Reducing medical error in the Military Health System: How can team training help? Alexander Alonso a, ⁎ , David P. Baker a,1 , Amy Holtzman a,2 , Rachel Day a,3 , Heidi King b,4 , Lauren Toomey b,5 , Eduardo Salas c,6 a American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA b TRICARE Management Activity, Office of the Chief Medical Officer, Skyline 5, Suite 810, 5111 Leesburg Pike, Falls Church, VA 22041, USA c Department of Psychology and Institute for Simulation & Training, University of Central Florida, 3100 Technology Parkway, Orlando, FL 32826, USA Abstract Medical error causes more than 98,000 deaths annually [Kohn, L. T., Corrigan, J. M., and Donaldson, M. S. (1999). To err is human: Building a safer health system. Washington, DC: National Academies Press.] making it a national epidemic during the late 1990s. In reaction, Congress passed the National Defense Authorization Act mandating the Department of Defense (DoD) to establish processes for patient safety in the military health care and veteran affairs. Among the many processes for patient safety identified by the DoD, team training stepped to the forefront in 2001 when the TRICARE Management Activity (TMA) commissioned the development of two programs based upon Crew Resource Management training from the aviation industry. A recent evaluation of these programs identified several limitations including the establishment of two distinct approaches to teamwork and an inability to leverage the larger body of team training available. TEAMSTEPPS, or the Team Strategies and Tools to Enhance Performance and Patient Safety, was developed to address the cultural issues facing the military health system and to take advantage of the state-of-the-art evidence-base on team training. Despite success, several challenges remain representing opportunities for human resources professionals and organizational researchers to help improve this program and further research on the impact of team training on patient safety. © 2006 Elsevier Inc. All rights reserved. Keywords: TEAMSTEPPS Human Resource Management Review 16 (2006) 396 – 415 www.socscinet.com/bam/humres ⁎ Corresponding author. Tel.: +1 202 403 5176. E-mail addresses: aalonso@air.org (A. Alonso), dbaker@air.org (D.P. Baker), aholtzman@air.org (A. Holtzman), rday@air.org (R. Day), Heidi.King@tma.osd.mil (H. King), Lauren.Toomey.ctr@tma.osd.mil (L. Toomey), esalas@ist.ucf.edu (E. Salas). 1 Please address all correspondence regarding the TEAMSTEPPS program to David P. Baker at dbaker@air.org. Tel.: +1 202 403 5036. 2 Tel.: +1 202 403 5643. 3 Tel.: +1 202 403 5188. 4 Tel.: +1 703 681 0064x3611. 5 Tel.: +1 703 681 0064x3686. 6 Tel.: +1 407 882 1325. 1053-4822/$ - see front matter © 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.hrmr.2006.05.006