Respond and reply to the following 4 people’s discussions. EACH reply must be 100 WORDS. There should be a total of 400 words. NOTE: 100 words for each person.
- Edgardo
- Kourtney
- Phillip
- Ezra
EDGARDO: Good evening class, One team I was able to see work well while deployed in support of Joint Special Operations Task Force Somalia (JSOTF-SOM) operated effectively because we had a common mission, clearly communicated and coordination, and trust amongst the team. We all understood our roles and responsibilities which made it simple to keep organized and adapt quickly when our priorities were adjusted. I believe leadership was at the forefront of this because expectations were clear and people were held accountable, but still respectfully treated. According to Dye (2022) effective leadership in healthcare relies on foundational core values and hard skills like communication, teamwork, and accountability. I witnessed how those traits can manifest while deployed on my last assignment. I have also been a member of teams that did not operate effectively. The number one problem was communication and lack of coordination. When we are not talking to each other or trusting one another the team becomes disjointed and it feels like everyone is on their own versus working together as a team. Roles become blurred and frustration can build quickly, limiting the teams overall performance. This ties into why teamwork directly affects safety and outcomes under stressful conditions. Manser (2009) states that failings in teamwork can occur when there is a breakdown in communication and lack of coordination which can introduce risk and decrease the teams effectiveness. If I were to improve that team I would establish clearer expectations, promote open communication, and build trust within the team early on so they may work together rather than in their own silo. References:
Dye, C. F. (2022). Leadership in healthcare: Essential values and skills (4th ed.). Health Administration Press.
Manser, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiologica Scandinavica , 53 (2) 143 151.
KOURTNEY: Hello Class,
One of the best teams Ive been part of was during Bahrains initial COVID-19 housing response. Our team included 14 service members and 25 local national employees. We managed quarantine and Restriction of Movement facilities for over 1,100 returning personnel. What made this team work so well was mutual respect. Everyone respected each others roles and contributions, which made communication and focus on the mission easier. Rank and job titles mattered less than teamwork. Ethics and integrity were huge during this time. COVID brought a lot of uncertainty and stress, but leadership was transparent and consistent. We also had strong servant leadership. Leaders focused on supporting the team, removing barriers, making sure we had what we needed, and stepping in when things got tough. Ive also been part of teams that didnt work nearly as well. As an RBT, I worked within a team that included BTs, other RBTs, a BCBA, and a field staff manager. There wasnt much interpersonal connection, which is important in ABA since the work is all about people. Communication was often unclear, expectations werent well defined, and not everyone was on the same page. This led to frustration, role confusion, and avoidable errors in client care. Some things that could have made the team more effective include better communication and clearer expectations. According to Dye (2022), effective teams work best when members understand their individual roles and expectations, recognize their value to the team, and help shape the shared values that guide how the team works together. Quick check-ins or short team huddles could have ensured everyone knew their roles and expectations. Making an effort to connect, listen, support each other, and recognize contributions would have helped morale and built more trust within our team.
References:Dye, Carson F.. Leadership in Healthcare: Essential Values and Skills, Fourth Edition, Health Administration Press, 2022. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/apus/detail.action?docID=7175471.
PHILIP: Error chains consist of a series of small failures – sometimes 10, 15, or even 20 that can gradually snowball and ultimately avalanche into serious patient harm. As a result, patients may experience prolonged hospital stays or additional complications stemming from preventable breakdowns in care. Many of these errors are entirely avoidable when systems are designed to identify risks early and communicate them effectively. In the video, this concept is illustrated during a leadership walkaround where it was discovered that blood pressure cuffs in a unit were not functioning. This raises an important question: why was this issue not communicated to leadership before it was identified during the walkaround?
This example particularly resonates with me because I routinely inspect medical equipment and can be held liable if I certify equipment that is not working as intended. Recently, a firefighter brought a suction unit to me for inspection, and I had to explain that because it was not charged routinely, it would fail during use. As a result, I could not sign off on the equipment. I also instructed them on proper preventative maintenance to preserve battery life. Had this routine inspection not occurred, a patients life could have potentially been at risk. This reinforces the importance of meaningful communication and shared best practices between departments, rather than simply checking the box during inspections. If I had not insisted on corrective action or emphasized the severity of routine maintenance, this situation could have resulted in significant risk.
The video highlights (VIDEO LINK: )vision boards as a tool to help prevent these types of failures by allowing frontline staff to identify and communicate risks early. Vision boards encourage open communication between staff and leadership, making safety concerns visible and actionable. During the Q&A portion of the video, it is further emphasized that vision boards allow teams to visualize expected actions, track updates, and provide real-time feedback. These tools support high reliability by ensuring that small issues are addressed before they contribute to larger error chains.
EZRA:In healthcare, its easy to assume that if nothing bad happened today, the system must be working. Frankel and Leonard challenge that comforting assumption head-on, and this was one of the most compelling insights from their presentation. They argue that high reliability is not about celebrating success, but about remaining uneasy even when things appear to be going well. In other words, smooth operations can actually hide risk. Recent research by Fricke et al (2023) supports this idea, showing that organizations applying high-reliability principles intentionally look for weak signals such as near misses or workarounds because these often reveal deeper system vulnerabilities. This perspective reframes safety as something actively maintained through constant attention and learning, rather than something achieved once errors stop occurring.
Another important takeaway from the presentation is the emphasis on psychological safety as a foundational requirement for high reliability. Frankel and Leonard highlight that frontline clinicians often notice safety threats first, but their insights only matter if they feel safe speaking up. Contemporary research confirms that teams with strong psychological safety and safety climate are more likely to report concerns and less likely to experience serious adverse events, because problems are addressed earlier rather than ignored (Vogus et al., 2020). When staff trust that raising concerns will lead to improvement instead of blame, safety becomes a shared responsibility rather than an individual risk.
Despite growing awareness of these principles, many healthcare organizations continue to struggle to achieve high reliability. One major challenge is the inherent complexity of healthcare systems, where frequent handoffs, unpredictable patient needs, and time pressure increase the likelihood of failure. Another barrier is cultural inertia, particularly environments that still respond to error with blame or silence rather than learning. Research suggests that these challenges can be overcome through sustained leadership commitment, reinforcement of reliability principles in daily work, and intentional efforts to strengthen safety culture across all levels of the organization (Fricke et al., 2023; Vogus et al., 2020). When leaders consistently prioritize learning, transparency, and trust, high reliability becomes an ongoing practice rather than an abstract goal.
References:Fricke, J., Galligan, M., Douma, C., Souder, J., Hedden-Gross, A., & Mull, N. (2023). Examining the Impact of Implementing High-Reliability Organization Principles on Patient Safety Outcomes. National Library of Medicine.