Carmen Diaz, MPP
PhD candidate
Northwestern University
Chicago, Illinois
Disclosure information not submitted.
Julie Johnson, MSPH, PhD
Scientific Director at the Surgical Outcomes and Quality Improvement Center
Northwestern University, Feinberg School of Medicine, United States
Disclosure information not submitted.
Bona Ko, MD
Research Fellow
Northwestern University, United States
Disclosure information not submitted.
Kaithlyn Tesorero, n/a
Undergraduate Student
University of Illinois Chicago, United States
Disclosure information not submitted.
Ali Amro, MD
Critical Care Medicine Fellow
Northwestern Univsersity, United States
Disclosure information not submitted.
Katherine Lin, MD
Master's Student
Northwestern University, United States
Disclosure information not submitted.
Anne Stey, MD, MS
Assistant Professor of Surgery
Northwestern University Feinberg School of Medicine-Trauma Critical Care Surgery, United States
Disclosure information not submitted.
Title: Improving Interdisciplinary Care Team Communication in the Intensive Care Unit
Introduction/Hypothesis: Poor interdisciplinary care team communication in Intensive Care Units (ICUs) is associated with worse outcomes. The aims of this study were (1) to define conditions for effective interdisciplinary care team communication and (2) design an intervention to promote care team communication. This qualitative stud was hypothesis generating.
Methods: This was a qualitative study of a single open ICU at an academic medical center conducted in two steps. First, we performed 6 interviews and 10 focus groups of interdisciplinary clinicians who work with the ICU team from February to June 2021 (N=33). The interviews were transcribed verbatim, de-identified, and inductively coded by at least two study members to derive themes for analysis. Second, representatives from key ICU roles participated in a two-day human-centered design (HCD) workshop to prototype a team-based communication intervention (N=15). Participants in the first session empathized SICU communication patterns. Workshop themes were integrated with themes from Step 1. During the second session, participants defined a question around the standardization of communication, brainstormed solutions, and prototyped a solution.
Results: We identified 5 themes related to issues of interdisciplinary communication in our SICU setting: psychological safety, patient ownership, formal communication, informal communication, and role definition. We explored the link between communicator roles (who speaks), the standardization of communication (what the communicator says), and psychological safety (the communicator's degree of comfort speaking). We posit that with clearer role definition and standardized formal communication processes will empower clinicians to engage in effective interdisciplinary communication. We prototyped an "ICU consult" formal communication mechanism with standardized, system-based care priorities to create a shared mental model, situational awareness and clear role definition upon admission to the SICU.
Conclusions: Addressing psychological safety and informal communication patterns by standardizing communication and creating more defined roles during formal care may improve interdisciplinary communication.