Teamwork & Communication

Introduction #

Healthcare delivery is inherently collaborative, requiring diverse teams across various stages of patient care, from emergency teams delivering immediate care to multidisciplinary tumor boards conferring on long-term cancer treatment [1]. The effectiveness of healthcare depends fundamentally on successful teamwork and communication among professionals [2]. Inaccurate or untimely communication and ineffective teamwork in healthcare are consistently reported as leading causes of preventable adverse events, including medication errors and misdiagnosis [3]. Communication, defined as the verbal and nonverbal processes by which information is clearly and accurately exchanged among team members, is an essential tool for reliable, safe, efficient, and patient-centered care [3].

The World Health Organization (WHO) recognized this critical need and in 2010 published a seminal framework for action on interprofessional education and collaborative practice, providing structure for healthcare education to engage learners from different disciplines [4]. This framework emphasized that when healthcare professionals work together effectively, patient outcomes improve, including reduced preventable adverse drug reactions, decreased morbidity and mortality rates, and optimized medication dosages [5,6].

Defining Teamwork in Healthcare #

A healthcare team consists of two or more individuals from different professional backgrounds who share common tasks or goals, have distributed expertise, have clearly defined roles and responsibilities, use shared resources, and communicate to coordinate their actions [2,7]. Teamwork encompasses how people interact to accomplish work and tasks together, involving complex processes of coordination, communication, and collaboration across disciplines with different training, professional norms, and specialized languages [8].

The complexity of healthcare teamwork is reflected in the diversity of team structures. Recent research has identified five distinct team types based on structure, membership, and function: structural teams (stable, ward-based), hybrid teams (mix of stable and rotating members), satellite teams (sub-units of larger teams), responsive teams (formed for specific events), and coordinating teams (overseeing patient flow) [2]. Each team type exhibits different teamwork behaviors, with structural teams demonstrating the most interprofessional collaboration through clear distributed leadership and frequent shared mental model development [2].

Core Components of Effective Teamwork #

Communication Quality Over Quantity

While communication is frequently cited as the most commonly reported factor influencing collaboration, recent evidence indicates that simply increasing communication volume does not rectify teamwork issues [9,10]. Meta-analytic evidence demonstrates that communication quality is more indicative of better team performance than quantity [10]. Effective communication requires four essential elements: clarity, accuracy, timeliness, and mutual understanding [10].

Communication challenges in healthcare manifest in multiple contexts. Care team member interactions contribute to specific clinical harms, with poor communication of medication information between physicians, pharmacists, nurses, and patients leading to medication errors [11]. Transitions of care represent particularly high-risk interactions where critical information about patient status and care plans can be miscommunicated, leading to treatment delays or inappropriate therapies [11,12]. These transitions are associated with approximately 28% of surgical adverse events [11].

Interprofessional Collaboration

Interprofessional collaboration (IPC) is defined by the WHO as “multiple health workers from different professional backgrounds working together with patients, families, caregivers, and communities to deliver the highest quality of care” [13]. Effective IPC leads to improved patient outcomes including enhanced access to healthcare interventions, improved coordination between sectors, improved patient safety and quality of care (particularly for complex cases and chronic diseases), more equitable care for marginalized populations, and increased job satisfaction among healthcare professionals [13,14].

Research demonstrates that IPC improves patient satisfaction, reduces mechanical complications for hospitalized patients, reduces mortality in heart failure, and positively impacts numerous clinical outcomes in critical care settings [15]. However, successful implementation faces barriers including fragmented healthcare systems, lack of standardized reporting formats, limited communication between professionals, delayed flow of relevant information, and reports tailored to insurance remuneration rather than patient or provider needs [14,16].

Core competencies for interprofessional collaborative practice, as outlined in the 2023 IPEC Core Competencies Version 3 and the 2024 CIHC Competency Framework, include: (1) roles and responsibilities understanding, (2) interprofessional communication skills, (3) values for interprofessional practice including respect and trust, and (4) teams and teamwork knowledge [17,18]. The Canadian framework notably emphasizes the importance of being mindful of diversity including culture, ethnicity, race, gender, sexual orientation, ability, and socioeconomic positions when working in interprofessional teams [18].

