Medical Teamwork and Patient Safety

A 1999 report by the Institute of Medicine (IOM) suggests that medical errors are responsible
for as many as 98,000 deaths annually. In response to this crisis, then President Clinton
established the Quality Interagency Coordination (QuIC) Task Force to develop a Federal plan
for reducing the number and severity of medical errors. One of the QuIC’s primary
recommendations was the adaptation of CrewResource Management (CRM) training—a subdomain of team training—to medicine.
This paper will present evidence to support the relation between team training and patient
safety. It extends earlier work by Pizzi and colleagues who argue that CRM training has a great
deal of potential as a safe patient practice. Training medical professionals to operate as a wellcoordinated team should enhance patient safety and lead to a reduction in medical errors. We
begin the paper by presenting background information related to teamwork, including the nature
of effective teamwork, teamwork-related knowledge, skills, and attitudes, and contextual issues
surrounding teamwork. We then provide further confirmation of team training effectiveness,
taken from high-risk domains such as commercial aviation and the military. Details are provided
on existing medical team training programs, including Anesthesia Crisis Resource Management,
MedTeams
™
, Medical Team Management, Team-Oriented Medical Simulation, Dynamic
Outcomes Management, and Geriatric Interdisciplinary Team Training, and the effectiveness of
each is discussed. Finally, we offer specific recommendations to guide future medical team
training research.