title: Teamwork in skull base surgery: An avenue for improvement in patient care.
abstract: BACKGROUND
  During the past several decades, numerous centers have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, but they are also related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges.
  
  
  METHODS
  Pubmed and Medline databases were searched for publications from 1970 to 2012 using the following keywords: "teamwork", "multidisciplinary", "interdisciplinary", "surgery", "skull base", "neurosurgery", "tumor", and "outcome".
  
  
  RESULTS
  Current literature testifies to the complexity of establishing and maintaining teamwork. To date, few reports on the impact of teamwork in the management of skull base pathologies have been published. This lack of literature is somewhat surprising given that most patients with skull base pathology receive care from multiple specialists. Common factors for success include a cohesive and well-integrated team structure with well-defined procedural organization. Although a multidisciplinary work force has clear advantages for improving today's quality of care and propelling research efforts for tomorrow's cure, teamwork is not intuitive and requires training, guidance, and executive support.
  
  
  CONCLUSIONS
  Teamwork is recommended to improve quality over the full cycle of care and consequently patient outcomes. Increased recognition of the value of an integrated team approach for skull base pathologies will hopefully encourage centers, physicians, allied health caregivers, and scientists devoted to treating these patients and advancing the field of knowledge to invest the time, effort, and resources to optimize and organize their collective expertise.
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 6236, Los Angeles, CA, 90095-7436, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: McLaughlin
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kelly
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Prevedello
authors.forename: Amin B
authors.initials: AB
authors.lastname: Kassam
keywords: Multidisciplinary; neurosurgery; outcome; skull base; teamwork