Shared Mental Models

Shared mental models (SMMs) represent individually held knowledge structures that help team members function collaboratively in their environments [19]. An SMM refers to a team’s common understanding of their task, interpretation of their environment, and required collaboration [20]. These mental models are comprised of four key attributes: content (what the team knows), similarity (degree of overlap among members), accuracy (correctness of the model), and dynamics (ability to adapt over time) [19].

Research demonstrates that SMMs facilitate coordination and improve team performance in healthcare settings [21,22]. Teams with higher frequency of behavioral markers indicating shared mental models display superior medical management outcomes beyond what is explained by general teamwork skills alone [22]. The development of SMMs requires clear communication, information sharing, speaking up behaviors, and opportunities for team members to interact and align their understanding [2,21].

In healthcare specifically, SMMs help teams navigate the complexity of: (1) interdisciplinary contexts requiring coordination across different professional norms and languages, (2) asynchronous care across boundaries over prolonged time periods, and (3) rapidly changing team membership in episodic performances [8]. Successful SMMs meet three criteria: accurate reflection of current reality, agreement among team members about goals and achievement methods, and description of how the group will work together [20].

Psychological Safety

Psychological safety is defined as “a shared belief held by members of a team that the team is safe for interpersonal risk taking” [23] and at the individual level as “a sense of being able to show and employ oneself without fear of negative consequences to self-image, status or career” [24]. In healthcare contexts, psychological safety encompasses five key attributes: (1) perceptions of consequences of taking interpersonal risks, (2) strong interpersonal relationships including trust and respect, (3) group-level phenomenon, (4) safe work environment for taking interpersonal risks, and (5) non-punitive culture [25].

Evidence demonstrates that psychological safety positively impacts patient safety, interprofessional collaboration, engagement in quality improvement work, learning from failures, and reporting of adverse events [25,26]. Healthcare workers who feel psychologically safe are more likely to report potentially harmful near-miss events compared to those who do not feel safe [24]. Additionally, psychological safety is positively associated with inclusive team leader behavior (encouraging input, providing rationale for decisions, admitting uncertainty) and negatively associated with job strain [24].

Creating psychological safety requires leadership engagement, structured curriculum design, and feedback loops to ensure continuous improvement [27]. Interventions focusing on psychological safety and communication training have shown significant benefits, with one study reporting a 93% perception of sustainable changes, most notably in communication (46-63% of respondents), teamwork (35-57%), and use of cognitive aids (20-57%) [27]. Furthermore, training programs emphasizing psychological safety have demonstrated reductions in patient safety incident scores and improvements in non-technical skills [27].

Standardized Communication Tools #

SBAR Framework

The Situation, Background, Assessment, Recommendation (SBAR) communication tool is recognized by The Joint Commission, Agency for Healthcare Research and Quality (AHRQ), Institute for Healthcare Improvement (IHI), and WHO as an effective framework for patient handoffs [28]. Originally developed by the US Navy and adopted for healthcare, SBAR provides a structured approach to communication that takes minimal time, delivers comprehensive information efficiently, encourages interprofessional collaboration, and limits error probability [29].

Research demonstrates that SBAR implementation significantly improves communication quality and patient safety, reduces handover-related errors, and promotes teamwork among nursing staff [30,31]. Studies show reductions in preventable adverse events from 13.5% to 8.83% following SBAR-focused communication training [3]. Training programs on SBAR have resulted in knowledge improvements from 4.8% to 92.8% adequate knowledge levels (p < 0.001), 100% adequate practice scores, and significant improvements in staff perception of handoff communication (p < 0.001) [31].

The structured nature of SBAR contributes to decreased sentinel events linked to miscommunication and enhances nurses’ confidence and satisfaction with the handoff process [30]. However, systematic reviews indicate heterogeneity in implementation and outcomes, with some studies lacking assessments of objective patient safety outcomes like adverse events or medical errors [29]. Challenges include perceptions among some staff that SBAR is time-consuming, though the majority complete the tool and recognize its positive contributions to handoff quality [32].

TeamSTEPPS

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based framework for communication and teamwork training in healthcare, released by AHRQ in 2006 and updated to version 3.0 in 2023 [33]. The framework includes structured tools for communication including briefings, huddles, debriefings, and the callout technique, all designed to enhance team communication and coordination [33].

