An Overlooked Quality of Excellent Teams

I was surprised to learn that the group of professionals involved with a surgery—the surgeons, nurses, anesthesiologists, and assistants—may not know each other’s names. Yet, according to surgeon and author, Atul Gawande, something as simple as introducing each other before starting an operation can help prevent mistakes and save lives. Previously I summarized a few points from Gawande’s The Checklist Manifesto; here I’ll expand on some implications for truly effective teams and leadership.

Illustration by Bob Greene. Original photo credit: S. Tipchai at

Illustration by Bob Greene. Original photo credit: S. Tipchai at

Given the tremendous complexity and stress of modern life, whether it is conducting heart surgery, planning strategically, or managing a project, it’s impossible to always note every detail, even if we are experienced experts. One of the most profound implications of the checklist idea is that it creates an expectation of collaboration and sharing information among team members—one reason why the safe surgery checklist that Gawande helped create includes a step where team members introduce themselves by name and role.

To cope with complexity, teams must be able to communicate and hear from everyone, so there are “pause points” in the safe surgery checklist where the team reviews progress together. Each team member is expected to speak up if they notice an error or omission—greatly increasing the possibility of catching and correcting mistakes. However, given the traditional power dynamics in an operating room, encouraging everyone to speak up is a huge cultural shift.

If open communication is to actually happen, team members must feel a measure of psychological safety—a key quality Harvard Business School professor Amy Edmonson observed in teams learning to implement a new heart surgery procedure. It’s certainly my experience that team members often hold back, assuming their ideas will be rejected or that someone with higher status will object. This can happen among members of any kind of group, whether a surgical team, board committee, project team, or family.

Building real teams is an area of leadership development that, I believe, is often neglected. Creating psychological safety requires leaders and content experts keep defensiveness in check for the sake of the full team’s success. The best teams focus on results, of course, but they also pay attention to how they work together to achieve those results. This requires a personal commitment to self-awareness and a team expectation of open dialogue.

Consider your own experience. Think about a team that you participate in (such as at work or in the community):

  • Are you comfortable speaking up and pointing things out?
  • Does everyone feel safe speaking up? How can you find out other team members’ answers to this question?
  • If you are the team leader, how might your status and actions impact other members’ willingness to share what they know or observe?
  • Regardless of your role on the team, what can you do to influence how the team works together?