[show abstract][hide abstract] ABSTRACT: 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.
Health Services Research 09/2006; 41(4 Pt 2):1576-98. · 2.29 Impact Factor
[show abstract][hide abstract] ABSTRACT: Medical error causes more than 98,000 deaths annually [Kohn, L. T., Corrigan, J. M., and Donaldson, M. S. (1999). To err is human: Building a safer health system. Washington, DC: National Academies Press.] making it a national epidemic during the late 1990s. In reaction, Congress passed the National Defense Authorization Act mandating the Department of Defense (DoD) to establish processes for patient safety in the military health care and veteran affairs. Among the many processes for patient safety identified by the DoD, team training stepped to the forefront in 2001 when the TRICARE Management Activity (TMA) commissioned the development of two programs based upon Crew Resource Management training from the aviation industry. A recent evaluation of these programs identified several limitations including the establishment of two distinct approaches to teamwork and an inability to leverage the larger body of team training available. TeamSTEPPS, or the Team Strategies and Tools to Enhance Performance and Patient Safety, was developed to address the cultural issues facing the military health system and to take advantage of the state-of-the-art evidence-base on team training. Despite success, several challenges remain representing opportunities for human resources professionals and organizational researchers to help improve this program and further research on the impact of team training on patient safety.
Human Resource Management Review - HUMAN RESOURCE MANAGEMENT REV. 01/2006; 16(3):396-415.