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How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis
  1. Jan B. Schmutz1,
  2. Laurenz L. Meier2,
  3. Tanja Manser3
  1. 1 Department of Communication Studies, Northwestern University, Evanston, Illinois, USA
  2. 2 Department of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
  3. 3 FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
  1. Correspondence to Dr Jan B. Schmutz; jan.schmutz{at}


Objectives To investigate the relationship between teamwork and clinical performance and potential moderating variables of this relationship.

Design Systematic review and meta-analysis.

Data source PubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email.

Eligibility criteria Studies were included if they reported a relationship between a teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting.

Data extraction and synthesis Moderator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results The review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation was r =0.28 (corresponding to an OR of 2.8), indicating that teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of teamwork on performance.

Conclusion Teamwork has a medium-sized effect on performance. The analysis of moderators illustrated that teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of teamwork and emphasise approaches that maintain and improve teamwork for the benefit of their patients.

  • teamwork
  • non-technical skills
  • communication
  • teams
  • meta-analysis

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  • Contributors All authors substantially contributed to this study and were involved in the study design. JS drafted the paper. LM analysed the data and revised the manuscript for content. TM revised the manuscript for content and language. All authors approved the final version.

  • Funding This work was funded by the European Society of Anaesthesiology (ESA) and the Swiss National Science Foundation (SNSF, Grant No. P300P1_177695). The ESA provided resources for an additional research assistant helping with literature search and selection. Part of the salary of JS was funded by the SNSF.

  • Competing interests None declared.

  • Patient and public involvement statement Patients and public were not involved in this study.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.