Evidence demonstrates that TeamSTEPPS training is associated with error rate reduction and increases in teamwork and communication [34]. Studies report a 13% increase in positive staff perceptions of teamwork and 20% increase in positive perceptions of communication one month after implementation [33]. During the COVID-19 pandemic, focus groups evaluating TeamSTEPPS found it promoted teamwork through shared mental models, provided clarity in roles within healthcare teams, and increased feelings of value, respect, and empathy among team members [33].

The 2023 TeamSTEPPS 3.0 updates reflect recognition of the importance of patients and family caregivers as central members of healthcare teams and adaptation to increasingly virtual care delivery spanning multiple care settings [33]. The framework now includes additional virtual resources focusing on patient and family engagement, acknowledging the evolving healthcare landscape and technological advances including telemedicine [33].

Leadership in Healthcare Teams #

Leadership plays a critical role in fostering effective teamwork and communication. Healthcare leadership involves not maintaining the status quo but actively identifying challenges in the system and finding solutions [35]. Effective leaders facilitate communication, boost productivity, put others first, and are essential to quality patient care where rapid response to arising issues requires communication and efficiency [35].

Research identifies several factors that improve teamwork including leadership, mutual performance monitoring, adaptability, ability to support team members, orientation to the team, psychological safety, mutual trust, improved communication, and use of shared mental models [7]. Leadership behaviors particularly important for fostering psychological safety include encouraging input from team members, providing rationale for key decisions, admitting when uncertainty exists, and creating an environment where staff can communicate freely without fear or inhibition [24,27].

The Team FIRST framework identifies 10 essential teamwork competencies critical for healthcare providers: (1) anticipate and plan ahead, (2) set priorities dynamically, (3) call for help early, (4) exercise leadership and followership, (5) communicate effectively, and (6) re-evaluate repeatedly [1,36]. Collective leadership, where leadership responsibilities are distributed among multiple team members rather than relying exclusively on one individual, has been recognized as one of six core competency domains for interprofessional education [5].

Training and Education Interventions #

Interprofessional Education

Interprofessional education (IPE) involves occasions when members of two or more professions learn with, from, and about each other to improve collaboration and quality of care [37]. IPE is essential in healthcare to enhance collaboration, communication, and teamwork among health professions education students [17]. Studies indicate that IPE implemented earlier in healthcare curricula positively influences students’ perceptions of teamwork, with increased exposure to other disciplines facilitating awareness and appreciation for interprofessional roles [5,17].

Systematic reviews examining IPE interventions for patient safety demonstrate that such programs improve teamwork and communication competencies [37,38]. However, effectiveness varies, with some studies lacking assessments of objective outcomes such as adverse events or medical errors [38]. Areas for improvement in future research include facilitating simulation-based IPE interventions, increasing observation of objective patient safety outcomes, and selecting appropriate tools to assess teamwork performance [38].

Evidence demonstrates that IPE enhances collaboration skills, awareness of roles and responsibilities, mutual understanding, and empathy among healthcare students [17,39]. The impact extends beyond educational settings, with team-based care models demonstrating improvements in patient satisfaction, reductions in costs, decreases in mechanical complications, and mortality reductions in specific patient populations [15].

Simulation-Based Team Training

Simulation-based team training (SBTT) provides healthcare professionals with controlled, safe environments to enhance teamwork and communication skills [40,41]. SBTT seeks to advance non-technical teamwork skills underlying effective team communication, cooperation, and coordination such as closed-loop communication, situational awareness, backup behaviors, and shared mental models [42].

Evidence demonstrates that SBTT is effective in improving team performance, reducing errors, and enhancing patient safety [40,43]. A study of pediatric intensive care unit staff showed statistically significant improvements in team performance following interdisciplinary SBTT (p < 0.0001), with regression analysis confirming immediate learning of optimal team performance behaviors [43]. Simulation training conducted in 2018-2023 at National Cheng Kung University Hospital improved teamwork, communication, and collaboration among emergency department and intensive care unit professionals [44].

Recent research reveals an additional benefit of SBTT: potential protective effects on employee wellbeing [45]. A cohort study across multiple hospital sites in Denmark (2015-2020) involving 14,872 clinicians found associations between participation in 210 simulation sessions and reduced sick leave rates [45]. This finding suggests that improved team dynamics and communication skills gained through simulation training may buffer against work-related stress contributing to sick leave [45].

