Department of Anesthesiology and Critical Care Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine.
Office of Assessment and Evaluation Studies, Virginia Commonwealth University School of Medicine.
Am Psychol. 2018 May-Jun;73(4):433-450. doi: 10.1037/amp0000298.
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue. Health care delivery systems exemplify complex organizations operating under high stakes in dynamic policy and regulatory environments. The coordination and delivery of safe, high-quality care demands reliable teamwork and collaboration within, as well as across, organizational, disciplinary, technical, and cultural boundaries. In this review, we synthesize the evidence examining teams and teamwork in health care delivery settings in order to characterize the current state of the science and to highlight gaps in which studies can further illuminate our evidence-based understanding of teamwork and collaboration. Specifically, we highlight evidence concerning (a) the relationship between teamwork and multilevel outcomes, (b) effective teamwork behaviors, (c) competencies (i.e., knowledge, skills, and attitudes) underlying effective teamwork in the health professions, (d) teamwork interventions, (e) team performance measurement strategies, and (f) the critical role context plays in shaping teamwork and collaboration in practice. We also distill potential avenues for future research and highlight opportunities to understand the translation, dissemination, and implementation of evidence-based teamwork principles into practice. (PsycINFO Database Record
医疗保健行业的规模鲜有与之匹敌的。仅在美国,据估计,85%的人口每年至少有 1 次医疗保健遭遇,至少四分之一的人每年有 4 到 9 次遭遇。一次就诊需要多学科临床医生、行政人员、患者及其家属的协作。多次就诊通常涉及在不同组织工作的不同临床医生。护理协调无效以及潜在的次优团队合作过程是一个公共卫生问题。医疗保健提供系统是在动态政策和监管环境下高风险运作的复杂组织的典范。安全、高质量护理的协调和提供需要在组织、学科、技术和文化界限内以及跨组织、学科、技术和文化界限进行可靠的团队合作和协作。在这篇综述中,我们综合了考察医疗保健提供环境中的团队和团队合作的证据,以描述当前的科学状况,并突出研究中的差距,这些差距可以进一步阐明我们基于证据的团队合作和协作理解。具体来说,我们强调了以下方面的证据:(a)团队合作与多层次结果之间的关系;(b)有效的团队合作行为;(c)卫生专业人员有效团队合作的能力(即知识、技能和态度);(d)团队合作干预措施;(e)团队绩效衡量策略;(f)背景在塑造实践中的团队合作和协作方面的关键作用。我们还总结了未来研究的潜在途径,并强调了了解循证团队合作原则转化为实践的翻译、传播和实施的机会。