Human factors - teamwork

Definition: Team "a distinguishable set of two or more people who interact, dynamically, interdependently, and adaptively toward a common and valued goal/objective/mission, who have each been assigned specific roles or functions to perform"(Salas et al 1992, p.4). 

Teams are a fact of working life and therefore the "health" of a team or teams has a bearing on patient safety. The size and structure of a team can influence how the team performs, as can the internal dynamics of the team members and how the group is led (Flin 2009).

Teamwork consists of team structures and team processes. Structure relates to size, roles and type of hierarchy but also accepted ways of behaving. Any of these can promote or destroy team cohesion. 

Team dynamics are psychological processes. They can be seen most clearly in the way the group interacts. Team leaders can understand the team dynamics by looking at how the team communicates, cooperates, coordinates and makes decisions.
 

In this simple model the team inputs (the skills, attitudes and personality of individuals) combine with team dynamics to influence team performance. The impact of these inputs and team dynamics on team performance has been researched in military and other high risk contexts (Flin 2009; Essens et al 2010). It is only relatively recently, however, that the same attention has been given to teamwork and patient safety (Cole and Crichton 2006; West 2012).

Alongside this is an interest in the transferability of human factors training, such as Crew Resource Management for pilots, to health care (Flin 2008; Fore et al. 2012) and a focus on how groups develop a shared understanding of a task and the steps required in order to achieve it (Gillespie and Chaboyer 2009).

For ideas about how to reduce risks to do with teamwork go to our Action on teamwork page.

References

These resources were last accessed on 21 November 2012. Some of them are in PDF format - see how to access PDF files.

Cole E and Crichton N (2006) The culture of a trauma team in relation to human factors, Journal of Clinical Nursing, 15(10), pp.1257-1266.

Essens P et al. (2010) CTEF 2.0. Assessment and improvement of Command Team Effectiveness; verification of model and instrument. RTO technical report, North Atlantic Treaty Organisation Research and Technology Organisation.

Flin R et al. (2008) Safety at the sharp end: A guide to non-technical skills, Farnham: Ashgate.

Flin R et al. (2009) Human factors in patient safety: review of topic and tools. Report for Methods and Measures Working Group of WHO Pa􀆟ent Safety (PDF 424KB), Geneva: World Health Organization.

Fore AM et al. (2012) Improving patient safety using the sterile cockpit principle during medication administration: a collaborative, unit-based project, Journal of Nursing Management. First published online 28 May 2012 doi: 10.1111/j.1365-2834.2012.01410.x
 
Gillespie B and Chaboyer W (2009) Shared mental models enhance team performance, Nursing in Critical Care, 14(5) Sep-Oct, pp.222-223.
 
Salas E et al. (1992) Toward an understanding of team performance and training, in Swezey R and Salas E (Editors) Teams: their training and performance, Norwood, New Jersey: Ablex pp.3-29.
 
West MA (2012). Effective teamwork: practical lessons from organisational research, 3rd edition, Chichester: BPS Blackwell-Wiley.