Effective teamwork can immediately and positively impact Patient safety and outcome in healthcare delivery. The need for effective teams is growing as co-morbidities and the complexity of care specialization increase. A doctor, a dentist, or any other health practitioner in any health organization used to be able to provide quality care that satisfied their patients solely. The evolution of health care and the global demand for high-quality patient care necessitates parallel professional development in health care, with a strong emphasis on patient-centered teamwork. This can only be accomplished by putting the Patient at the center of care and sharing a broad set of values and principles. This will aid in forming and developing an effective team capable of providing exceptional care to patients. To achieve goals and overcome challenges, team members’ motivation should be backed up by strategies and practical skills. This article highlights team values and principles and provides team members with a practical approach to providing quality patient care.
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Some key terms are teamwork, health organization, quality care, effective team, and communication.
Effective teamwork is now widely recognized as necessary for building a more efficient and patient-centered healthcare delivery system. Identifying best practices through rigorous research, which can provide data on optimal processes for team-based care, is contingent on identifying the system’s core elements. Researchers will be able to compare team-based care models more easily once the underlying principles and core values are agreed upon and shared. Commissioners will be able to promote effective practices . As a result, several designated health professional bodies worldwide have recently issued statements to define teams, their roles, and the characteristics of a successful team [1-4]. They elaborated on the essential values and principles of team-based health care to find common ground on this extremely contentious subject. This article has highlighted all of them. The potential challenges and practical tips on how to approach the task successfully have been explored and included alongside proposed implementation strategies.
Definitions, Importance, and Change
A team’s nature is diverse and complex. Although many patients believe that a multidisciplinary team is the most effective, teams can be formed from a single professional group.
Definitions A team is a distinct group of two or more people who interact dynamically, interdependently, and adaptively toward a common and valued goal/objective/mission, have been assigned specific roles or functions to perform, and have a limited membership lifespan .
Team-based health care is the delivery of health services to individuals, families, and communities by at least two health providers who collaborate with patients and caregivers—to the extent desired by each Patient—to achieve shared goals within and across settings to achieve coordinated, high-quality care . Incorporating team members sharing responsibilities and accountability in healthcare systems provides significant benefits. However, shared responsibility without high-quality teamwork can pose immediate risks to patients. Poor communication between healthcare professionals, patients, and caregivers, for example, has emerged as a common reason for patients suing healthcare providers . Even in a well-coordinated team, medical errors, “near misses,” and other adverse events can occur due to poor communication among team members [6-10]. Furthermore, a lack of purposeful team care can result in unnecessary waste . As a result, identifying best practices may aid in avoiding some of these hazards and controlling costs [12,13].
An effective team is one in which team members, including patients, communicate with one another while also combining their observations, expertise, and decision-making responsibilities to optimize patients’ care . Understanding the workplace culture and its impact on team dynamics and functioning will help a team member become a good team player.
Importance Nowadays, patients are rarely seen by a single health professional. Effective teamwork is critical for patient safety in a complex healthcare system because it reduces adverse events caused by miscommunication with others caring for the Patient and misunderstandings of roles and responsibilities . Patients are undoubtedly interested in their care and must be included in the communication process; their early and ongoing participation has also been shown to reduce errors and potential adverse events .
The advancement of Patient care People was cared for by a single all-knowing physician or a private nurse living in the community in the “good old days,” and either was very easy to approach at any time of day . Since then, health care has changed dramatically and at a faster rate in the last 20 years. It is now considered undesirable in health care to practice in isolation, as it may endanger the Patient [14,15]. The complexity of modern health care, which is rapidly evolving, is a driving force behind the transition of health care practitioners from solo practitioners to members of teams with a common goal .
Today, as clinicians and patients incorporate new technologies into their management processes, the overall rate of change in healthcare systems will accelerate. The National Guideline Clearinghouse in the United States now lists over 2,700 clinical practice guidelines, and the results of over 25,000 new clinical trials are published yearly . No single practitioner can handle, absorb and use all this information, and the need for specific knowledge in specialized care areas by different team members has become necessary. Now, more than ever, there is an obligation to strive for perfection in the science and practice of inter-professional team-based health care . Each clinician relies upon information and action from other team members. Yet, without explicit acknowledgment and purposeful team cultivation, systematic inefficiencies and errors cannot be addressed and prevented .
The Development and Characteristics of a Successful Health Care Team
In healthcare systems, various types of teams can be identified :
Core groups These are directly involved in the Patient’s care.
They are typically comprised of team leaders and direct-care providers such as nurses, dentists, pharmacists, doctors, and assistants. Case managers are also included.
Coordination of groups The group in charge of core team operational management, coordinating functions, and resource management.
