In addition, health professionals interact in a variety of ways, ranging from loosely coordinated collaborative relationships at one end of the continuum to more tightly organized work teams at the other, often within the same day (Headrick et al., 1998). Clear differences exist in those situations in which team makeup is driven by hierarchical learning or reporting mechanisms and those in which the team members have equal influence on team performance and outcome.
Addressing this demand is hindered by a number of factors, including the wide variation in team makeup, which ranges from those composed of senior clinicians overseeing residents and fellows (Posner and Freund, 1999) to those involving representatives of multiple professions from multiple organizations (Green and Plesk, 2002 Kosseff and Niemeier, 2001 Stone et al., 2002). Others stress the increasing numbers of professionals directly involved in care delivery processes and the relationship between the resulting importance of cooperative working relationships and the complexity of patient needs (Headrick et al., 1998). The importance of understanding and maximizing team performance has been discussed by several authors, who note that 70 to 80 percent of health care errors are caused by human factors associated with interpersonal interactions (Schaefer et al., 1994). The final section delineates needs for further research. The second section provides evidence-based recommendations for strategies to develop, train, and assess the performance of interdisciplinary teams. Included in the review are summaries of relevant research from health care, industry, and other work groups involved in error-prone and high-risk team behaviors.
The first contains an extensive review of the literature concerning interdisciplinary teams and their impact on care delivery and safety outcomes. This appendix is divided into three main sections. These unknown attributes and products of work teams should be explored thoroughly to enable sound recommendations concerning the promotion of interdisciplinary teams and collaborative work groups as a measure for assuring safe patient care. What has been less evident is what constitutes effective team performance, how it is created and nurtured, and how it directly or indirectly influences care delivery outcomes. The desire for effective team performance has been mentioned in the health care literature for years. Among the strategies proposed by experts is the creation, training, and support of highly developed interdisciplinary teams and collaborative work groups (Chassin et al., 1998 Disch et al., 2001 Palmersheim, 1999). As concern over the number of health care errors has risen, so has interest in the development of care delivery processes that minimize the potential for error.
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