1. Being an effective team player
Topic 4
Being an effective team player

2. Learning objectives
understand the importance of teamwork in health care
know how to be an effective team player
recognize you will be a team member as a medical student
When Rabia first mentioned this conference to me in September I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realized here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally.
In my presentation I will draw on
the global work on patients safety, reflecting on how patient safety affects us all
how we should and can learn from error
the work of the WHO World Alliance for Patient Safety and
the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world
I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop.

3. Knowledge requirements
Understand:
the different types of teams in health care
the characteristics of effective teams
how ones values and assumptions affect interactions with others
When Rabia first mentioned this conference to me in September I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realised here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally
In my presentation I will draw on
the global work on patients safety, reflecting on how patient safety affects us all
how we should and can learn from error
the work of the WHO World Alliance for Patient Safety and
the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world
I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop

4. Knowledge requirements
Understand:
the role of team members and how psychological factors affect team interactions
the impact of change on teams
the role of the patient on the team
When Rabia first mentioned this conference to me in September I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realised here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally
In my presentation I will draw on
the global work on patients safety, reflecting on how patient safety affects us all
how we should and can learn from error
the work of the WHO World Alliance for Patient Safety and
the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world
I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop

5. Performance requirements
Using the following teamwork principles to promote effective health care:
using communication techniques
resolving conflicts
using mutual support techniques
changing and observing behaviours
When Rabia first mentioned this conference to me in September I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realised here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally
In my presentation I will draw on
the global work on patients safety, reflecting on how patient safety affects us all
how we should and can learn from error
the work of the WHO World Alliance for Patient Safety and
the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world
I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop

6. What is a team? A team is a group of two or more individuals who:
interact dynamically
have a common goal/mission
have been assigned specific tasks
possess specialized and complementary skills
When Rabia first mentioned this conference to me in September I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realised here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally
In my presentation I will draw on
the global work on patients safety, reflecting on how patient safety affects us all
how we should and can learn from error
the work of the WHO World Alliance for Patient Safety and
the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world
I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop

7. A team is….
a distinguishable set of two or more people who interact dynamically, interdependently and adaptively towards a common and valued goal/objective/mission, who have been each assigned specific roles or functions to perform, and who have a limited lifespan of membership.
Eduardo Salas

8. What types of teams do you find in health care?
Many different teams are found in health care:
multiprofessional/drawn from a single profession
co-located/distributed
transitory or long standing
Launched in 2004 following the WHA Resolution that called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

9. What types of teams do you find in health care?
TeamSTEPPS identify the following team types in health care:
Core teams
coordinating teams
contingency teams
ancillary services
support services
administration
Launched in 2004 following the WHA Resolution that called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

10. How do teams improve patient care?
teams represent a pragmatic way to improve patient care
teams can improve care at the level of:
the organization
the patient – outcomes and safety
the team as a whole
the individual team member
Launched in 2004 following the WHA Resolution that called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

11. How do teams form and develop?
Tuckmann* identified four stages of team formation and development:
forming
storming
norming
performing
Launched in 2004 following the WHA Resolution that called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.
*Tuckmann 1965

12. What makes for a successful team?
Effective teams possess the following features:
a common purpose
measurable goals
effective leadership and conflict resolution
good communication
good cohesion and mutual respect
situation monitoring
self-monitoring
flexibility
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

13. Leadership
Effective teams leaders coordinate and facilitate teamwork by:
delegating tasks or assignments
conducting briefs, huddles, debriefs
empowering team members to speak freely and ask questions
organizing improvement activities and training for the team
inspiring “‘followers” and maintain a positive group culture
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

14. Leadership… continued
Effective teams leaders coordinate and facilitate teamwork by:
accepting the leadership role
calling for help appropriately
constantly monitoring the situation
setting priorities and making decisions
utilizing resources to maximize performance
resolving team conflicts
balancing the workload within a team
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

15. Communication
A number of techniques have been developed to promote communication in health care including:
SBAR
call-out
check-back
handover/handoff
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

16. Resolving disagreement and conflict
A number of techniques have been developed to help all members of a team speak out including:
the two challenge rule
CUS
DESC script
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

17. Barriers to teamwork changing roles medical hierarchies
individualistic nature of medicine
instability nature of teams
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

18. Incidents in other industries
Failures in the following team behaviours have been identified as being responsible for accidents in other industries:
roles not being clearly defined
lack of explicit coordination
miscommunication/communication
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

19. Assessing team performance
assessing team performance can be carried out:
in the workplace
in simulated environments
through observing teamwork exercises
teamwork can be assessed by external experts or by peer observation
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

20. Summary teamwork doesn’t just happen
there are well documented teamwork principles medical students should know
there are a variety of techniques that have been developed to improve communication in teams
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

21. Performance requirements
Medical students can apply teamwork principles in their interactions with other students and through observing and being part of health-care teams
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

22. Performance requirements…
Practical tips medical students can start practising now to improve teamwork include:
always introducing yourself to the team
reading back/closing the communication loop
stating the obvious to avoid assumptions
asking questions, checking and clarifying
delegating tasks to people not to the air
clarifyng your role
using objective (not subjective) language
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.

23. Performance requirements…
Practical tips medical students can start practising now to improve teamwork include:
learning and using people’s names
being assertive when required
if something doesn’t make sense, finding out the other person’s perspective
doing a team briefing before undertaking a team activity and a debriefing afterwards
when conflict occurs, concentrating on “what” is right for the patient, not “who” is right
Launched in 2004 following the WHA Resolution which called for Member States to
"pay the closest possible attention to the problem of patient safety"
Promote awareness and political commitment
Expert-led technical programmes to improve patient safety worldwide
The Alliance will be publishing its Forward programme shortly.