Guidelines from the 2023 Society for Simulation in Healthcare Research Summit emphasize evidence-based approaches to simulation training, including proper scenario design, structured debriefing, psychological safety during training, and assessment of both technical and non-technical skills [46]. Implementation considerations include establishing clear learning objectives, ensuring facilitator training in debriefing techniques, incorporating crisis resource management principles, and using validated assessment tools [42,43].

Impact on Patient Safety and Outcomes #

The relationship between teamwork, communication, and patient safety is well-established in the literature. Communication failures are consistently identified as root causes in more than 60-70% of sentinel events reviewed by The Joint Commission [12,29]. Specific patient safety impacts include:

Medical Errors: Poor communication and teamwork are estimated to contribute to 80% of serious medical errors worldwide [47]. Hierarchy between professional roles and occupational tenure can inhibit assertive communication necessary for effective error recovery, such as when evidence-based treatment protocols are violated [11].

Adverse Events: Teamwork and communication failures lead to preventable adverse events across healthcare settings [3,11]. Care transitions represent particularly vulnerable periods associated with increased safety risks including medication errors, misdiagnosis, and treatment delays [3].

Quality Improvement: Psychological safety and effective teamwork facilitate engagement in quality improvement work, learning from failures, and reporting of adverse events [25,26]. Healthcare workers in psychologically safe environments demonstrate greater willingness to discuss errors, share knowledge and information, and provide constructive feedback [24].

Patient Outcomes: Effective interprofessional collaboration leads to improved patient outcomes including reduced morbidity and mortality rates, optimized medication management, improved care coordination, enhanced patient satisfaction, and better management of complex cases and chronic diseases [5,6,13].

Organizational Benefits: Strong teamwork and communication contribute to increased job satisfaction, reduced work stress and burnout, decreased turnover, improved workplace culture, and enhanced organizational commitment [13,24,45].

Barriers to Effective Teamwork and Communication #

Despite recognized benefits, several barriers impede effective teamwork and communication in healthcare:

Structural and Organizational Barriers: These include fragmented healthcare systems limiting interprofessional collaboration, physical geography of hospitals with dispersed teams, lack of standardized processes and reporting formats, inadequate time and resources for team coordination, organizational policies prioritizing individual performance over team outcomes, and insufficient support for interprofessional practice [2,7,14,16].

Professional and Cultural Barriers: Hierarchical structures and power imbalances, differences in professional training and communication styles, lack of interprofessional role understanding, professional silos and in-group/out-group dynamics, limited interprofessional education in curricula, and belief that quality care results solely from individual training and effort [7,21,47].

Communication-Specific Barriers: These encompass inadequate handoff processes, information systems not supporting information sharing, language barriers in multilingual settings, cognitive overload and effects of stress and fatigue, imperfect information processing and flawed decision-making, and fear of speaking up in non-psychologically safe environments [14,21,24,47].

System and Resource Barriers: Limited access to standardized communication tools, insufficient training in teamwork and communication skills, lack of time for team meetings and coordination, competing priorities and high workload, and financial constraints limiting interprofessional initiatives [14,21,47].

Strategies for Improvement #

Organizational Level

Healthcare organizations can enhance teamwork and communication through: implementing evidence-based frameworks like TeamSTEPPS, establishing standardized communication protocols such as SBAR, creating dedicated time and space for interprofessional collaboration, developing clear policies supporting psychological safety, providing resources for ongoing training and education, measuring and monitoring teamwork and safety culture, implementing comprehensive unit-based safety programs (CUSP), and recognizing and rewarding effective teamwork behaviors [3,24,33,47].

Educational Level

Educational institutions should focus on: integrating interprofessional education throughout curricula, implementing simulation-based team training early in training, teaching standardized communication frameworks, developing competencies in psychological safety and speaking up, providing opportunities for interprofessional clinical experiences, training in shared mental model development, educating about various professional roles and responsibilities, and assessing both technical and non-technical skills [17,37,38,40].

Individual Level

Healthcare professionals can improve through: participating actively in team training opportunities, practicing standardized communication techniques, developing situational awareness and anticipation skills, speaking up about safety concerns, building trust and respect with team members, seeking feedback on communication and teamwork, mentoring others in effective teamwork practices, and committing to continuous learning and improvement [10,34,42].

