The potential for improved teamwork to reduce medical errors in the emergency department

This article describes emergency department care work teams designed to imp rove team communication and coordination and reduce error. The core of this teamwork system is the teaching of teamwork behaviors and skills, developm ent of teamwork habits, and creation of small work teams, all of which are key teamwork concepts largely drawn from successful aviation programs. Argu ments for enculturating teamwork into ED practice are drawn from a retrospe ctive study of ED malpractice incidents. Fifty-four incidents (1985-1996), a sample of convenience drawn from 8 hospitals, were identified and judged mitigable or preventable by better teamwork. An average of 8.8 teamwork fai lures occurred per case. More than half of the deaths and permanent disabil ities that occurred were judged avoidable. Better teamwork could save nearl y $3.50 per ED patient visit. Caregivers must improve teamwork skills to re duce errors, improve care quality, and reduce litigation risks.