RT Journal
A1 Pronovost PJ, Freischlag JA
T1 IMproving teamwork to reduce surgical mortality
JF JAMA
JO JAMA
YR 2010
FD October 20
VO 304
IS 15
SP 1721
OP 1722
DO 10.1001/jama.2010.1542
UL http://dx.doi.org/10.1001/jama.2010.1542
AB 
Operating rooms are among the most complex political, social, and cultural structures that exist, full of ritual, drama, hierarchy, and too often conflict. For instance, in a surgical morbidity and mortality conference in which a roomful of surgeons were reviewing the delayed transport of a trauma patient from the emergency department to the operating room, the senior surgeon asked a junior surgeon what he would do differently next time. He replied, “I’m going to push harder, I’m going to transport them to the operating room faster.”1 This response highlights what is so great but also so myopic about medicine. Physicians strongly advocate for patients, believing they alone are responsible for patient outcomes. Yet pushing harder is an ineffective intervention and may result in conflict rather than better patient outcomes. Health care, and especially surgical care, is too often viewed as primarily a solo activity rather than as a team function.