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Team Coordination and Breakdowns in a Real-Life Stressful Environment

This paper describes a study of team coordination and its breakdowns in a complex and dynamic work environment. Sixteen videotaped cases of real-life trauma patient resuscitation in a trauma center's patient admitting areas were analyzed. The findings from the study suggest that highly skilled work teams used a variety of ways to coordinate, many of which were non-verbal and implicit. Breakdowns in coordination occurred in several stressful situations, and the lack of explicit, verbal communications could be a major contributing factor. The paper characterizes the situations where coordination breakdowns were observed, and recommends that the team training be targeted at those situations where verbal communications are essential yet team coordination is prone to breakdowns.