Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
J Pain Symptom Manage. 2019 Jul;58(1):11-18. doi: 10.1016/j.jpainsymman.2019.04.009. Epub 2019 Apr 18.
Interprofessional teams often develop a care plan before engaging in a family meeting in the pediatric cardiac intensive care unit (CICU)-a process that can affect the course of the family meeting and alter team dynamics but that has not been studied.
To characterize the types of interactions that interprofessional team members have in pre-family meeting huddles in the pediatric CICU by 1) evaluating the amount of time each team member speaks; 2) assessing team communication and teamwork using standardized instruments; and 3) measuring team members' perceptions of collaboration and satisfaction with decision making.
We conducted a prospective observational study in a pediatric CICU. Subjects were members of the interprofessional team attending preparation meetings before care meetings with families of patients admitted to the CICU for longer than two weeks. We quantitatively coded the amount each team member spoke. We assessed team performance of communication and teamwork using the PACT-Novice tool, and we measured perception of collaboration and satisfaction with decision making using the Collaboration and Satisfaction About Care Decisions questionnaire.
Physicians spoke for an average of 83.9% of each meeting's duration (SD 7.5%); nonphysicians averaged 9.9% (SD 5.2%). Teamwork behaviors were present and adequately performed as judged by trained observers. Significant differences in physician and nonphysician perceptions of collaboration were found in three of 10 observed meetings.
Interprofessional team members' interactions in team meetings provide important information about team dynamics, revealing potential opportunities for improved collaboration and communication in team meetings and subsequent family meetings.
多专业团队通常会在儿科心脏重症监护病房(CICU)进行家庭会议之前制定护理计划——这一过程会影响家庭会议的进程并改变团队动态,但尚未对此进行研究。
通过以下方式来描述儿科 CICU 中的多专业团队成员在会前团队会议中的互动类型:1)评估每位团队成员的发言时间;2)使用标准化工具评估团队沟通和团队协作;3)测量团队成员对协作的看法以及对决策制定的满意度。
我们在儿科 CICU 中进行了一项前瞻性观察研究。研究对象为在 CICU 中接受治疗的患者的家庭护理会议前准备会议中参加的多专业团队成员,这些患者的住院时间超过两周。我们对每位团队成员的发言量进行了定量编码。我们使用 PACT-Novice 工具评估团队沟通和团队协作表现,使用“协作和对护理决策的满意度”问卷来测量对协作的看法以及对决策制定的满意度。
医生在每次会议中的平均发言时间为 83.9%(标准差为 7.5%);非医生的平均发言时间为 9.9%(标准差为 5.2%)。根据经过培训的观察员的判断,团队协作行为表现良好且充分。在观察到的 10 次会议中,有 3 次医生和非医生对协作的看法存在显著差异。
团队会议中多专业团队成员的互动提供了有关团队动态的重要信息,揭示了团队会议以及随后的家庭会议中改进协作和沟通的潜在机会。