.

[11]  M. Leonard,et al.  The human factor: the critical importance of effective teamwork and communication in providing safe care , 2004, Quality and Safety in Health Care.

[12]  Michelle L. Zbylut,et al.  Development of a Conditional Reasoning Measure of Team Orientation , 2004 .

[13]  Daniel R. Ilgen,et al.  Backing up behaviors in teams: the role of personality and legitimacy of need. , 2003, The Journal of applied psychology.

[14]  John C. Morey,et al.  Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. , 2002, Health services research.

[15]  Sheila Simsarian Webber,et al.  Leadership and trust facilitating cross‐functional team success , 2002 .

[16]  Clint A. Bowers,et al.  Team Training in the Skies: Does Crew Resource Management (CRM) Training Work? , 2001, Hum. Factors.

[17]  Diane Bandow,et al.  Time to Create Sound Teamwork , 2001 .

[18]  David M. Gaba,et al.  Simulation-Based Training in Anesthesia Crisis Resource Management (ACRM): A Decade of Experience , 2001 .

[19]  Eduardo Salas,et al.  Applying Resource Management Training in Naval Aviation: A Methodology and Lessons Learned , 2001 .

[20]  Eduardo Salas,et al.  Improving Teamwork in Organizations : Applications of Resource Management Training , 2001 .

[21]  M. Leonard,et al.  Culture, Systems, and Human Factors— Two Tales of Patient Safety: The KP Colorado Region's Experience , 2001 .

[22]  E. Salas,et al.  The science of training: a decade of progress. , 2001, Annual review of psychology.

[23]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[24]  Clint A. Bowers,et al.  The Design and Delivery of Crew Resource Management Training: Exploiting Available Resources , 2000, Hum. Factors.

[25]  D. Buckley.  Assessment of clinical performance during simulated crises occurring in dental conscious sedation , 2000 .

[26]  J. Mathieu,et al.  The influence of shared mental models on team process and performance. , 2000, The Journal of applied psychology.

[27]  Eduardo Salas,et al.  The Effect of Team Building on Performance , 1999 .

[28]  Jeffrey T. Hansberger,et al.  INSTRUCTOR/EVALUATOR EVALUATIONS OF ACRM EFFECTIVENESS , 1999 .

[29]  Deborah A. Boehm-Davis,et al.  JUMP SEAT OBSERVATIONS OF ADVANCED CREW RESOURCE MANAGEMENT (ACRM) EFFECTIVENESS , 1999 .

[30]  R. Helmreich,et al.  Culture at Work in Aviation and Medicine: National, Organizational and Professional Influences , 1998 .

[31]  Steven J. Tourville,et al.  Tactical Team Resource Management Effects on Combat Mission Training Performance. , 1998 .

[32]  David M. Gaba,et al.  Assessment of Clinical Performance during Simulated Crises Using Both Technical and Behavioral Ratings , 1998, Anesthesiology.

[33]  G. Keenan,et al.  Norms and nurse management of conflicts: keys to understanding nurse-physician collaboration. , 1998, Research in nursing & health.

[34]  Scott I. Tannenbaum,et al.  Training team leaders to facilitate team learning and performance. , 1998 .

[35]  James E. Driskell,et al.  Stress exposure training. , 1998 .

[36]  Eduardo Salas,et al.  Making decisions under stress: Implications for individual and team training. , 1998 .

[37]  Elliot E. Entin,et al.  Team coordination training. , 1998 .

[38]  Janis A. Cannon-Bowers,et al.  Teamwork competencies: the interaction of team member knowledge, skills and attitude , 1997 .

[39]  Eduardo Salas,et al.  TRAINING TEAM PERFORMANCE‐RELATED ASSERTIVENESS , 1996 .

[40]  Gina J. Medsker,et al.  RELATIONS BETWEEN WORK TEAM CHARACTERISTICS AND EFFECTIVENESS: A REPLICATION AND EXTENSION , 1996 .

[41]  Paul E. Spector,et al.  The Impact of Cross-Training on Team Functioning: An Empirical Investigation , 1996, Hum. Factors.

[42]  S D Small,et al.  Anesthesia crisis resource management: real-life simulation training in operating room crises. , 1995, Journal of clinical anesthesia.

[43]  E. Salas,et al.  Military Team Research: 10 Years of Progress , 1995 .

[44]  J. Wagner.  Studies of Individualism-Collectivism: Effects on Cooperation in Groups , 1995 .

[45]  Catherine E. Volpe,et al.  Defining Competencies and Establishing Team Training Requirements , 1995 .

[46]  S. Mohammed,et al.  Team Mental Model: Construct or Metaphor? , 1994 .

[47]  Gina J. Medsker,et al.  RELATIONS BETWEEN WORK GROUP CHARACTERISTICS AND EFFECTIVENESS: IMPLICATIONS FOR DESIGNING EFFECTIVE WORK GROUPS , 1993 .

[48]  Robert L. Helmreich,et al.  Why crew resource management? Empirical and theoretical bases of human factors training in aviation. , 1993 .

[49]  D. Gaba,et al.  Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. , 1992, Aviation, space, and environmental medicine.

[50]  E. Salas,et al.  Collective Behavior and Team Performance , 1992 .

[51]  E. Salas,et al.  Toward an understanding of team performance and training. , 1992 .

[52]  Captain H. C. Alger.  Cockpit resource management. , 1989, Aviation, space, and environmental medicine.

[53]  K. Roberts.  Managing High Reliability Organizations , 1990 .

[54]  K. Roberts.  Some Characteristics of One Type of High Reliability Organization , 1990 .

[55]  B. Shamir,et al.  Calculations, Values, and Identities: The Sources of Collectivistic Work Motivation , 1990 .

[56]  Karlene H. Roberts,et al.  Research in nearly failure-free, high-reliability organizations: having the bubble , 1989 .

[57]  Arthur S Blaiwes,et al.  Measurement of Team Behaviors in a Navy Environment , 1986 .

[58]  H. Foushee,et al.  Dyads and triads at 35,000 feet: Factors affecting group process and aircrew performance , 1984 .