Harvard University PhD Program in Health Policy, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Crit Care. 2011 Feb;26(1):104.e7-15. doi: 10.1016/j.jcrc.2010.04.003. Epub 2010 Jun 19.
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.
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.
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.
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.
团队式医疗照护是现代重症加强治疗病房（ICU）的重要组成部分。受训医师（“住院医师”）作为核心团队成员，在学术型 ICU 中提供直接患者护理。然而，人们对住院医师对 ICU 团队功能的看法与其他学科的看法有何不同知之甚少。因此，我们比较了住院医师与护士（另一个主要的直接护理人员群体）在医疗 ICU 中的看法。
采用经过验证的团队功能量表（包括真实团队的存在、沟通质量、协作和协调）进行横断面调查。该调查在城市学术医疗中心的医疗 ICU 中对护士和住院医师进行了调查。我们分析了护士和住院医师在回答问题和对结构之间相互关系的看法方面的差异。
与护士相比，住院医师认为团队的边界更明确、协作性更强、工作计划性更强，但对沟通的满意度较低。住院医师和护士对团队功能结构之间的关系有非常相似的看法。两组都认为沟通的开放性和协作性是正相关的，但沟通的准确性和及时性是负相关的，这表明有机会提高整体团队绩效。
我们发现，在管理学术型 ICU 以及制定沟通和团队为基础的课程的住院医师项目主任方面，重症监护护士和医学住院医师（负责照顾学术医疗中心 ICU 中重症患者的主要类型的提供者）对团队功能的关键方面有不同的看法。这些结果可能对负责管理学术型 ICU 的人员以及制定沟通和团队为基础的课程的住院医师项目主任有用。
