Defining Conditions for Effective Interdisciplinary Care Team Communication in an Open Surgical Intensive Care Unit: a Qualitative Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 Dec 14

PMID 38097232

Authors

Carmen M Diaz

Abahuje Egide

Andrew Berry

Miriam Rafferty

Ali Amro

Kaithlyn Tesorero

Michael Shapiro

Bona Ko

Whitney Jones

John D Slocum

Julie Johnson

Anne Madeleine Stey

Affiliations

Soon will be listed here.

Abstract

Objective: Poor interdisciplinary care team communication has been associated with increased mortality. The study aimed to define conditions for effective interdisciplinary care team communication.

Design: An observational cross-sectional qualitative study.

Setting: A surgical intensive care unit in a large, urban, academic referral medical centre.

Participants: 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.

Primary Outcome: Conditions for effective interdisciplinary care team communication.

Results: 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.

Conclusions: Standardising communication and creating defined roles in formal processes can promote effective interdisciplinary care team communication by fostering psychological safety.

Citing Articles

Barriers and Strategies to Effective Serious Illness Communication for Patients with End-Stage Liver Disease in the Intensive Care Setting.

Brown C, Khan S, Parekh T, Muir A, Sudore R J Intensive Care Med. 2024; :8850666241280892.

PMID: 39247992 PMC: 11890205. DOI: 10.1177/08850666241280892.

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