The Connection Between Safety and Teamwork – It’s all about Communication and Taking Workers’ Individual Differences into Account!

Starting as young children, we’re taught about the importance of teamwork.  For example, we might have learned to work together to bring the groceries in from the car, maybe one person brought the bags into the house, another took them into the kitchen, another unpacked them, and someone else put the food away in the cabinets and fridge.  It felt fun working together at something; the experience was certainly more enjoyable than anyone doing the whole job on their own.  And, we could see that this four person exercise accomplished the task in a quarter of the time it would take one person to do the whole thing (if you were lucky enough to have four people to pitch in and help!).

Ralph Waldo Emerson said, “No member of a crew is praised for the rugged individuality of his rowing.”

As adults we’re told that teamwork is critical to achieving success in our jobs too.  But, is this really the case?


Previous studies have shown a clear connection between teamwork and safety, and this appears to be true across all occupations.  For example, The Institute of Medicine 2000 study, To Err is Human, revealed that an estimated 44,000 of 98,000 errors are made per year in health care settings. Since this report was published, there has been a material amount of work done to develop and implement new work processes to make health care safer.  Also, consider a 1999 study (Carter and West) of two groups of pilots, one team of long-term work associates whose members were exhausted, and another group who had not worked together before but whose members where fully rested.  The tired team made fewer errors than the rested one!Â

Perhaps we should take a step back and define teamwork in a workplace context.  There are several definitions provided by researchers in the field of working conditions[i]:

  • Where the goal is to improve the production process, group teamwork is much more about complexity, communication, and integrative work (OLeary-Kelly, 1994).
  • Teams are groups of employees who have at least some collective tasks and where the team members are authorized to mutually regulate the execution of these collective tasks (Delarue, 2003).
  • Group work is defined by a common task requiring interdependent work and successive or integrative action (Hacker, 1998).

One research team identified eight key components of teamwork: team leadership, collective orientation (group vs. individual focus), mutual performance monitoring, backup help with tasks, adaptability (able to adjust strategies and resource allocation as needed), shared mental models (mutual understanding of the tasks, roles, strengths and weaknesses), closed-loop communication, and mutual trust (Salas, Sims, and Burke).

A 2007 study by the European Foundation for the Improvement of Living and Working Conditions (Eurofound) looked across companies in 16 European countries to see how teamwork was incorporated into companies overall organizational strategy.  The study also analyzed the prevalence of teamwork according to various factors including sex, industry sector, and occupation.  It considered whether teamwork helps give workers greater autonomy and higher job satisfaction and whether the presence of teamwork makes the whole enterprise a better learning environment. The study also looked at the possible negative impacts of teamwork, such as higher work intensity, work overload, and the resulting impact on employee health.

The Eurofound study started by reviewing a previous Spanish study (Galve G³rriz and Ortega Lapiedra, 2000) where researchers examined the efficiency of two steel company plants each of which approached teamwork differently. Plant A, with the lower work performance results of the two (less efficient), organized its work around a production line which made establishing informal contacts in the workplace nearly impossible. In addition, teamwork training was given only to senior managers.  The plant operations did not take into consideration the specific needs of the plant by customizing the teamwork structures to the specific characteristics of the plant (e.g. need for job specialization, types of jobs, job rotation, size of operation, gender of workers, work schedules).  Finally, the managerial hierarchy weakened the communication flow among the different business process levels, and as a result performance was diminished.

Conversely, Plant B used of a combination of Japanese and Swedish production models. Japanese production models use a flat, flexible, and decentralized organizational structure that enhances a quicker adaptation to market changes. Swedish models use informal and open communication among workers to improve the communication flow within and between the different levels of the company. Plant B had a teamwork structure that resulted in higher (more efficient) work performance.

