The systems of surgery

This paper raises the vital question of how the systems approach to safety should be implemented in the surgical domain. It argues that teams are the natural vehicles of change in a complex distributed system of work and so the ideal units of analysis. Generalized models of team performance frame the research needed to implement the approach. However, models of teamwork must be developed that account for the technical aspects of different procedures in order to improve team performance across systems. For that purpose, an account of the information that comprises teams and teamwork and the infrastructure and technology that supports it is essential. There could be an improvement in safety across healthcare if the design of surgical teams co-evolves systematically with technology, and if the technical relevance of teamwork is realized. © 2007 Taylor & Francis.