{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T18:29:04Z","timestamp":1782152944706,"version":"3.54.5"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies.<\/jats:p>","DOI":"10.1136\/amiajnl-2013-002606","type":"journal-article","created":{"date-parts":[[2014,7,23]],"date-time":"2014-07-23T03:38:45Z","timestamp":1406086725000},"page":"11-18","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["An integrative framework for sensor-based measurement of teamwork in healthcare"],"prefix":"10.1093","volume":"22","author":[{"given":"Michael A","family":"Rosen","sequence":"first","affiliation":[{"name":"The Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, USA"},{"name":"Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron S","family":"Dietz","sequence":"additional","affiliation":[{"name":"The Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yang","sequence":"additional","affiliation":[{"name":"The Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey E","family":"Priebe","sequence":"additional","affiliation":[{"name":"The Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Pronovost","sequence":"additional","affiliation":[{"name":"The Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, USA"},{"name":"Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,7,22]]},"reference":[{"key":"2020110613023334900_R1","volume-title":"Adverse events in hospitals: national incidence among Medicare beneficiaries","author":"Levinson","year":"2010"},{"key":"2020110613023334900_R2","volume-title":"To err is human: Building a safer health system","author":"Kohn","year":"2000"},{"key":"2020110613023334900_R3","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1146\/annurev-med-061410-121352","article-title":"Reducing medical errors and adverse events","volume":"63","author":"Pham","year":"2012","journal-title":"Annu Rev Med"},{"key":"2020110613023334900_R4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1136\/bmjqs-2013-001848","article-title":"Team-training in healthcare: a narrative synthesis of the literature","volume":"23","author":"Weaver","year":"2014","journal-title":"BMJ Qual Saf"},{"key":"2020110613023334900_R5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.healthpol.2009.09.015","article-title":"Interventions to improve team effectiveness: a systematic review","volume":"94","author":"Buljac-Samardzic","year":"2010","journal-title":"Health Policy"},{"key":"2020110613023334900_R6","first-page":"398","article-title":"What are the critical success factors for team training in health care?","volume":"35","author":"Salas","year":"2009","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"2020110613023334900_R7","first-page":"39","volume-title":"The wisdom of collectives in organizations: an update of the teamwork competencies. Team effectiveness in complex organizations: cross-disciplinary perspectives and approaches","author":"Salas","year":"2009"},{"key":"2020110613023334900_R8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1529-1006.2006.00030.x","article-title":"Enhancing the effectiveness of work groups and teams","volume":"7","author":"Kozlowski","year":"2006","journal-title":"Psychol Sci Public Interest"},{"key":"2020110613023334900_R9","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1146\/annurev.psych.56.091103.070250","article-title":"Teams in organizations: From input-process-output models to IMOI models","volume":"56","author":"Ilgen","year":"2005","journal-title":"Annu Rev Psychol"},{"key":"2020110613023334900_R10","first-page":"59","article-title":"How can team performance be measured, assessed, and diagnosed?","volume-title":"Improving patient safety through teamwork and team training","author":"Rosen","year":"2012"},{"key":"2020110613023334900_R11","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/SIH.0b013e31802b68ee","article-title":"The Mayo high performance teamwork scale: reliability and validity for evaluating key crew resource management skills","volume":"2","author":"Malec","year":"2007","journal-title":"Simulation Healthc"},{"key":"2020110613023334900_R12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/1467-8721.01235","article-title":"Why people fail to recognize their own incompetence","volume":"12","author":"Dunning","year":"2003","journal-title":"Current Dir Psychol Sci"},{"key":"2020110613023334900_R13","doi-asserted-by":"crossref","first-page":"S87","DOI":"10.1097\/00001888-200110001-00029","article-title":"Difficulties in recognizing one's own incompetence: novice physicians who are unskilled and unaware of it","volume":"76","author":"Hodges","year":"2001","journal-title":"Acad Med"},{"key":"2020110613023334900_R14","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1037\/0022-3514.77.6.1121","article-title":"Unskilled and unaware of it: How difficulties in recognizing one's own incompetence lead to inflated self-assessments","volume":"77","author":"Kruger","year":"1999","journal-title":"J Pers Soc Psychol"},{"key":"2020110613023334900_R15","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/chp.21156","article-title":"Rater training to support high-stakes simulation-based assessments","volume":"32","author":"Feldman","year":"2012","journal-title":"J Contin Educ Health Prof"},{"key":"2020110613023334900_R16","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.jamcollsurg.2010.11.001","article-title":"Observational teamwork assessment for surgery: content validation and tool refinement","volume":"212","author":"Hull","year":"2011","journal-title":"J Am Coll Surg"},{"key":"2020110613023334900_R17","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jcrc.2007.12.005","article-title":"Measuring team performance in healthcare: review of research and implications for patient safety","volume":"23","author":"Jeffcott","year":"2008","journal-title":"J Crit