Northwestern University, Evanston, Illinois, USA.
Department of Surgery, Northwestern University, Evanston, Illinois, USA.
BMJ Open. 2023 Dec 13;13(12):e075470. doi: 10.1136/bmjopen-2023-075470.
Poor interdisciplinary care team communication has been associated with increased mortality. The study aimed to define conditions for effective interdisciplinary care team communication.
An observational cross-sectional qualitative study.
A surgical intensive care unit in a large, urban, academic referral medical centre.
A total 6 interviews and 10 focus groups from February to June 2021 (N=33) were performed. Interdisciplinary clinicians who cared for critically ill patients were interviewed. Participants included intensivist, transplant, colorectal, vascular, surgical oncology, trauma faculty surgeons (n=10); emergency medicine, surgery, gynaecology, radiology physicians-in-training (n=6), advanced practice providers (n=5), nurses (n=7), fellows (n=1) and subspecialist clinicians such as respiratory therapists, pharmacists and dieticians (n=4). Audiorecorded content of interviews and focus groups were deidentified and transcribed verbatim. The study team iteratively generated the codebook. All transcripts were independently coded by two team members.
Conditions for effective interdisciplinary care team communication.
We identified five themes relating to conditions for effective interdisciplinary care team communication in our surgical intensive care unit setting: role definition, formal processes, informal communication pathways, hierarchical influences and psychological safety. Participants reported that clear role definition and standardised formal communication processes empowered clinicians to engage in discussions that mitigated hierarchy and facilitated psychological safety.
Standardising communication and creating defined roles in formal processes can promote effective interdisciplinary care team communication by fostering psychological safety.
跨学科护理团队沟通不畅与死亡率升高有关。本研究旨在确定有效的跨学科护理团队沟通的条件。
观察性横断面定性研究。
一家大型城市学术转诊医疗中心的外科重症监护病房。
2021 年 2 月至 6 月期间共进行了 6 次访谈和 10 次焦点小组（N=33）。采访了照顾重症患者的跨学科临床医生。参与者包括重症监护医师、移植医师、结直肠医师、血管医师、外科肿瘤医师、创伤外科教授（n=10）；急诊医学、外科、妇科、放射科住院医师（n=6）、高级实践提供者（n=5）、护士（n=7）、研究员（n=1）和呼吸治疗师、药剂师和营养师等专科临床医生（n=4）。访谈和焦点小组的录音内容被匿名化并逐字转录。研究团队迭代生成了代码本。所有转录本均由两名团队成员独立编码。
有效的跨学科护理团队沟通的条件。
我们确定了五个与我们外科重症监护病房环境中有效的跨学科护理团队沟通条件相关的主题：角色定义、正式流程、非正式沟通途径、等级影响和心理安全感。参与者报告称，明确的角色定义和标准化的正式沟通流程使临床医生能够进行讨论，从而减轻等级制度的影响并促进心理安全感。
标准化沟通和在正式流程中创建明确的角色可以通过促进心理安全感来促进有效的跨学科护理团队沟通。
