Royal Inland Hospital, Kamloops, British Columbia. Canadian health care is publicly funded and administered by provincial and territorial governments. Most Canadians are proud of their health care system with public hospitals and universal health insurance that provides preventive care and treatment to all Canadian citizens. The British Columbia Ministry of Health has divided the province geographically into seven large "Health Authorities" in order to provide care to BC residents. The Interior Health Authority has several hospitals under its jurisdiction including the Royal Inland Hospital, which serves patients in Kamloops and the surrounding Okanagan region. Lately, Royal Inland has come under intense scrutiny for a series of grievous management and patient care issues: In one instance, surgical instruments and implements that were supposed to be sterile prior to surgery were found contaminated with bone fragments and surgical cement from a previous operation. A few weeks later, another contaminated surgical cement bottle was found on a surgical tray prior to surgery. These contaminations forced the cancellation of all non-emergency procedures, and hundreds of patients were affected. Staff at Royal Inland claimed that the problem had existed for months, and the RCMP investigated whether the contamination could have been the result of deliberate sabotage. The situation was not only potentially dangerous for patients, but very embarrassing to hospital staff, management, and the provincial government. Top managers were called in to analyze the problem and come up with potential solutions, and it was immediately suggested that a number of Canadian hospitals use teams to improve patient care and service; maintain a clean and sanitary environment; manage costs; reduce patient mortality rate; and reduce medical errors. Providence Health Care in Vancouver and Toronto General Hospital use patient- centred care teams, who are responsible for everything from admission to discharge, and process-centred care teams, who are charged with identifying hospital processes and making them more effective and efficient. Successful patient- and process-centred teams may help Royal Inland reduce dangerous, costly, and embarrassing medical errors, while at the same time improve quality of patient care, increase customer satisfaction, and perhaps help reduce overall costs. #1. Would a team be likely to resolve the issue at Royal Inland? #2. What type of team might be used at Royal Inland? #3. Why is team cohesiveness important? What can Royal Inland do to promote team cohesiveness?