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Intensive care units examined in Interprofessional working

Staff at St Georges hospital

The need for effective interprofessional collaboration to reduce duplication of effort, restrict clinical error, improve safety and enhance the quality of patient care is now widely acknowledged in intensive care unit (ICU) settings.

However, there’s been little empirical work in this context to generate rich, qualitative insights into the nature of collaborative processes between staff or between family carers and staff. Led by Professor Scott Reeves, this 2-year study aims to explore, using ethnographic methods, the cultures of eight ICU settings in the US and Canada.

Based on the data, the study will develop an empirically-based diagnostic and intervention toolkit to identify and attempt to address collaboration. To date, over 1,000 hours of ethnographic data have been collected at San Francisco, Baltimore, Pittsburgh, Minneapolis and Toronto. In addition, 56 interviews were conducted with a range of ICU staff and family members.

A key finding from these sites was that interprofessional interactions tended to be terse in nature. Indeed, at these sites, it was often noted that for long periods of time staff were focused on completing their profession-specific activities.

Nevertheless, during periods of clinical crisis, these staff shifted from working as parallel teams into a highly collaborative interprofessional team. In relation to involving family members, the findings indicate the importance of examining family involvement in the ICU as it occurs over time with a multitude of staff and care teams.

It remains to be seen, as the study progresses and data are gathered in four more ICUs, how these conclusions will shape a framework going forward, and whether some modifications will be needed to draw conclusions about interprofessional collaboration and family involvement that are applicable to a broader context.

For more information on this study, visit: http://informahealthcare.com/doi/abs/10.3109/13561820.2014.955914