Toward the Development of the Perfect Medical Team: Critical Components for Adaptation

Megan E. Gregory, Ashley M. Hughes, Lauren E. Benishek, Shirley C. Sonesh, Elizabeth H. Lazzara, Le Chauncy D. Woodard, Eduardo Salas

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Medical teams play a vital role in the delivery of safe and effective patient care. Toward the goal of becoming a high-reliability health system, the authors posit that the "perfect" medical team is one that develops their attitudes, behaviors, and cognitions (ABCs) to facilitate adaptation. METHODS: The authors synthesized the literature (frameworks, measures, and conceptual models) on teamwork in healthcare (k = 161) to develop an evidence-based model of ABCs, which current evidence suggests, are requisite for medical team adaptation. Clinical vignettes were garnered from the media and other sources to illustrate how these ABCs-or failure in using these ABCs-can lead to positive or negative events in healthcare. RESULTS: The resulting model contains the most frequently included ABCs in healthcare teamwork models, measures, and frameworks: psychological safety (41, 25.5%), situation assessment (66, 41.0%), shared mental models (56, 34.8%), team leadership behaviors (78, 48.4%), role awareness (64, 39.7%), team decision-making (61, 37.9%) and planning (41, 25.5%), conflict management (51, 31.7%), task coordination (71, 44.1%), adaptation (46, 28.6%), and backup behavior (54, 33.5%). The authors posit that communication and organizational conditions-other highly cited components-(141, 87.6%, and 90, 55.9%, respectively) serve as moderators of these relationships. CONCLUSIONS: The authors argue that each of these ABCs is critical for enhancing team adaptation and subsequently increasing patient safety. A list of practical tools and educational strategies that teams and organizations can use to improve their performance on each of these ABCs is provided.

Original languageEnglish (US)
Pages (from-to)e47-e70
JournalJournal of patient safety
Issue number2
StatePublished - Mar 1 2021

ASJC Scopus subject areas

  • Leadership and Management
  • Public Health, Environmental and Occupational Health


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