Team Science and Critical Care

Abstract

Because critical care is administered by multidisciplinary teams, it is plausible that behavioral methods to enhance team performance may impact the quality and outcomes of care. This review highlights the social and behavioral scientific principles of team building and briefly reviews four features of teams--leadership, psychological safety, transactive memory, and accountability--that are germane to critical care teams. The article highlights how team principles might be used to improve patient care and navigate hospital hierarchies, and concludes with implications for future educational and scientific efforts.

A nursing perspective of interprofessional work in critical care: Findings from a secondary analysis

“…Collaborative interprofessional interactions, a key factor in critical care team (CCT) performance, influence patient outcomes [1][2][3][4][5]. Critically ill patients are vulnerable both clinically, where small errors in care can produce significant morbidity and mortality [3,4], as well as psychologically, where patients may experience "voicelessness" due to their lifethreatening conditions and power imbalance between the patient and provider relationship [ 6,7].…”

“…Critically ill patients are vulnerable both clinically, where small errors in care can produce significant morbidity and mortality [3,4], as well as psychologically, where patients may experience "voicelessness" due to their lifethreatening conditions and power imbalance between the patient and provider relationship [ 6,7]. Critically ill patients in the intensive care unit (ICU) depend on the collective expertise and skill of the CCT to function cohesively, collaboratively, and effectively to give patients the "greatest chance of high-quality survival" [8, p. 307).…”

“…A multitude of team, organizational, and managerial factors can impact patient outcomes in the ICU [4,[12][13][14]. Models conceptualizing possible interrelationships among these factors have been proposed but not quantified regarding the respective contribution of each factor to defined outcomes [11,14].…”

“…Models conceptualizing possible interrelationships among these factors have been proposed but not quantified regarding the respective contribution of each factor to defined outcomes [11,14]. Emerging evidence suggests that of the three types of factors, team factors, particularly those that shape interprofessional interactions (IP interactions) where exchange of crucial information and problem-solving may or may not occur, play a crucial role in ICU patient outcomes [3,4,11]. A high-functioning, collaborative CCT is one where all team members feel respected and empowered to participate; CCTs do not happen by chance but are built deliberatively through ICU physician and nursing leadership and creation of a culture of psychological safety where all team members feel safe to offer their opinions and expertise in caring for the patient [4].…”

Hippocrates as Hospital Employee: Balancing Beneficence and Contractual Duty

“…In this model of commodified health care, 21 a preponderance of power rests with hospital executives whose interests include both finances, which are easily quantified for the boards to which they answer, and patient primacy, which is ethereal. Nonetheless, critical care nurses are core members of a potentially strong interdisciplinary team, 22 in which the combined voices of professionals such as physicians, nurses, respiratory therapists, and nutritionists may be more likely to affect managerial decision making.…”