Emergency teams are Founded to respond to emergencies or specific events (e.g., cardiac-arrest teams, disaster-response teams. etc.).
Additional teams/services The organization supports services that aid in Patient care, such as cleaners and domestic staff.
Administration and support services are provided by those who provide indirect, task-specific services in a healthcare facility. Secretaries and the executive leadership of a unit or facility are included. This team is responsible for the organization’s overall operation 24 hours a day, seven days a week. According to research, any team must go through the following stages to form and develop in a way that makes it coherent, effective, and strong enough to face future challenges .
Forming: Usually marked by ambiguity and confusion. At this point, team members may be confused about their responsibilities. They have not yet chosen to collaborate, so their communication may be superficial and impersonal.
Storming: A difficult stage in which team members may disagree and rebel against the assigned tasks. When team members do not make good progress on their tasks, they may become frustrated.
Norming: Team members establish open communication, and the team begins confronting the task. Procedures and communication patterns that are widely accepted are established.
Performing: The team devotes its full attention to achieving the objectives. The team is now close and supportive, open and honest, resourceful and efficient.
Healthcare teams interact dynamically after they are formed and continue to develop, intending to provide health services to patients. To be successful, team members must share certain characteristics, which include :
Have specialized knowledge and skills and frequently work under high-workload conditions.
Understand their role and the roles of others in the team(s), and interact with one another to achieve a common goal.
As a result of the interdependence of the tasks performed by team members, they act as a collective unit.
Knowledge and skills that are specialized and complementary.
Make a decision.
Values, Principles, and Benefits
The values needed in an effective team member harmonize with the core competency domain of “Values/Ethics” put forward in the meeting sponsored by Inter-professional Education Collaborative (IPEC)entitled “Team-Based Competencies.”
The following are five personal values that distinguish the most effective members of high-functioning healthcare teams :
Honesty: Effective communication within the team is highly valued, including transparency about goals, decisions, uncertainty, and mistakes. Honesty is essential for continuous development and mutual trust, both of which are required for a high-functioning team.
Discipline: Team members exercise discipline in carrying out their roles and responsibilities, even when it appears inconvenient. Such discipline enables teams to develop and adhere to standards and protocols while seeking ways to improve.
Team members are excited and motivated to tackle new problems creatively. Even errors and unanticipated negative outcomes are viewed as potential opportunities for improvement.
Humility: Team members recognize differences in training but do not believe that one type of training or perspective is uniformly superior to others. They are also aware that they are only human and will make mistakes. As a result, a key benefit of working in a team is that team members can rely on one another to help recognize and avoid failures, regardless of their position in the hierarchy.
Curiosity: Team members are committed to reflecting on the lessons learned in their daily activities and applying this reflective experience to their professional development and team functioning.
Team-Based Health Care Principles
Numerous models can be used to describe effective teamwork. Historically, these have come from other industries, such as aviation crew resource management (CRM) . The following principles characterize successful team-based health care: 
Shared goals: The team, which includes the Patient and, if necessary, family members or other support people, develops a common and clearly defined purpose that incorporates collective interests and demonstrates shared ownership.
Clear roles: There are clear expectations for each team member’s functions, responsibilities, and accountabilities, which optimizes team efficiency and frequently allows the team to take advantage of the division of labor, allowing it to accomplish more than the sum of its parts. Mutual trust and respect: Team members earn each other’s trust, establishing strong norms of reciprocity and expanding opportunities for shared success. They respect and value each other’s contributions. In addition to their professional contributions, they value each other’s talents and beliefs. Effective teams also accept and encourage members’ differing points of view.
Effective communication is critical to teamwork success. The team prioritizes and constantly improves its communication abilities. It has consistent and accessible communication channels used by all team members in all settings.
Measurable processes and outcomes: The team should agree on and implement reliable and timely feedback on successes and failures. These are used to track and improve performance in the short term and to plan for the future.
Effective team leaders facilitate, coach, and coordinate the activities of their colleagues. An effective team is distinguished by effective leadership.
Advantages of Effective Teamwork
Effective teams can improve care at the organizational level, the team as a whole, the individual team member, and the Patient (Table 1):
Table 1 shows the advantages of effective teamwork.
Advantages of working together
Team members benefit from reduced hospitalization time and costs.
Improved care coordination Improved Patient satisfaction Improved job satisfaction
decrease in unexpected admissions
Effective utilization of healthcare services
increased role clarity
Patients now have easier access to services.
Improvements in communication and professional diversity
improved health outcomes and care quality. Medical errors have been reduced. improved well-being
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Problems with Effective Teamwork
There are several obstacles to establishing and maintaining effective teamwork in health care :
The roles of various healthcare professionals change and overlap significantly in many healthcare teams. These shifting roles can pose difficulties for teams regarding acknowledgment and role allocation.
