Residents' and nurses' perceptions of team function in the medical intensive care unit.
BACKGROUND: Team-based care is integral to modern intensive care units (ICUs). Trainee physicians ("residents") serve as core team members who provide direct patient care in academic ICUs. However, little is known about how resident perceptions of ICU team function differ from those of other disciplines. Therefore, we compared residents' perceptions to those of nurses', the other predominant direct caregiver group, in the medical ICU. METHODS: A cross-sectional survey was performed with validated team function scales including presence of a real team, communication quality, collaboration, and coordination. The survey was administered to nurses and residents in medical ICUs in an urban academic medical center. We analyzed differences between nurses and residents both in their responses and in their perceptions of how constructs were interrelated. RESULTS: Residents felt that the team was more bounded, was more collaborative, and planned its work to a greater degree, but they were less satisfied with communication, compared with nurses. Residents and nurses perceived relationships between team function constructs in very similar ways. Both groups felt that communication openness and collaboration were positively associated but that communication accuracy and timeliness were negatively correlated, revealing an opportunity to improve overall team performance. CONCLUSIONS: We found important differences in the way that ICU nurses and medical trainee physicians, the predominant types of providers caring for the critically ill in academic medical center ICUs, perceive key aspects of team function. These results may be useful to those responsible for administering academic ICUs as well as to residency program directors developing communication- and team-based curricula.
Adler-Milstein, J; Neal, K; Howell, MD
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