**7. Synthesis and conclusions**

Patient safety is a dynamically evolving discipline, with many challenges and opportunities along the journey to operational excellence, just culture, and sustained "zero defect" performance record. The overarching theme of this chapter and this book is that effective teamwork requires the investment of significant amounts of time, effort, and energy by all stakeholders. Modern healthcare requires safe and efficient teamwork, which in turn requires intensive training and education. Most people find it challenging to work with large, complex teams and are often unaware of the various barriers to effective communication and coordination required to thrive in such environment. The creation of team-based healthcare systems must begin with breaking "old habits" and proactive advocacy for the adoption of modern, evidence-based approaches. Beginning with institutional leadership's vision and strategy, trust and respect are fostered to help encourage positive behaviors and implement just culture. The ultimate goal of "zero harm" must always remain the top priority within the safer and more efficient healthcare systems of tomorrow.
