Toward the Development of the Perfect Medical Team: Critical Components for Adaptation

Objective Medical teams play a vital role in the delivery of safe and effective patient care. Toward the goal of becoming a high-reliability health system, the authors posit that the perfect medical team is one that develops their attitudes, behaviors, and cognitions (ABCs) to facilitate adaptation. Methods The authors synthesized the literature (frameworks, measures, and conceptual models) on teamwork in healthcare (k = 161) to develop an evidence-based model of ABCs, which current evidence suggests, are requisite for medical team adaptation. Clinical vignettes were garnered from the media and other sources to illustrate how these ABCs-or failure in using these ABCs-can lead to positive or negative events in healthcare. Results The resulting model contains the most frequently included ABCs in healthcare teamwork models, measures, and frameworks: psychological safety (41, 25.5%), situation assessment (66, 41.0%), shared mental models (56, 34.8%), team leadership behaviors (78, 48.4%), role awareness (64, 39.7%), team decision-making (61, 37.9%) and planning (41, 25.5%), conflict management (51, 31.7%), task coordination (71, 44.1%), adaptation (46, 28.6%), and backup behavior (54, 33.5%). The authors posit that communication and organizational conditions-other highly cited components-(141, 87.6%, and 90, 55.9%, respectively) serve as moderators of these relationships. Conclusions The authors argue that each of these ABCs is critical for enhancing team adaptation and subsequently increasing patient safety. A list of practical tools and educational strategies that teams and organizations can use to improve their performance on each of these ABCs is provided.

Automated summary

The authors of this study synthesized literature on teamwork in healthcare to develop an evidence-based model of attitudes, behaviors, and cognitions necessary for medical team adaptation. The model includes components like psychological safety, situation assessment, shared mental models, team leadership behaviors, role awareness, team decision-making, planning, conflict management, task coordination, adaptation, and backup behavior. Communication and organizational conditions are also highlighted as important moderators in enhancing team adaptation and patient safety.