Some changes in health care, such as increased delivery of chronic condition care, necessitate forming new teams and modifying existing teams.
Hierarchies in healthcare
The strongly hierarchical healthcare structure can be counterproductive to well-functioning and effective teams where all members’ views are considered.
Individualistic nature of healthcare
Many healthcare professions, such as nursing, dentistry and medicine, are based on the autonomous one-to-one relationship between the healthcare provider and Patient. While this relationship remains a core value, it is challenged by many concepts of teamwork and shared care.
Instability of teams
Some healthcare teams are transitory, coming together for a specific task or event (e.g., Trauma team) (e.g., Trauma team).
Failing teamwork leads to accidents.
Reviews of high-profile incidents have identified three main types of teamwork failings, namely, unclear definitions of roles, lack of explicit coordination and other miscommunication.
Resolving disagreements and conflict
The ability to resolve conflict or disagreement in the team is crucial to successful teamwork. This can be especially challenging for junior members of the team or in highly hierarchical teams.
Go to: \sPractical Tips
How to apply teamwork principles?
Here are some tips to help healthcare teams to head toward achievements, which include:
A living example of a strategic plan.
Practical tips for health care team members.
Monitoring progress through patients’ satisfaction.
Practical strategic approach
“The context for health care and support is changing. Most significantly, with people living longer, we have a greater number of older patients and people to support, many with multiple and complex needs, and with higher expectations of what health, care and support can and should deliver. Delivering health and care support and services involves us working with people in a new partnership, offering and engaging with people in making choices about their health and care, and supporting ‘no decision about me without me” . These are statements made by the senior NHS nurses, Midwifery staff and other health-related professionals in the UK who have engaged a wide range of professionals and patients in assessing satisfaction and suggestions of these team members regarding the quality of delivered care. Accordingly, they put a strategy to meet the rapidly progressing demands on the service. The purpose of the engagement was two-fold. Firstly, they wanted to get wider views on the 6Cs: care, compassion, competence, communication, courage and commitment. They wanted to test whether these would resonate with staff and patients and form a common language of their vision. Secondly, they wanted to test responses to six areas of action (underpinned by the 6Cs of value and behavior) which will enable ongoing improvements in care and services for all patients and service users . The strategy addressed equality issues under the Equality Act 2010, considering it from the point of view of both the people receiving care and those giving it. The six areas of action that were supposed to deliver their vision included :
Action area one: Helping people stay independent, maximizing well-being and improving health outcomes.
Action area two: Working with people to provide a positive experience of care.
Action area three: Delivering high-quality care and measuring the impact.
Action area four: Building and strengthening leadership.
Action area five: Ensuring we have the right staff and skills in the right place.
Action area six: Supporting positive staff experience.
Practical tips for healthcare professionals 
Always introduce yourself to the team
Clarify your role
Use objective (not subjective) language
Learn and use people’s names
Be assertive when required
Read back/close the communication loop
State the obvious to avoid assumptions
Ask questions, check and clarify
Delegate tasks to specific people, not to the air
If something doesn’t make sense, find out the other person’s perspective
Always do a team briefing before starting a team activity, and a debrief afterward
When in conflict, concentrate on “what” is right for the Patient, not “who” is right/wrong.
And remember: “Teamwork doesn’t just happen.” It requires :
– \sAn understanding of the characteristics of successful teams
– \sKnowledge of how teams function and of ways to maintain effective teams.
Patient satisfaction A sensitive indicator for successful health-delivered teamwork is Patient satisfaction, which requires: \sC.P.R.
C: Compassionate Communication
P: Patient information/Pain management
For high patient satisfaction, the delivery of the following is critical :
Communicate to the Patient who you are, what you do and who the team members are.
Inform the Patient daily what their plan is for the day and set expectations – write on the whiteboard so they can see it and revise as they need.
Inform the Patient and family if they have any questions or concerns to call – you are there to help.
Encourage the patient to communicate how they manage their pain – their comfort is vital!
Include the Patient – tell them what you are doing in the room, even the simple things like adjusting IVs or taking vital signs. The more you communicate about what you are doing, the more comfortable they will be with asking questions.
The ambition of delivering quality patient care is subject to high performance through Patient focused teams. However, we must close the gap between traditional practices and the new attitudes an effective team requires to achieve such great ambition. Therefore, healthcare organizations should aim at providing exceptional patient care by adopting a wide team-based culture in which certain values and principles are shared and transparently communicated among team members, including patients, who should be placed at the heart of the care.
Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients?
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