• Eduardo Salas, Katherine A Wilson, Carrie E Murphy, Heidi King, and Mary Salisbury.
• Department of Psychology, University of Central Florida, Orlando, Florida, USA. esalas@ist.ucf.edu
• Jt Comm J Qual Patient Saf. 2008 Jun 1; 34 (6): 333-41.

BackgroundIn health care, others' lives depend on the team operating at a level beyond the sum of its individual parts. A framework (a heuristic) represents a three-pronged approach to teamwork in health care that entails communication, coordination, and cooperation. These fundamental requirements of teamwork represent the constant interaction that team members undertake to become an effective team. Guidelines, tips, and examples show how the framework can be applied to establishing and enabling teams to provide safe, reliable care.GuidelinesThe guidelines are as follows: (1) Support precise and accurate communication through a closed-loop communication protocol; (2) diagnose communication errors as you would any illness--Examine the team and look for symptoms, then treat the symptoms through team learning and self-correction; (3) recognize functional expertise by identifying and publicizing topical experts to evenly distribute work load and increase accuracy; (4) institute frequent practice opportunities to keep team skills in good shape because poorly honed skills will limit performance; (5) refine the team's shared mental models (SMMs) by pre-planning to build its implicit coordination skills, adaptability, and flexibility; (6) shape adaptive expertise by fostering a deep understanding of the task to increase team effectiveness; (7) build team orientation by taking steps to increase trust and cohesion to lower stress levels and increase satisfaction, commitment, and collective efficacy; and (8) prepare the team by providing learning opportunities for new competencies that will expose members to feedback and increase the team's overall efficacy.ConclusionAlthough not a comprehensive list, the guidelines and tips represent the most essential requirements for effective teamwork.

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