Future Directions #

Several areas warrant attention in future research and practice:

Technology Integration: The growing role of technology in healthcare presents opportunities for research into how artificial intelligence, electronic health records, and digital communication platforms support interprofessional communication and distributed cognition across professionals, patients, families, and caregivers [3,13]. Design characteristics that enhance psychological safety and effective communication in virtual teams require further investigation [33].

Patient and Family Engagement: Although the importance of patient engagement is clear, further research is needed on how to better engage patients and families from disadvantaged populations in care transitions and as active members of healthcare teams [3,13]. The 2023 World Patient Safety Day theme emphasized “Engaging patients for patient safety,” recognizing the crucial role patients, families, and caregivers play [48].

Measurement and Assessment: Development and validation of tools to measure teamwork quality, psychological safety, and communication effectiveness remains an ongoing need [2,38]. Research should focus on objective patient outcomes rather than relying solely on self-reported measures or process outcomes [29,38].

Implementation Science: More research is needed on successful strategies for implementing and sustaining teamwork interventions across diverse healthcare settings [6,14]. Understanding contextual factors that facilitate or impede implementation, as well as cost-effectiveness analyses of teamwork training programs, will support broader adoption [40,45].

Equity and Inclusion: Future work must address how teamwork and communication practices can be adapted to promote equity for marginalized populations and ensure all team members, regardless of rank, seniority, or demographic characteristics, feel empowered to contribute [18,24].

Conclusion #

Effective teamwork and communication are fundamental to delivering safe, high-quality healthcare. The evidence demonstrates clear links between these elements and improved patient outcomes, reduced medical errors, enhanced healthcare professional satisfaction, and stronger organizational performance. Structured frameworks like SBAR and TeamSTEPPS, combined with educational interventions including interprofessional education and simulation-based training, provide practical approaches to building teamwork competencies.

Success requires multilevel commitment spanning organizational leadership, educational institutions, and individual professionals. Creating psychologically safe environments where all team members can speak up without fear, developing shared mental models that align team understanding, and fostering true interprofessional collaboration remain essential priorities. As healthcare systems continue to evolve with advancing technology and changing care delivery models, maintaining focus on the human elements of teamwork and communication will be critical to achieving the goal of safe, effective, and equitable patient care.

