Defining conditions for effective interdisciplinary care team communication in an open surgical intensive care unit: a qualitative study.

adult intensive & critical care clinical reasoning emotional intelligence health services administration & management interprofessional relations organisational development

Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
13 Dec 2023
Historique:
medline: 15 12 2023
pubmed: 15 12 2023
entrez: 14 12 2023
Statut: epublish

Résumé

Poor interdisciplinary care team communication has been associated with increased mortality. The study aimed to define conditions for effective interdisciplinary care team communication. An observational cross-sectional qualitative study. A surgical intensive care unit in a large, urban, academic referral medical centre. A total 6 interviews and 10 focus groups from February to June 2021 (N=33) were performed. Interdisciplinary clinicians who cared for critically ill patients were interviewed. Participants included intensivist, transplant, colorectal, vascular, surgical oncology, trauma faculty surgeons (n=10); emergency medicine, surgery, gynaecology, radiology physicians-in-training (n=6), advanced practice providers (n=5), nurses (n=7), fellows (n=1) and subspecialist clinicians such as respiratory therapists, pharmacists and dieticians (n=4). Audiorecorded content of interviews and focus groups were deidentified and transcribed verbatim. The study team iteratively generated the codebook. All transcripts were independently coded by two team members. Conditions for effective interdisciplinary care team communication. We identified five themes relating to conditions for effective interdisciplinary care team communication in our surgical intensive care unit setting: role definition, formal processes, informal communication pathways, hierarchical influences and psychological safety. Participants reported that clear role definition and standardised formal communication processes empowered clinicians to engage in discussions that mitigated hierarchy and facilitated psychological safety. Standardising communication and creating defined roles in formal processes can promote effective interdisciplinary care team communication by fostering psychological safety.

Identifiants

pubmed: 38097232
pii: bmjopen-2023-075470
doi: 10.1136/bmjopen-2023-075470
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e075470

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Carmen M Diaz (CM)

Northwestern University, Evanston, Illinois, USA.

Abahuje Egide (A)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Andrew Berry (A)

Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA.

Miriam Rafferty (M)

19th floor Strength+Endurance AbilityLab, Shirley Ryan AbilityLab, Chicago, Illinois, USA.
Department of Physical Medicine and Rehabilitation & Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Ali Amro (A)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Kaithlyn Tesorero (K)

University of Illinois Chicago, Chicago, Illinois, USA.

Michael Shapiro (M)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Bona Ko (B)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Whitney Jones (W)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

John D Slocum (JD)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Julie Johnson (J)

Department of Surgery, Northwestern University, Evanston, Illinois, USA.

Anne Madeleine Stey (AM)

Department of Surgery, Northwestern University, Evanston, Illinois, USA as013j@gmail.com.

Classifications MeSH