Evaluating Teamwork in the Neonatal Intensive Care Unit

Abstract

Background: A unified vision of team mission, psychologically safe practice environment, effective communication, and respect among team members are key characteristics of an effective interdisciplinary neonatal intensive care unit (NICU) team. Purpose: A quality improvement team in a quaternary NICU surveyed parents, physicians, and nurses on perceptions of teamwork to identify opportunities for improvement. Design/Methods: Parents and healthcare staff (n = 113) completed an anonymous survey from May to July of 2014 to assess team roles and membership, team qualities, shared mission, psychological safety, hierarchy, communications, and conflict awareness. An expert panel assigned questions into one or more characteristics of team intelligence. Results: Physicians, nurses, and parents perceive their roles and the composition of the healthcare team differently. Most providers reported a shared mission and having a cooperative spirit as their teams' best attributes. While most nurses chose safety as most important, the majority of doctors chose treatment plan. Parents consider tenderness toward their infant, providing medical care and answers to their questions important. All expressed varying concerns about psychological safety, conflict resolution, and miscommunications. Implications for Practice: This survey identifies strengths and gaps of teamwork in our NICU and provides insight on necessary changes that need to be made to improve collaboration among the interdisciplinary care team including parents. Implications for Research: This quality improvement report identifies aspects of team care delivery in NICUs that require further study. The concept of team intelligence and its impact on team effectiveness invites in-depth exploration.

Neonatal medical trainee doctors' perceptions and parents' self‐reported needs and stressors in a surgical neonatal intensive care unit: An individualised approach

“…It was highly important to mothers to be told about the NICU environment before admission, to know the expected outcome and for parents to know which staff member is most appropriate to discuss about their infant. Perhaps doctors did not accurately perceive these needs because they assume other members of the multidisciplinary team have attended to these 2,15 . It was particularly important to mothers to be given directions about infant care.…”

“…Perhaps doctors did not accurately perceive these needs because they assume other members of the multidisciplinary team have attended to these. 2,15 It was particularly important to mothers to be given directions about infant care. While doctors underestimated this need, it is not generally considered part of a doctors' role, 7 with mothers reporting they generally seek this information from nurses.…”

“…Increasingly complex care requires collaboration across interdisciplinary care teams to optimise outcomes for families and infants. Traditionally, doctors' roles have focused on diagnosis, treatment and prognosis, and communicating this information with parents 2 . In the contemporary neonatal intensive care unit (NICU), doctors are encouraged to practice family‐centred care and collaborate with parents as partners 2 .…”

“…Traditionally, doctors' roles have focused on diagnosis, treatment and prognosis, and communicating this information with parents 2 . In the contemporary neonatal intensive care unit (NICU), doctors are encouraged to practice family‐centred care and collaborate with parents as partners 2 . Attending to the psycho‐emotional needs of parents promotes their involvement in the clinical care team and decision‐making regarding their infant 2 .…”

What Is Teamwork? A Mixed Methods Study on the Perception of Teamwork in a Specialized Neonatal Resuscitation Team

“…The neonatal intensive care unit (NICU) exemplifies a complex, high acuity healthcare environment dependent on teamwork and inter-professional collaboration. Delivering high-quality care to medically complex infants requires a cohesive team that collaborates and communicates well ( 4 ). Neonatal resuscitation is a key task in NICU care; in fact, ~10% of infants will require some help at birth, with 1% needing more extensive resuscitation such as endotracheal intubation and chest compressions ( 5 ).…”