Non-technical skills and the future of teamwork in healthcare settings

2 NoN-techNical skills aNd the future of teamwork iN healthcare settiNgs Acknowledgments This article borrows heavily from a recent review led by the author (sevdalis N, hull l, Birnbach dJ. improving patient safety in the operating theatre and perioperative care: obstacles, interventions and priorities for accelerating progress. Br J Anaesth. 2012;109:i3-16). The author would like to thank dr stephanie russ for her comments on an earlier version of this article and Professor david Birnbach for the simulated ward picture in figure 1. Introduction: A team of experts is not an expert team safe and effective delivery of care relies very heavily on teamworking. teamwork can be defined as a 'set of interrelated behaviours, actions, cognitions and attitudes that facilitate the required task work that must be completed'. 1 healthcare teams are required to look after patients when they are transferred between primary and secondary or tertiary care settings, or within a single setting when patients require review and input by multiple specialists. handovers between teams or, increasingly in the present era of working time restrictions, between shifts are thus ubiquitous and they need to be carried out effectively to ensure safety and quality in care. 2,3 even within a single healthcare environment, however, such as an operating theatre, an intensive care unit or a hospital ward, the assembly of expert doctors or nurses typically involved in looking after a patient does not necessarily make up an 'expert team'. 4 to add to the challenge, team membership can be transient and inconsistent – which makes the creation of cohesive teams with a shared vision even more problematic. Psychological science has long shown that team performance and effectiveness cannot be taken for granted but need to be measured, analysed and improved. 5-7 why is effective teamworking so challenging to achieve within hospitals? multiple interrelated factors are likely to contribute to this. The nature of healthcare is changing rapidly – biomedical advances require increasing subspecialisation, whereas novel technologies (e.g. laparoscopic, endoscopic or robotic procedures) have significant learning curves, thereby requiring practitioners to devote lengthy periods of time to training in order to achieve proficiency so that the benefits of such techniques can be realised. medical and nursing schools, on the other hand, have traditionally focused on uni-specialty training – systematic interprofessional training is only recently emerging in medical and nursing education. These developments mean increased training in professional and specialty 'silos'. it is …