The impact of power on health care team performance and patient safety: a review of the literature

Communication failure within health care teams is a major cause of patient harm across health care settings. Factors which contribute to communication failure include actual or perceived 'power'. Whilst a great deal of ergonomics research has focussed on teamwork in health care, the role o...

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Bibliographic Details
Published in:Ergonomics 2021-08, Vol.64 (8), p.1072-1090
Main Authors: Stevens, Erin L., Hulme, Adam, Salmon, Paul M.
Format: Article
Language:English
Subjects:
Abbreviations
Collaboration
Communication
Crew resources management
Decision making
Ergonomics
Error analysis
Health and Safety
Health care
Health care ergonomics
Literature reviews
Network analysis
Patient safety
Patients
Research design
Resource management
Safety
Safety research
Social networks
Social organization
socio-technical systems
Space life sciences
Teams
Teamwork
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Summary:Communication failure within health care teams is a major cause of patient harm across health care settings. Factors which contribute to communication failure include actual or perceived 'power'. Whilst a great deal of ergonomics research has focussed on teamwork in health care, the role of power in relation to measurable patient safety and performance outcomes remains relatively unknown. This article presents the findings from a review of the literature on power within multidisciplinary health care team settings. Following a systematic literature search, nineteen studies were evaluated in terms of research design, methods and analyses across the included studies. The main impacts resulting from power imbalances include negative effects on team collaboration, decision-making, communication and overall performance. Wider patient safety research, and more specifically the ergonomics discipline, is encouraged to address the complex interplay between power and teamwork in the health care sector. Practitioner Statement: We conducted a review of studies focussed on the influence of power on teamwork in health care. The findings show that power can have negative impacts on collaboration, decision-making, communication, and team performance. We conclude that power represents an important area for ergonomics, both in health care and other settings. Abbreviations: CRM: crew resource management; TEM: threat and error management; SNA: social network analysis; EAST: event analysis of systemic teamwork
ISSN:0014-0139
1366-5847
DOI:10.1080/00140139.2021.1906454