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The Seven C’s of Teamwork By Eduardo Salas, PhD

At the 10th annual Midwest Interprofessional Education and Practice Conference (MIPERC) in Grand Rapids, MI. the focus of the conference was to highlight the need for clinicians to understand each other’s areas of expertise and work together effectively to achieve optimal patient outcomes. One of the keynote speakers at this year’s conference was Dr. Eduardo Salas, a psychology graduate and professor at Rice University in Houston, Texas.

Dr. Salas focuses on teamwork and has more than 450 publications on this topic, as well as several books. It is highly sought after to aid in team development by a wide variety of industries. NASA is using its experience to help identify the psychological skills and strengths of its Mars team. As he recounted at the conference, this will be a team of five to seven astronauts who will live in a very close environment for about 30 months. Not only will they live in tight spaces, but they will have limited communication with Earth once they are on Mars due to the time it takes for a message to travel between the two.

Dr. Salas also works with the Houston oil and refining industries to help develop processes and teamwork so workers can be evacuated from oil rigs when hurricanes approach. Work with hospitals to improve teamwork.

Dr. Salas is able to gain buy-in from CEOs and organizational leaders because all of his work is evidence-based and cost-effective. CFOs are often asked what the return is for organizations that follow their advice. You can show that the groups you work with reduce costs by 20-25% by building effective teams. With physicians, it has significantly reduced mortality in hospital settings while improving outcomes.

Dr. Salas says there are 7 key C’s for teams to be successful. They are Cooperation, Coordination, Communication, Cognition, Coaching, Conflict and Conditions.

Cooperation it is based on the attitudes and beliefs of individual team members and is shared by the entire team. Team members focus on success as a team and work effectively together. There is a high level of trust. This trust gives rise to psychological safety, a key ingredient of any effective team.

Coordination it’s the team members checking in with each other to help each other do their best. Team members are very aware and knowledgeable of each other’s role and each is ready to help another member if help is needed. Good teams work so well together that if a mistake is made, members work collectively to overcome it without hesitation.

Communication saying what needs to be said at the right time. Some think that communication is the key to good teamwork but Dr. Salas says that this is not as important as other C’s. He once watched a surgery where hardly a word was spoken and the result was remarkable. Since each member of the team knew his or her own role very well and understood the role of the other members of the surgical team, there was no need for much communication. The surgical process flowed smoothly with only an occasional intervention from a member of the team.

Cognition it is mastery and skill in the role of the team itself. That is, each team member is highly competent to complete their own task for the process the team is involved in. The team member is not only an expert in his or her own work, but is also very knowledgeable about team norms, team resources, and the mission.

Training it is the role of a team leader(s) and leadership at the site where the team works. Good coaches work with team members to build efficiency and cohesion. They encourage each member of the team and work hard to build trust between team members, to increase the psychological safety of each member.

conflict it is the successful resolution of tensions that can arise in any team. Instead of avoiding tension, a team leader addresses it and helps reach a resolution so the team can continue to work together effectively. Good team leaders overcome any defensiveness among members that may arise from conflict and ensure that psychological safety is strengthened.

Terms it is the environment is the one that the team exists. A positive attitude toward teams on the part of a site’s leadership fosters the ongoing development of effective teams. Leadership provides support by providing the necessary resources for teams to thrive and achieve their goals.

This is just a quick overview of the basics of Dr. Salas’ work. Teamwork can be taught and learned. To further study his work and his recommendations for team building, you can access many of his articles for free here.

I recently participated in a group that met to develop a survey instrument to assess the success of our group’s work in educating students with special needs. There were four of us present, one of whom was the project leader, with whom I have worked for many years and who I see as one of the most effective leaders I have ever met. We both knew that the others were working for this project. I have visited instructional sites where two of our team members have worked with these students. Before starting the task of the day, I left the group with the objectives:

1. Meet the needs of students’ full-time teachers.

2. Measure the key elements of what our group teaches

3. Develop questions that are capable of detecting student growth

4. Meet the requirements of project funders

The team agreed to these goals and the work went smoothly, although we did not always agree during the development process. Because we had so much respect for each other and because of effective leadership, we created two instruments that we believe will be effective. Our work as a group reflected the guidelines of Dr. Salas.

Through my years of attending MIPERC conferences, I see how important teamwork is to achieving any worthwhile goal in healthcare and business in general. As Dr. Salas demonstrated, much better results are achieved when teams work effectively together. I think your 7 C’s provide good ideas for working well together. These benchmarks along with the AMA STEPS ahead the module on team culture will help practice sites achieve their goals

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