How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis

Jan B Schmutz; Laurenz L Meier; Tanja Manser

doi:10.1136/bmjopen-2018-028280

How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis

BMJ Open. 2019 Sep 12;9(9):e028280. doi: 10.1136/bmjopen-2018-028280.

Authors

Jan B Schmutz¹, Laurenz L Meier², Tanja Manser³

Affiliations

¹ Department of Communication Studies, Northwestern University, Evanston, Illinois, USA jan.schmutz@northwestern.edu.
² Department of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
³ FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland.

Abstract

Objectives: To investigate the relationship between teamwork and clinical performance and potential moderating variables of this relationship.

Design: Systematic review and meta-analysis.

Data source: PubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email.

Eligibility criteria: Studies were included if they reported a relationship between a teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting.

Data extraction and synthesis: Moderator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: The review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation was r=0.28 (corresponding to an OR of 2.8), indicating that teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of teamwork on performance.

Conclusion: Teamwork has a medium-sized effect on performance. The analysis of moderators illustrated that teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of teamwork and emphasise approaches that maintain and improve teamwork for the benefit of their patients.

Keywords: communication; meta-analysis; non-technical skills; teams; teamwork.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Checklist
Clinical Competence*
Cooperative Behavior*
Humans
Models, Theoretical*
Patient Care Team*