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Commentary
Emerging Classic

Teamwork- Part 1: Divided We Fall; Part 2: Cursed By Knowledge: Building a Culture of Psychological Safety; and Part 3: The Not-My-Problem Problem.

Rosenbaum L. Divided We Fall. N Engl J Med. 2019;380(7):684-688. doi:10.1056/NEJMms1813427.

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March 6, 2019
Rosenbaum L. N Engl J Med. 2019;380(7):684-688.
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Breakdowns in communication and teamwork are common contributors to adverse events and can compromise safety. As medical care becomes more complex, more teams and subspecialists are involved in a patient's care, which may lead to fragmentation of care and a lack of clear ownership. This three-part series on teamwork highlights the challenges surrounding interprofessional communication and collaboration in today's health care environment, with an emphasis on the resultant adverse effects for patients. The first commentary describes a scenario in which many consultants were carefully considering a patient's case but were not communicating effectively with one another. The second commentary underscores how psychological safety can facilitate improved collaboration and error disclosure among teams. In the third part of the series, the author points out that although the practice of medicine is highly dependent on effective teamwork, medical culture continues to emphasize and even heroize the individual to its own detriment. The author suggests that further research is necessary to achieve optimal teamwork in medicine. A PSNet interview discussed the importance of leadership and teamwork in health care.

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Rosenbaum L. Divided We Fall. N Engl J Med. 2019;380(7):684-688. doi:10.1056/NEJMms1813427.