title: A systematic review of teamwork in the intensive care unit: what do we know about teamwork, team tasks, and improvement strategies?
abstract: OBJECTIVE
  Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research.
  
  
  METHODS
  A keyword search of the PubMed database was conducted in February 2013. Keyword combinations focused on 3 areas: (1) teamwork, (2) the ICU, and (3) training/quality improvement interventions. All studies that investigated teamwork, team tasks, or team interventions within the ICU (ie, intradepartment) were selected for inclusion.
  
  
  RESULTS
  Teamwork has been investigated across an array of research contexts and task types. The terminology used to describe team factors varied considerably across studies. The most common team tasks involved strategy and goal formulation. Team training and structured protocols were the most widely implemented quality improvement strategies.
  
  
  CONCLUSIONS
  Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work.
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dietz
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA; Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA.
authors.forename: Pedro Alejandro
authors.initials: PA
authors.lastname: Mendez-Tellez
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Wyskiel
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA; Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Marsteller
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA; Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Thompson
authors.affiliation: The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins University School of Medicine, Baltimore, MD USA; Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA. Electronic address: mrosen44@jhmi.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rosen
mesh_terms: D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units; D010348:Patient Care Team; D058996:Quality Improvement; D012449:Safety
keywords: Group processes; Intensive care unit; Patient safety; Teamwork