The Culture Code: The Secrets of Highly Successful Groups

by Daniel Coyle

Framing: Successful teams conceptualized MICS as a learning experience that would benefit patients and the hospital. Unsuccessful teams conceptualized MICS as an add-on to existing practices. Roles: Successful teams were explicitly told by the team leader why their individual and collective skills were important for the team’s success, and why it was important for them to perform as a team. Unsuccessful teams were not. Rehearsal: Successful teams did elaborate dry runs of the procedure, preparing in detail, explaining the new protocols, and talking about communication. Unsuccessful teams took minimal steps to prepare. Explicit encouragement to speak up: Successful teams were told by team leaders to speak up if they saw a problem; they were actively coached through the feedback process. The leaders of unsuccessful teams did little coaching, and as a result team members were hesitant to speak up. Active reflection: Between surgeries, successful teams went over performance, discussed future cases, and suggested improvements. For example, the team leader at Mountain Medical wore a head-mounted camera during surgery to help facilitate discussion and feedback. Unsuccessful teams tended not to do this.