Teamwork and safety

Burtscher, M. J., Manser, T. (2012). Team mental models and their potential to iminove teamwork and safety A review and implications for future research in healthcare. Safety Science, 50, 1344-1354. 

The power of the study to deteet a 50 per eent improvement in the number of respondents reporting positive teamwork and safety from the median value of the index institutions was calculated to be 0.77 and 0.99 respectively (a = 0.05) assuming a 50 per eent response rate to both the pre- and post-intervention questionnaires. 

Table 19.2 Preliminary data on tbe effect of the CRM training program on teamwork and safety climates...

Initial power ealeulations suggest fliat our ehoice of a 50 per eent improvement in teamwork and safety climates from the median values would require a sample size of 150 respondents before and after the training (p = 0.05) to aeeept the null hypothesis that there is no effeet with simulation-based team training. The elinieal signifieanee of a 50 per eent improvement in these measures is unknown furthermore, as no previous studies have examined flie influenee of simulation-based training on elimate... 

Orienting the health and safety organization toward teamwork. 

Relying on teamwork to integrate health and safety and line management functions for the planning and accomplishment of work activities is vital to providing a safe working environment. Health and safety... 

Ten employees on Outward Bound challenge in Colorado, an experience reflecting on safety skills and awareness needing back at their jobs. Teamwork, staying calm, knowing your limits, replacing casual habits with careful skills, proper equipment, safety attitude, and safety as a duty. 

How preparation and teamwork lead to accident-free performance by paralleling the routine of a small circus. Shows teamwork, awareness, safety meetings, thinking through actions, protective equipment, housekeeping, working deliberately, and following established procedures. 

Davenport, D.L., Henderson, W.G., Mosca, C.L. et al. (2007) Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. Journal of the American College of Surgeons, 205(6),... 

Watching teams and teamwork quickly reveals that a group of weU intentioned individuals does not make a team and furthermore, that teamwork has to be planned and organized. In this section we will review some apparently simple interventions, which turn out to have quite profound effects. Daily goals, preoperative and post-operative checklists seem mundane, and this partly accounts for clinicians resistance to their use. However, a checklist is not a piece of paper or even a list it is a team intervention which, used well, can affect the wider team functioning, the relationships across professions and hierarchies and even the values and safety culture of the team. To my mind, the impact of these simple tools on clinical processes and patient outcome suggests that their effect can only be fully understood by appreciating their wider impact on team performance. 

Leonard, M., Graham, S. and Bonacum, D. (2004) The human factor the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care, 13(suppl l), i85-i90. 

The Facility Supervisor and Hot Cell Operators are qualification positions requiring successful completion of a formal training program before an individual Is allowed to operate specific HCF equipment and/or controls unsupervised. Proficiency for the qualified positions is demonstrated by minimum acceptable scores on written tests and by observation of the individual s operating skill with manipulators, production process equipment, and plant safety equipment and safety systems. Qualification also requires demonstrated adherence to conduct of operations principles, ability to follow procedures, and commitment to cultivating an environment of teamwork and continuous improvement. Staff contributions to improvement of procedures and processes are actively encouraged as a way to enhance the safety and work culture. 

Recently, one of the most visible agendas has been the urge for highly improved ( ideal ) decision processes. Ringstad and Andersen (2007) define lO as new work processes which use real time data to improve the collaboration between disciplines, organizations, companies and locations to achieve safety, better and faster decisions . They argue that lO improve decision making by increased availability of real time data, work performed independent of physical location, more work performed in a parallel fashion, multidisciplinary teamwork and a proactive focus. 

Probably the most traditional type of inspection is that conducted by the laboratory supervisor. This form of inspection presents an excellent opportunity to promote a culture of safety and prudence within an organization. The supervisor gains the opportunity to take a close look at the facilities and operations. He or she also can discuss with individual workers issues of interest or concern that may fall outside the scope of the actual inspection. Again, a constructive and positive approach to observed problems and issues will foster an attitude of cooperation and leadership with regard to safety. It can help build and reinforce a culture of teamwork and cooperation that has benefits far beyond protecting the people and physical facilities. 

Individual safety awards are certainly important to any safety program. However, because drivers lead a fairly independent lifestyle, all the more reason to make sure you have at least a few group rewards in your program. Doing so will help create a sense of teamwork and build stronger ties between your drivers and the company. 

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. 

Timmel et al. (2010) CUSP Across one year Surgical floor of an academic medical centre Safety Attitudes Questioimaire Teamwork culture improved from 65% to 71% and safety culture improved from 61% to 69%... 

Pettker et al. (2009) Patient safety programme with eight components Two years Tertiary-level academic medical centre Safety Attitudes Questiormaire Teamwork culture improved from 39% to 55% and safety culture improved from 33% to 55%... 

Some questions cross-loaded onto more than one factor in factor analysis (e g. Teamwork and Communications), or loaded on different factors in different factor analyses, suggesting that the item may not fit consistently into a coherent model of safety culture. Many of these concerned issues that were better covered by other items statistical analysis was used to determine the best - most precise - questions. An engineering-related example was I sometimes have to do workarounds to compensate for lack of resources (equipment, manpower or time) . Wording was another reason for removal of certain questiotmaire items. For instance, controllers pointed out that they could not be sure what would constitute sufficient system checks by maintenance staff when asked whether Maintenance staff perform sufficient system checks . 

Tanja Manser is Associate Professor of Industrial Psychology and Human Factors at the University of Fribourg. Her research is focused on human performance and patient safety. Her work focuses on acute care settings, studying safety relevant behaviour such as teamwork and communication at organisational interfaces, using clinical and simulated environments. 

One organization, profiled in the following case study, has received national acclaim for its work in reconfiguring clinical teamwork to improve communication and safety. 

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