Care"},{"key":"2020110613023334900_R18","doi-asserted-by":"crossref","first-page":"353","DOI":"10.4103\/0974-2700.70746","article-title":"Tools for evaluating team performance in simulation-based training","volume":"3","author":"Rosen","year":"2010","journal-title":"J Emergencies Trauma Shock"},{"key":"2020110613023334900_R19","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1007\/s11606-013-2686-8","article-title":"Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes","volume":"29","author":"Havyer","year":"2014","journal-title":"J Gen Intern Med"},{"key":"2020110613023334900_R20","article-title":"A systematic review of behavioral marker systems in healthcare: what do we know about their attributes, validity, and application?","author":"Dietz","journal-title":"BMJ Qual Safety"},{"key":"2020110613023334900_R21","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1093\/bja\/aeg112","article-title":"Anaesthetists\u2019 Non-Technical Skills (ANTS): evaluation of a behavioural marker system","volume":"90","author":"Fletcher","year":"2003","journal-title":"Br J Anaesth"},{"key":"2020110613023334900_R22","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s00268-007-9320-z","article-title":"Surgeons\u2019 non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system","volume":"32","author":"Yule","year":"2008","journal-title":"World J Surg"},{"key":"2020110613023334900_R23","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.ijnurstu.2011.08.012","article-title":"Evaluation of the scrub practitioners\u2019 list of intraoperative non-technical skills (SPLINTS) system","volume":"49","author":"Mitchell","year":"2012","journal-title":"Int J Nurs Stud"},{"key":"2020110613023334900_R24","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/per.588","article-title":"Personality and team performance: a meta-analysis","volume":"20","author":"Peeters","year":"2006","journal-title":"Eur J Pers"},{"key":"2020110613023334900_R25","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1037\/0021-9010.92.3.595","article-title":"Deep-level composition variables as predictors of team performance: a meta-analysis","volume":"92","author":"Bell","year":"2007","journal-title":"J Appl Psychol"},{"key":"2020110613023334900_R26","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/104649640003100303","article-title":"When member homogeneity is needed in work teams a meta-analysis","volume":"31","author":"Bowers","year":"2000","journal-title":"Small Group Res"},{"key":"2020110613023334900_R27","first-page":"130","article-title":"A review and integration of team composition models moving toward a dynamic and temporal framework","volume":"40","author":"Mathieu","year":"2014","journal-title":"J Managt"},{"key":"2020110613023334900_R28","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1037\/0022-3514.90.5.862","article-title":"Personality in its natural habitat: Manifestations and implicit folk theories of personality in daily life","volume":"90","author":"Mehl","year":"2006","journal-title":"J Pers Soc Psychol"},{"key":"2020110613023334900_R29","article-title":"Pervasive Computing Technologies for Healthcare, 2009","author":"Wearable sensors for pervasive healthcare management","year":"2009"},{"key":"2020110613023334900_R30","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1108\/00483480310488360","article-title":"Work team trust and effectiveness","volume":"32","author":"Costa","year":"2003","journal-title":"Personnel Rev"},{"key":"2020110613023334900_R31","doi-asserted-by":"crossref","first-page":"350","DOI":"10.2307\/2666999","article-title":"Psychological safety and learning behavior in work teams","volume":"44","author":"Edmondson","year":"1999","journal-title":"Adm Sci Q"},{"key":"2020110613023334900_R32","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1037\/0021-9010.78.1.61","article-title":"Complex interdependence in task-performing groups","volume":"78","author":"Saavedra","year":"1993","journal-title":"J Appl Psychol"},{"key":"2020110613023334900_R33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/0963721410364728","article-title":"Health care, aviation, and ecosystems a socio-natural systems perspective","volume":"19","author":"Durso","year":"2010","journal-title":"Curr Dir Psychol Sci"},{"key":"2020110613023334900_R34","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.ijmedinf.2011.03.015","article-title":"Using ORA to explore the relationship of nursing unit communication to patient safety and quality outcomes","volume":"80","author":"Effken","year":"2011","journal-title":"Int J Med Inform"},{"key":"2020110613023334900_R35","first-page":"963","article-title":"Advancing the use of checklists for evaluating performance in health care","volume-title":"Acad Med","author":"Rosen","year":"2014"},{"key":"2020110613023334900_R36","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1109\/TSMCB.2008.2006638","article-title":"Sensible organizations: technology and methodology for automatically measuring organizational behavior","volume":"39","author":"Olgu\u00edn","year":"2009","journal-title":"IEEE Trans Syst Man Cybern B Cybern"},{"key":"2020110613023334900_R37","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.jbi.2010.05.015","article-title":"Toward automated workflow analysis and visualization in clinical environments","volume":"44","author":"Vankipuram","year":"2011","journal-title":"J Biomed Inform"},{"key":"2020110613023334900_R38","doi-asserted-by":"crossref","first-page":"e17144","DOI":"10.1371\/journal.pone.0017144","article-title":"Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors","volume":"6","author":"Isella","year":"2011","journal-title":"PLoS ONE"},{"key":"2020110613023334900_R39","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/0018720812448394","article-title":"Do team and individual debriefs enhance performance? A meta-analysis","volume":"55","author":"Tannenbaum","year":"2013","journal-title":"Hum