Growing evidence exists that patient outcomes are related to how effec
tively health care organizations coordinate work responsibilities amon
g their staffs. However, information is lacking on actual practices th
at can be used to achieve effective coordination. This article reports
on a National Veterans Affairs Surgical Risk Study, in which the auth
ors studies the coordination practices of 20 surgical services that, b
ased on risk-adjusted mortality and morbidity rates, occupied differen
t ends of the patient outcomes continuum.