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Hoonakker PLT, Wooldridge AR, Hose B-Z, et al. Intern Emerg Med. 2019;14:797-805.
Patient acuity and the need for interdisciplinary collaboration contribute to patient safety issues in trauma care. This qualitative study explored perceptions of handoff safety in pediatric trauma patients and found a high potential for information loss due to the rapidity of handoffs and the multiple disciplines involved.
Epstein NE. Surg Neurol Int. 2014;5:S295-303.
Multidisciplinary teamwork is essential in developing appropriate treatment plans. This review summarizes the literature documenting the benefits of teamwork, including better communication, fewer adverse events, and increased job satisfaction. The author advocates for keeping teams that work well together to further optimize improvements.
Richter JP, McAlearney AS, Pennell ML. Health Care Manage Rev. 2016;41:32-41.
Incomplete handoffs and insufficient communication regarding key clinical information may lead to adverse events or missed or delayed diagnoses. This analysis of data from the AHRQ Hospital Survey of Patient Safety Culture sought to determine how perceptions of organizational factors that affect safety can contribute to optimal handoffs. Perceived teamwork across units was a significant predictor for successful handoffs. Perceptions of staffing adequacy and management support for patient safety efforts were also related to good handoffs. Among frontline staff, open communication was associated with optimal handoffs, while among management safe handoffs were linked to a continuous learning culture. These findings add to existing studies which underscore the need for high-reliability organizations to promote safety efforts. The authors advocate for hospital leadership to promote teamwork and open communication to augment handoffs in their facilities. Dr. Vineet Arora discussed the challenges of handoffs in a prior AHRQ WebM&M interview.
Dietz AS, Pronovost PJ, Mendez-Tellez PA, et al. J Crit Care. 2014;29:908-14.
Improving teamwork and communication is a continued focus in the hospital setting. This systematic review revealed that although studies of teamwork in the intensive care unit abound, the field lacks common definitions and constructs. Teamwork usually entailed joint strategy and shared goals, and quality improvement approaches to enhance teamwork typically involve team training and development of structured protocols. Many interventions target rounds, during which interdisciplinary providers discuss each patient, or handoffs between clinicians. The authors suggest that communication is the most prominent aspect of teamwork and propose further study in conceptualizing teamwork to design effective interventions. The heterogeneity in defining and measuring teamwork may account for mixed results in improving safety outcomes. An AHRQ WebM&M perspective describes the Veterans Health Administration's medical team training program.
Sarcevic A, Marsic I, Burd RS. ACM Transactions on Computer-Human Interaction. 2012;19.
This study examines the nature of trauma teamwork errors and suggests structures to better support team cognition and decision-making.
Institute for Healthcare Improvement. 2009 -2013.
This Web site supports an initiative to reduce avoidable rehospitalizations by improving transitions in care and communication between multiple care sites. The program ran from May 2009 through June 2013.  
BMJ Qual Saf. 2011;22.
Silence and poor communication are known threats to patient safety. Despite efforts to promote teamwork and develop shared tools for communication, there are persistent gaps between nurse and physician practices. This study surveyed nurses and physicians working in labor and delivery units and discovered significant differences in their perceptions of patient harm associated with various clinical scenarios. These differences in patient harm ratings were the greatest predictor of speaking up, suggesting that differences in clinical assessment may serve as a useful target for intervention. The authors discuss the negative impact of environments where mental models are not shared, conflict is poorly managed, and disruptive behaviors stifle open communication. A past AHRQ WebM&M commentary discussed a case of "silence" when members of the operating room team were reluctant to speak up to a senior surgeon.
Emergency medicine has evolved from a location, with variably trained and experienced providers ("the ER"), to a discipline with a well-defined knowledge base and skill set that focus on the diagnosis and care of undifferentiated acute problems.(1) The importance of rapid diagnosis and treatment of serious conditions (e.g., myocardial infarction, stroke, trauma, and sepsis) has made timeliness not simply a determinant of patient satisfaction but also a significant safety and quality concern—delays in care can be deadly.(2) Emergency physicians (EPs) have identified delays caused by crowding fr
Sehgal NL, Green A, Vidyarthi AR, et al. J Hosp Med. 2010;5:234-9.
This study discovered that while nurses and physicians use patient whiteboards differently, they all value its potential for improving teamwork, communication, and patient care. The authors provide a series of recommendations for those adopting whiteboards and advocate for their use as a patient-centered tool.