The Eurofound study report commented that “most experts believe that teamwork should contribute to a better quality of work life for employees and improve productivity. Employee autonomy is considered an important attribute of the quality of work. In the Eurofound study, worker autonomy was characterized by decision-making in relation to one’s work, based on answers to the following questions:

1. Are you able, or not, to choose or change your order of tasks?

2. Are you able, or not, to choose or change your methods of work?

3. Are you able, or not, to choose or change your speed or rate of work?

Surprisingly, the Eurofound study didn’t find any clear broad-reaching correlation between the presence of teamwork and increased autonomy in performing the work.  The researchers concluded that this correlation is really profession based; meaning that team work and autonomy go together in certain professions like legislators and senior officials and managers, professionals, and technicians and associate professionals, where people tend to work more autonomously, but have to work together when drawing conclusions about key issues. In other professions, more shift working oriented ones of course, like craft and related trades workers, and plant and machine operators and assemblers, very low autonomy was reported, despite a high incidence of teamwork.

The study found that working in a team is closely associated with a greater opportunity to learn new things and perform complex tasks.  Team workers were more likely to learn new things in their work than those not working in teams were. But, the results showed that the health of team workers was negatively affected by their work more than the health of employees not working was.  Working in a team usually means a faster pace of work, an effort to meet tight deadlines, and a reliance on the other members of the team to meet goals.  This increased work intensity, work pressure, and need for collaboration have a negative impact on employees’ health. Employees working in teams more often reported that they were sure that their work had a negative impact on their health than employees not working in teams did. Other studies have also indicated that team workers’ jobs interfere more with their private lives.

Just this month (November, 2009) a new study, Nursing Teamwork, Staff Characteristics, Work Schedules, and Staffing, was released by researchers from University of Michigan. The study was conducted in a large academic science center of 943 beds and a community hospital of 120 beds.  In total 1,800 nursing staff members participated in the study.  Most worked full-time (80%) and about half had baccalaureate degrees.  The average number of years of work experience was ten years.  The nursing staff completed a confidential survey: incentives were given to complete the survey (units with a 50% or higher return rate were given a pizza party).

The survey questions related to the eight key areas of teamwork addressed above (Salas, Sims, and Burke).  The results from the two types of hospitals were very different.  The community hospital scored higher on trust, team orientation, back up, and shared mental models.  Maternity, pediatric, intensive and intermediate care units had the best trust, team orientation, back up, shared mental models, and team leadership skills.  The medical surgical units had low team work scores and ranked low on backup.

Women reported higher teamwork overall.  No differences were reported by ethnicity or education.  Older workers reported higher shared mental scores.  Staff with less than six months of experience scored highest on teamwork overall and highest on trust, team orientation, and shared mental models.  Significant differences were found between the four shift work categories (day, evening, night, and rotating).  The night shift had the highest scores on back up and team leadership and the day and rotating shifts had the lowest level of teamwork. Those working 8 or 10 hours had the highest level of teamwork and workers working a combination of 8 and 12 hour shifts had the lowest teamwork scores.  Nursing staff who worked less than 30 hours per week had a significantly higher team work score and scored significantly higher  on trust, team orientation, backup, shared mental models, and team leadership than those working over 30 hours per week.

Nursing staff reporting no overtime in the past three months had the highest team work scores overall and the highest scores on trust, team orientation, backup, shared mental models, and team leadership.  The nursing staff who felt that staffing levels were adequate all the time had the highest teamwork scores while those who rated the adequacy of staffing to less than 50% had the lowest teamwork scores.

The study concluded that communication is a critical component to successful teamwork.  The community hospital had recently undertaken a project to increase teamwork and engagement on all patient units.  Possibly fatigue and stress (as evidenced by the low scores when overtime is worked or when the perception is that staffing levels are inadequate) lead to interpersonal communication problems resulting in lower teamwork scores.

So, it appears that whether workers are in a steel mill, on an airplane or in a hospital, communication, taking into account individual differences of the workers in the facility, and work schedules (again tied to the workers attributes/needs) are critical to successful teamwork and engagement.

©2009 Circadian Age, Inc. ˜Working Nights”

[i] Team Work and High Performance Organization, by the European Foundation for the Improvement of Living and Working Conditions, downloaded on November 7, 2009 from

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