References #

1. Kämmer JE, Boos M, Seelandt JC. Editorial: Promoting teamwork in healthcare. Front Psychol. 2024;15:1422543. https://doi.org/10.3389/fpsyg.2024.1422543
2. Sanford N, Lavelle M, Moore A. Decoding healthcare teamwork: a typology of hospital teams. J Interprof Care. 2024;38(4):602-611. https://doi.org/10.1080/13561820.2024.2343835
3. Gurses AP, Sousane Z, Mossburg S. Communication During Transitions of Care. PSNet. 2024. https://psnet.ahrq.gov/perspective/communication-during-transitions-care
4. World Health Organization. Framework for Action on Interprofessional Education and Collaborative Practice. Geneva: WHO; 2010. https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice
5. Bosch B, Mansell H. Interprofessional collaboration in health care: Lessons to be learned from competitive sports. Can Pharm J. 2015;148(4):176-179. https://doi.org/10.1177/1715163515588106
6. Campbell KA, Aarons GA, Byrne KA, et al. Teamwork and implementation of innovations in healthcare and human service settings: a systematic review. Implement Sci. 2024;19:47. https://doi.org/10.1186/s13012-024-01381-9
7. Weller J, Boyd M, Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J. 2014;90(1061):149-154. https://doi.org/10.1136/postgradmedj-2012-131168
8. Hughes AM, Gregory ME, Joseph DL, et al. Saving lives: a meta-analysis of team training in healthcare. J Appl Psychol. 2016;101(9):1266-1304. https://doi.org/10.1037/apl0000120
9. Fernández Castillo G, Khalid M, Chamberlain A, et al. Beyond communication: an update on transforming healthcare teams. Front Med. 2024;11:1282173. https://doi.org/10.3389/fmed.2024.1282173
10. Bollen A, Euwema M, Munniksma A. Conflict and health: a systematic review of the literature and potential pathways. Int J Conflict Manag. 2019;30(1):49-68. https://doi.org/10.1108/IJCMA-06-2018-0076
11. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6):614-621. https://doi.org/10.1067/msy.2003.169
12. Müller M, Jürgens J, Redaèlli M, et al. Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open. 2018;8(8):e022202. https://doi.org/10.1136/bmjopen-2018-022202
13. World Health Professions Alliance. Interprofessional Collaborative Practice. 2024. https://www.whpa.org/activities/interprofessional-collaborative-practice
14. Berger-Estilita J, Fuchs A, Hahn M, et al. Interprofessional Collaboration in Complex Patient Care Transition: A Qualitative Multi-Perspective Analysis. Healthcare. 2023;11(3):359. https://doi.org/10.3390/healthcare11030359
15. Cadet TJ, Cusimano J, McKearney S, Honaker JA. Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review. J Interprof Care. 2024;38(3):476-485. https://doi.org/10.1080/13561820.2023.2283119
16. Lian SC, Leo YS, Ng GH, Seow E. Healthcare professionals’ experiences of interprofessional collaboration in patient education: A systematic review. Nurse Educ Today. 2023;128:105864. https://doi.org/10.1016/j.nedt.2023.105864
17. Shuyi AT, Zikki LYT, Mei Qi A, et al. A scoping review of interprofessional education in healthcare: evaluating competency development, educational outcomes and challenges. BMC Med Educ. 2025;25:130. https://doi.org/10.1186/s12909-025-06969-3
18. Canadian Interprofessional Health Collaborative. CIHC Competency Framework for Advancing Collaboration 2024. 2024. https://cihc-cpis.com/wp-content/uploads/2024/06/CIHC-Competency-Framework.pdf
19. McComb SA, Simpson V. The concept of shared mental models in healthcare collaboration. J Adv Nurs. 2014;70(7):1479-1488. https://doi.org/10.1111/jan.12307
20. Larson L, DeChurch LA. Leading teams in the digital age: four perspectives on technology and what they mean for leading teams. Leadersh Q. 2020;31(1):101377. https://doi.org/10.1016/j.leaqua.2019.101377
21. Im J, Evans JM, Grudniewicz A, et al. On the same page? A qualitative study of shared mental models in an interprofessional, inter-organizational team implementing goal-oriented care. J Interprof Care. 2023;37(4):586-595. https://doi.org/10.1080/13561820.2022.2113048
22. Hjälmhult E, Haaland GUH, Litland AS, Holte HH. Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design. Scand J Trauma Resusc Emerg Med. 2010;18:47. https://doi.org/10.1186/1757-7241-18-47
23. Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350-383. https://doi.org/10.2307/2666999
24. Kingston MB, Dowell P, Mossburg SE, et al. Annual Perspective: Psychological Safety of Healthcare Staff. PSNet. 2022. https://psnet.ahrq.gov/perspective/annual-perspective-psychological-safety-healthcare-staff
25. Noda S, Kamakura Y. A concept analysis of psychological safety: Further understanding for application to health care. J Adv Nurs. 2022;78(4):939-950. https://doi.org/10.1111/jan.15064
26. Grailey KE, Murray E, Reader T, Brett SJ. The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis. BMC Health Serv Res. 2021;21:773. https://doi.org/10.1186/s12913-021-06740-6
