Structuring team communication

At UCLH, operating theatre teams led the adaptation and implementation of the checklist. Most notably, implementation did not focus on the checklist per se, but on resolving issues with poor communication, teamwork and culture in the operating theatres. Whilst the checklist provides a platform for structuring team communication, the hospital had a clear goal that bigger cultural issues needed to be addressed in order to improve patient safety. 

To judge the quality of team performance it is necessary to examine the following PIFs distribution of workload, clarity of responsibilities, communications, team structure and leadership, and finally, group planning and orientation. 

The components and their lines of communication mirror those of the business. The diagram could represent a business structure of departments and flows of work, or a software structure of components and connectors. Just as departments are composed of teams and people, so a closer look at ary one of these components would reveal that it is built from smaller ones. 

The problems associated with joint planning between local authorities and health authorities have been well documented elsewhere.29,30,31,32 Of particular relevance to alcohol and other drug services, however, are the findings of a recent survey that whereas 87 per cent of district health authorities had joint planning teams for mental handicap services, only 16 per cent had planning teams concerned with drug and/or alcohol services.33 The structure within which Community... 

Given the difficulties which have faced multidisciplinary community teams, it seems almost a miracle that any have survived. The central issue is how these teams can be integrated into the existing service structure in such a way as to not only enhance the over-all pattern of service provision, but also to facilitate and support the work done by the team. If this is going to happen we need to be much clearer about what the needs of our client group are, and how we propose to meet them. The fact that so many teams have survived is a tribute to the adaptability and commitment of their individual members. In order to sustain their commitment the teams themselves need to receive the support and commitment of others. If we cannot learn this lesson from existing teams the future of community services looks bleak. 

Several excellent works on collaboration have been published (Blount, 1998 Doherty 8c Baird, 1983 Seaburn, Lorenz, Gunn, Ga-winski, 8c Mauksch, 1996). Doherty (1995) developed a model that defines five levels of collaboration. The levels range from minimal collaboration, in which professionals work in different sites and rarely communicate about a case, to close collaboration in a fully integrated system, in which professionals from different disciplines practice in the same site and hold team meetings regularly to discuss collaboration issues. For most physicians and therapists, level 5 is more of a dream than a reality. Because of the structure of health care today, most professionals probably practice at levels 1 or 2. 

The capability to communicate 3D structural studies with the chemists and other researchers has evolved significantly [80]. Today in our laboratories, the use of a 3D projection room has advanced the HIV-1 protease inhibitor design to a team effort, in which creative design ideas can be discussed within a group in an extremely productive manner, while visualizing the protein/inhibitor interactions. 

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