Interprofessional Care and Teamwork in the ICU

  • Anne L. Donovan
    Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.
  • J. Matthew Aldrich
    Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.
  • A. Kendall Gross
    Pharmaceutical Services, School of Pharmacy, University of California, San Francisco, CA.
  • Denise M. Barchas
    Department of Nursing, University of California, San Francisco, CA.
  • Kevin C. Thornton
    Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.
  • Hildy M. Schell-Chaple
    Department of Nursing, University of California, San Francisco, CA.
  • Michael A. Gropper
    Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.
  • Angela K. M. Lipshutz
    Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.

Description

<jats:sec> <jats:title>Objectives:</jats:title> <jats:p>We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success.</jats:p> </jats:sec> <jats:sec> <jats:title>Data Sources:</jats:title> <jats:p>Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles.</jats:p> </jats:sec> <jats:sec> <jats:title>Study Selection:</jats:title> <jats:p>Original articles, review articles, and systematic reviews were considered.</jats:p> </jats:sec> <jats:sec> <jats:title>Data Extraction:</jats:title> <jats:p>Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles.</jats:p> </jats:sec> <jats:sec> <jats:title>Data Synthesis:</jats:title> <jats:p>“Interprofessional care” refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils, end-of-life care, coordinated sedation awakening and spontaneous breathing trials, intrahospital transport, and transitions of care.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.</jats:p> </jats:sec>

Journal

  • Critical Care Medicine

    Critical Care Medicine 46 (6), 980-990, 2018-06

    Ovid Technologies (Wolters Kluwer Health)

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