27. Evain JN, Zoric L, Mattatia L, et al. Changing minds, saving lives: how training psychological safety transforms healthcare. BMJ Simul Technol Enhanc Learn. 2025;11:e001242. https://doi.org/10.1136/bmjstel-2024-001242
28. Shahid S, Thomas S. Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. Saf Health. 2018;4:7. https://doi.org/10.1186/s40886-018-0073-1
29. Müller M, Jürgens J, Redaèlli M, et al. Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open. 2018;8(8):e022202. https://doi.org/10.1136/bmjopen-2018-022202
30. Wiyadi, Dwiantoro L, Suryawati C. The Effective Communication using SBAR (Situation, Background, Assessment, Recommendation) of Patient Handover in Inpatient Installation. 2025. https://doi.org/10.13140/RG.2.2.27456.32000
31. Ghonem NM, El-Husany WA. SBAR Shift Report Training Program and its Effect on Nurses’ Knowledge and Practice and Their Perception of Shift Handoff Communication. SAGE Open Nurs. 2023;9:23779608231159340. https://doi.org/10.1177/23779608231159340
32. Pazar B, Kavakli O, Ak EN, Erten EE. Implementation and Evaluation of the SBAR Communication Model in Nursing Handover by Pediatric Surgery Nurses. J Perianesth Nurs. 2024;39(5):847-852. https://doi.org/10.1016/j.jopan.2023.12.021
33. Mossburg S, Haugstetter M. Revising TeamSTEPPS: The Evolution of Patient Safety Teamwork Training. PSNet. 2024. https://psnet.ahrq.gov/perspective/revising-teamstepps-evolution-patient-safety-teamwork-training
34. Dietl A, Derksen C, Keller S, Lippke S. Interdisciplinary and interprofessional communication intervention: How psychological safety fosters communication and increases patient safety. Front Psychol. 2023;14:1028048. https://doi.org/10.3389/fpsyg.2023.1028048
35. Northeastern University. Healthcare Leadership: What Is It and Why Is It Important? 2024. https://graduate.northeastern.edu/knowledge-hub/what-is-healthcare-leadership/
36. Greilich PE, Kilcullen M, Paquette S, et al. Team FIRST framework: identifying core teamwork competencies critical to interprofessional healthcare curricula. J Clin Transl Sci. 2023;7:e106. https://doi.org/10.1017/cts.2023.27
37. Spaulding EM, Marvel FA, Jacob E, et al. Interprofessional education and collaboration among healthcare students and professionals: a systematic review and call for action. J Interprof Care. 2021;35(4):612-621. https://doi.org/10.1080/13561820.2019.1697214
38. Jiang Y, Cai Y, Zhang X, Wang C. Interprofessional education interventions for healthcare professionals to improve patient safety: a scoping review. Med Educ Online. 2024;29(1):2391631. https://doi.org/10.1080/10872981.2024.2391631
39. Sezgin MG, Bektas H. Effectiveness of interprofessional simulation-based education programs to improve teamwork and communication for students in the healthcare profession: a systematic review and meta-analysis of randomized controlled trials. Nurse Educ Today. 2023;120:105619. https://doi.org/10.1016/j.nedt.2022.105619
40. Eiriksson HA, Tómasdóttir LB, Kvaran RB, et al. Simulation-based team training for healthcare professionals in pediatric departments: study protocol for a nonrandomized controlled trial. BMC Med Educ. 2024;24:607. https://doi.org/10.1186/s12909-024-05602-z
41. Picard J, Evain JN, Douron C, et al. Impact of a large interprofessional simulation-based training course on communication, teamwork, and safety culture in the operating theatre: A mixed-methods interventional study. Anaesth Crit Care Pain Med. 2022;41(1):100991. https://doi.org/10.1016/j.accpm.2021.100991
42. Weaver SJ, Salas E, Lyons R, et al. Simulation-based team training at the sharp end: A qualitative study of simulation-based team training design, implementation, and evaluation in healthcare. J Emerg Trauma Shock. 2010;3(4):369-377. https://doi.org/10.4103/0974-2700.70758
43. Colman N, Doughty CB, Long G, et al. Simulation-Based Team Training Improves Team Performance among Pediatric Intensive Care Unit Staff. J Pediatr Intensive Care. 2019;8(3):129-135. https://doi.org/10.1055/s-0039-1683967
44. Sung TC, Hsu HC. Improving critical care teamwork: simulation-based interprofessional training at a Taiwanese hospital 2018-2023. J Multidiscip Healthc. 2025;18:221-234. https://doi.org/10.2147/JMDH.S490901
45. Schram A, Jensen HI, Gamborg M, et al. Exploring the relationship between simulation-based team training and sick leave among healthcare professionals: a cohort study across multiple hospital sites. BMJ Open. 2023;13(10):e076163. https://doi.org/10.1136/bmjopen-2023-076163
46. McGaghie WC, Barsuk JH, Cohen ER, et al. Healthcare Simulation Training Guidelines and Literature Reviews From the Third Society for Simulation in Healthcare Research Summit. Simul Healthc. 2024;19(1S):S1-S3. https://doi.org/10.1097/SIH.0000000000000774
47. Mistri N, Patel D, Doshi R. Enhancing Patient Safety Culture in Hospitals. Cureus. 2023;15(12):e51159. https://doi.org/10.7759/cureus.51159
48. Kumar S. Psychological Safety: What It Is, Why Teams Need It, and How to Make It Flourish. Chest. 2024;165(4):942-949. https://doi.org/10.1016/j.chest.2023.11.016