performance through coordination and receipt of feedback from other members Hierarchy is flattened; the common goal is more important than any individual’s contribution or performance Facilitating Teamwork There are three mechanisms that facilitate teamwork: shared mental models, closed-loop communication, and mutual trust Salas notes that teams which employ the five competencies of teamwork, while making sure to utilize the three coordinating mechanisms, should outperform those teams that not TABLE 4.1 ACHIEVING A SHARED MENTAL MODEL a Individual Group Environment Know the patient care plan Active listening Closed-loop communication Read back Verify Mutual performance monitoring Self-monitoring Brief (before) Debrief (after) Huddle (during) Documentation Hand-overs Call out Visual management tools Checklists Distraction control Technology aids Communication boards a Team members, patient and family are on the same page Shared Mental Models Structures must be put into place to support team work SBAR (S ituation, B ackground, A ssessment, R ecommendation) and I-PASS (Illness severity, P atient summary, A ction list, S ituational awareness and contingency plan, S ynthesis by receiver) are examples of structured communication tools to standardize hand-offs and reduce error Clinical standards can guide care for chief complaints, specific diseases, procedures, or care processes Communication boards can assure the patient/family understands the current care plan Table 4.1 lists some other strategies for team guidance