Factors"},{"key":"2020110613023334900_R40","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/1046496408317794","article-title":"Guided team self-correction impacts on team mental models, processes, and effectiveness","volume":"39","author":"Smith-Jentsch","year":"2008","journal-title":"Small Group Res"},{"key":"2020110613023334900_R41","first-page":"243","article-title":"In situ simulation in continuing education for the health care professions: a systematic review","volume-title":"J Contin Educ Health Prof","author":"Rosen","year":"2012"},{"key":"2020110613023334900_R42","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1097\/ACM.0b013e318159e1ff","article-title":"Organizational factors associated with high performance in quality and safety in academic medical centers","volume":"82","author":"Keroack","year":"2007","journal-title":"Acad Med"},{"key":"2020110613023334900_R43","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.jbi.2011.02.007","article-title":"Making sense: sensor-based investigation of clinician activities in complex critical care environments","volume":"44","author":"Kannampallil","year":"2011","journal-title":"J Biomed Inform"},{"key":"2020110613023334900_R44","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10588-005-5378-z","article-title":"Scan statistics on enron graphs","volume":"11","author":"Priebe","year":"2005","journal-title":"Comput Math Organ Theory"},{"key":"2020110613023334900_R45","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s11203-011-9058-y","article-title":"A latent process model for time series of attributed random graphs","volume":"14","author":"Lee","year":"2011","journal-title":"Stat Inference Stochastic Process"},{"key":"2020110613023334900_R46","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1080\/01621459.2012.699795","article-title":"A consistent adjacency spectral embedding for stochastic blockmodel graphs","volume":"107","author":"Sussman","year":"2012","journal-title":"J Am Stat Assoc"},{"key":"2020110613023334900_R47","article-title":"On latent position inference from doubly stochastic messaging activities","author":"Lee","journal-title":"Multiscale Modeling Simulation"},{"key":"2020110613023334900_R48","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1109\/MPRV.2006.53","article-title":"Moving out of the lab: deploying pervasive technologies in a hospital","volume":"5","author":"Hansen","year":"2006","journal-title":"Pervasive Comput IEEE"},{"key":"2020110613023334900_R49","doi-asserted-by":"crossref","first-page":"3507","DOI":"10.1007\/s10916-011-9789-8","article-title":"The adoption and implementation of RFID technologies in healthcare: a literature review","volume":"36","author":"Yao","year":"2012","journal-title":"J Med Syst"},{"key":"2020110613023334900_R50","author":"National Transportation Safety Board"},{"key":"2020110613023334900_R51","first-page":"3","article-title":"Toward an understanding of team performance and training","volume-title":"Teams: their training and performance","author":"Salas","year":"1992"},{"key":"2020110613023334900_R52","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2307\/20159571","article-title":"The impact of team empowerment on virtual team performance: the moderating role of face-to-face interaction","volume":"47","author":"Kirkman","year":"2004","journal-title":"Acad Manage J"},{"key":"2020110613023334900_R53","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/0018720810369807","article-title":"Toward an understanding of macrocognition in teams: predicting processes in complex collaborative contexts","volume":"52","author":"Fiore","year":"2010","journal-title":"Hum Factors"},{"key":"2020110613023334900_R54","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1518\/001872008X288457","article-title":"On teams, teamwork, and team performance: discoveries and developments","volume":"50","author":"Salas","year":"2008","journal-title":"Hum Factors"},{"key":"2020110613023334900_R55","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1037\/0021-9010.90.5.964","article-title":"Teamwork in multiteam systems","volume":"90","author":"Marks","journal-title":"J Appl Psychol"},{"key":"2020110613023334900_R56","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.jbi.2012.04.003","article-title":"Introducing RFID technology in dynamic and time-critical medical settings: requirements and challenges","volume":"45","author":"Parlak","year":"2012","journal-title":"J Biomed Inform"},{"key":"2020110613023334900_R57","doi-asserted-by":"crossref","first-page":"25","DOI":"10.7812\/TPP\/08-021","article-title":"A 36-hospital time and motion study: how do medical-surgical nurses spend their time?","volume":"12","author":"Hendrich","year":"2008","journal-title":"Perm J"},{"key":"2020110613023334900_R58","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1007\/s00464-010-1239-z","article-title":"New technologies for information retrieval to achieve situational awareness and higher patient safety in the surgical operating room: the MRI institutional approach and review of the literature","volume":"25","author":"Kranzfelder","year":"2011","journal-title":"Surg Endosc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/1\/11\/34145264\/amiajnl-2013-002606.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/1\/11\/34145264\/amiajnl-2013-002606.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T12:11:47Z","timestamp":1689423107000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/22\/1\/11\/833032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,22]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,7,22]]},"published-print":{"date-parts":[[2015,1,1]]}},"URL":"https:\/\/doi.org\/10.1136\/amiajnl-2013-002606","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,1]]},"published":{"date-parts":[[2014,7,22]]}}}