title: How familiar are clinician teammates in the emergency department?
abstract: OBJECTIVE
  Lack of familiarity between teammates is linked to worsened safety in high risk settings. The emergency department (ED) is a high risk healthcare setting where unfamiliar teams are created by diversity in clinician shift schedules and flexibility in clinician movement across the department. We sought to characterise familiarity between clinician teammates in one urban teaching hospital ED over a 22 week study period.
  
  
  METHODS
  We used a retrospective study design of shift scheduling data to calculate the mean weekly hours of familiarity between teammates at the dyadic level, and the proportion of clinicians with a minimum of 2, 5, 10 and 20 h of familiarity at any given hour during the study period.
  
  
  RESULTS
  Mean weekly hours of familiarity between ED clinician dyads was 2 h (SD 1.5). At any given hour over the study period, the proportions of clinicians with a minimum of 2, 5, 10 and 20 h of familiarity were 80%, 51%, 27% and 0.8%, respectively.
  
  
  CONCLUSIONS
  In our study, few clinicians could be described as having a high level of familiarity with teammates. The limited familiarity between ED clinicians identified in this study may be a natural feature of ED care delivery in academic settings. We provide a template for measurement of ED team familiarity.
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Patterson
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Pfeiffer
authors.affiliation: Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Judith R
authors.initials: JR
authors.lastname: Lave
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Weaver
authors.affiliation: Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Kaleab
authors.initials: K
authors.lastname: Abebe
authors.affiliation: David A Tepper School of Business, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
authors.forename: David
authors.initials: D
authors.lastname: Krackhardt
authors.affiliation: Division of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Yealy
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies
keywords: emergency department management