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In the United States, researchers looked recently at more than 20 years of research on specific techniques for building and training teams, which focuses on building appropriate knowledge, skills, and attitudes among potential team members in medical environments. This review produced an extensive collection of guidelines relating to the content and style of team training programs (Baker et al. 2005b; Volpe et al. 1996). In addition, a recent review of six medical team training programs concluded that crew resource management (CRM), a team training model from the aviation field, has many important lessons to offer healthcare professionals, a point also noted by the CHSRF-funded team (Baker et al. 2006; Oandasan et al. 2006). So far, a few jurisdictions have developed customized healthcare CRM programs for teams in operating rooms, obstetrics, intensive care and emergency care. However, the delivery of medical team training across the healthcare community is "generally haphazard" (Baker 2005b).

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It is difficult to imagine who could oppose implementing effective teamwork as a way to improve healthcare. Even casual observers would likely equate the healthcare sector with teams and teamwork, and cite the history of nursing as an example. However, in healthcare delivery, teams rarely exist that incorporate different professions and occupations, as well as patients and families.

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Effective Time Management essaysThe constructive use of time is beneficial in any aspect of life
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Outside of healthcare, research tells us that teams working together in high-risk and high-intensity work environments make fewer mistakes than do individuals. This includes empirical evidence from commercial aviation, the military, firefighting and rapid-response police activities. These studies show a strong relationship between qualities such as flexibility, adaptability, resistance to stress, cohesion, retention and morale with effective team performance (Baker et al. 2005a; Gully et al. 1995, 2002).

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This paper addresses the issue of effective teamwork, a critical element of a healthy workplace but so far not at the "tipping point" where workers or employers expect it. However, for people receiving health services, effective teamwork is already more than just highly desirable. It is a basic prerequisite they often assume to be in place. The task of health system managers, policy makers and clinicians is to find ways of implementing the desired conditions for workers while meeting the expectations of patients.

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However, when the CHSRF and its partners repeated the Listening for Direction process in 2004, a clear separation appeared between the and aspects of the issue, and concerns about teamwork were pervasive and prominent within both themes. Within the workforce aspect were concerns about the best ways to facilitate inter-professional teamwork and approaches, as well as the regulation of scope of practice and entry to practice. Within the workplace aspect was an interest in the role of occupational hierarchies, organizational structures and management practices and approaches and their effects on workplace productivity, stress, absenteeism and so on (Dault et al. 2004).

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