Why your boss is white, middle-class and a show-off

It is hoped the research can be used to develop strategies to encourage clinical professionals to work together more effectively.

"We need to stop being simplistic and realise that changing behaviours and encouraging teamwork is much harder than we think," says Professor Braithwaite. "Getting different groups together and talking through some of the differences, and appreciating some of the unwritten rules which drive people, are crucial steps in improving trust.

"We also need to re-think education. We train doctors in a completely different arena from nurses and allied health staff, then we bring them together in the workplace after they graduate and expect everyone to be team players," he says. "We need to bring them together much earlier in the educational process."

Other features include:

• Meetings are held in the most senior manager's office, who typically dominates proceedings

• Managers do not spend as much of their time as people think sitting reading quietly, or attending to paperwork in front of a computer. They are out there manoeuvring and positioning at meetings, one-on-one encounters and coffee cliques.

• Managers rarely take lunch or tea breaks

• Non-managerial staff regularly take an allocated period of time for breaks

The paper has just been published in the Journal of Health Organisation and Management.

About the Institute for Health Innovation:

Internationally, patient safety is a growing concern. Overseas data reports that patients receive recommended care only 50% of the time. The Institute will investigate how and why this occurs, with a focus on the roles of teamwork, safe medication use and the application of information technology to support improved decision-making.