ÐÏà¡±á>þÿ =?þÿÿÿ<ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á#` ð¿Ábjbj\.\. 8$>D>DÁÿÿÿÿÿÿ¤ªªªªªªª¾‚‚‚‚Ž¾ ¶®®®®®®®®!!!!!!$Vh¾pEª®®®®®Eªª®®Z®®®®ª®ª®®®®®ŽKhªª÷®¢°±^ªôÉ‚®³p0 Ã4. ®. ÷÷è. ªß@®®®®®®®®EE®®®® ®®®®¾¾¾Ä‚¾¾¾‚¾¾¾ªªªªªªÿÿÿÿEffective Teamwork Key Messages A healthcare system that supports effective teamwork can improve the quality of patient care, enhance patient safety and reduce workload issues that cause burnout among healthcare professionals. Teams work most effectively when they have a clear purpose; good communication; co-ordination; protocols and procedures; and effective mechanisms to resolve conflict when it arises. The active participation of all members is another key feature. Successful teams recognize the professional and personal contributions of all members; promote individual development and team interdependence; recognize the benefits of working together; and see accountability as a collective responsibility. The make-up and functioning of teams varies depending on the needs of the patient. The complexity of the health issue defines the task. The more interdependency needed to serve the patient, the greater the need for collaboration among team members. Patients and their families are important team members with an important role in decision-making. To enable patients to participate effectively, they need to learn about how to participate in the team; how to obtain information about their condition; and how each healthcare professional will contribute to their care. Teams function differently depending on where they operate. Teams in hospitals have clearly defined protocols and procedures, professional hierarchies, and shared institutional goals, while teams in community-based primary care practices face challenges related to the role-blurring in community settings. This wide variety of settings and tasks means that transferability of processes is not always straightforward. It also highlights the need for a common definition of “team.” Teamwork is influenced by organizational culture. A clear organizational philosophy on the importance of teamwork can promote collaboration by encouraging new ways of working together; the development of common goals; and mechanisms to overcome resistance to change and turf wars about scopes of practice. Teams need training to learn how to work together and understand the professional role/responsibility of each member. They also require an effective administrative structure and leadership. The larger policy context can promote teamwork by providing consistent government policies and approaches; health human resource planning; legislative frameworks to break down silos; and models of funding/remuneration that encourage collaboration. Successful team interventions are often embedded in initiatives working to improve quality of care through better co-ordination of healthcare services and the effective utilization of health resources with a focus on the determinants of health. Drawn from: TEAMWORK IN HEALTHCARE:PROMOTING EFFECTIVE TEAMWORK IN HEALTHCARE IN CANADA Policy Synthesis and Recommendations June 2006 Reference List 1. Kohn LT, Corrigan JM and Donaldson MS. To Err is human: building a safer health system. Institute of Medicine, National Academies Press, Washington DC, 1999 2. Donaldson L. An organisation with a memory. Clin Med. 2002 Sep-Oct;2(5):452-7. 3. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ. 2001 Mar 3;322(7285):517-9. 4. Sari AB, Sheldon TA, Cracknell A, Turnbull A, Dobson Y, Grant C, Gray W, Richardson A. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf Health Care. 2007 Dec;16(6):434-9. 5. Leape LL. Error in Medicine. JAMA 1994; 272(23):1851-1857. 6. Rutherford W. Aviation safety: a model for health care? Qual Saf Health Care 2003;12:162-163 7. Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, Bohnen J, Orser B, Doran D, Grober E. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004 Oct;13(5):330-4 8. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery. 2006 Feb;139(2):159-73. 9. Makary MA, Sexton JB, Freischlag JA, Holzmueller CG, Millman EA, Rowen L, Pronovost PJ. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg. 2006 May;202(5):746-52. 10. Reason J. A systems approach to organizational error. Ergonomics, Volume 38, Issue 8 August 1995 , pages 1708 - 1721 11. Helmreich, R. L., Merritt, A. C., & Wilhelm, J. A. (1999). The evolution of crew resource management training in commercial aviation. International Journal of Aviation Psychology, 9(1), 19-32. 12. Helmreich, R. L., & Schaefer, H-G. (1994). Team performance in the operating room. In M. S. Bogner (Ed.), Human error in medicine (pp. 225-253). Hillsdale, NJ: Lawrence Erlbaum Associates. 13. Flin R, O'Connor P, Mearns K. Crew resource management: improving team work in high reliability industries. Team Performance Management 2002; 8 (3-4): 68-78. 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