title: Review article: Effectiveness of patient care teams and the role of clinical expertise and coordination: a literature review.
abstract: Health care is increasingly provided by teams of health professionals rather than by individual doctors. For decision makers, it is imperative to identify the critical elements for effective teams to transform health care workplaces into effective team-based environments. The authors reviewed the research literature published between 1990 and February 2008. The available research indicated that teams with enhanced clinical expertise improved professional performance and had mixed effects on patient outcomes. Teams with improved coordination had some positive effects on patient outcomes and limited effects on costs and resource utilization. The combination of enhanced expertise and coordination only showed some limited effect on patient outcomes. The authors conclude that enhancement of the clinical expertise is a potentially effective component of improving the impact of patient care teams. The added value of coordination functions remained unclear. Overall, current studies provide little insight into the underlying mechanisms of teamwork.
authors.affiliation: Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marije
authors.initials: M
authors.lastname: Bosch
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: Faber
authors.forename: Juliette
authors.initials: J
authors.lastname: Cruijsberg
authors.forename: Gerlienke E
authors.initials: GE
authors.lastname: Voerman
authors.forename: Sheila
authors.initials: S
authors.lastname: Leatherman
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: Marlies
authors.initials: M
authors.lastname: Hulscher
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D002983:Clinical Competence; D003299:Cooperative Behavior; D017598:Efficiency, Organizational; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care