Safer Surgery part 27. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 234 Safer Surgery in anaesthesia crews in clinical and simulated work environments. Furthermore we were able to establish a relationship between certain coordination patterns and clinical performance ratings for a specific anaesthetic crisis in a simulator scenario. In a current project see also Chapter 13 by Kolbe et al. in this book we continue the task-analytic approach to adaptive coordination in anaesthesia crews. This research aims at improving instruments and procedures for team performance assessment by comparing and potentially integrating two observation systems for coordination behaviour. The focus of this project is to empirically evaluate the predictive power of two different observation systems for coordination processes with regard to non-technical skills and clinical performance assessments. Because many assessments of healthcare professionals work especially in critical situations are only possible in a simulator environment we continue a research strategy using both clinical and simulated research settings to best develop the strengths and counter the limitations associated with either setting. The results of this study will provide an important contribution to improving systems used to assess coordination as a central aspect of team performance. If team performance cannot be assessed accurately efforts to define specific training needs and to improve team performance may be futile Manser 2008 . In order to define specific competencies that team training should address to monitor progress and to finally assess competence research needs to establish a link between specific behaviours and patient outcome. Acknowledgements This research was funded by the Swiss National Science Foundation PBZH1-100994 . We thank the clinical staff at the VAPAHCS especially the cardiac team and the staff at the Patient Simulation Center of Innovation for their support in conducting this research. The ongoing study referred to in this chapter is funded by the Swiss .
