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Published in: Journal of General Internal Medicine 10/2018

01-10-2018 | Original Research

Interprofessional Collaborative Practice in the Medical Intensive Care Unit: a Survey of Caregivers’ Perspectives

Authors: Debbie W. Chen, MD, Angela M. Gerolamo, PhD, RN, Elissa Harmon, RN, DNP, CCRN, PHNA-BC, Anna Bistline, BS, Shoshana Sicks, EdM, Lauren Collins, MD

Published in: Journal of General Internal Medicine | Issue 10/2018

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Abstract

Background

Research on caregivers, defined as designated family members or support persons, in the medical intensive care unit (MICU) has primarily focused on their emotional needs and experiences, thus leaving a gap in knowledge related to their perceptions of team dynamics.

Objective

To examine caregivers’ perceptions of team interactions and competencies for interprofessional collaborative practice (IPCP) and overall satisfaction with the MICU team.

Methods

The Support Person Jefferson Teamwork Observation Guide (JTOG)™ was administered to a convenience sample of caregivers in the MICU at a large urban academic medical center between May 2016 and December 2016.

Results

One hundred sixty-one JTOG surveys were completed. Caregivers agreed on the importance of healthcare professionals working together as a team to provide patient care (3.97 out of 4.0 on Likert response scale where 1 is “Not at all important” and 4 is ‘Extremely important”) and were satisfied with the MICU team (3.74 out of 4.0), positively evaluating the four core competencies for IPCP (3.55 for values/ethics, 3.58 for interprofessional communication, 3.61 for roles/responsibilities, and 3.64 for teams/teamwork) and the patient/family-centeredness sub-competency (3.58 out of 4.0). There was a strong positive correlation between caregivers’ Global JTOG scores and overall satisfaction with the MICU team (r = 0.596, p < 0.01). Caregivers’ comments about factors that affected their experience focused on aspects of interprofessional communication and patient/family-centeredness.

Conclusion

Findings underscore the importance of interprofessional communication and providing patient/family-centered care. Assessing caregivers’ perceptions of IPCP can provide a critical lens into team functioning and, thus, be used to identify teams’ strengths as well as opportunities for improvement.
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Literature
1.
go back to reference Committee on Quality Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press; 2001. Committee on Quality Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press; 2001.
2.
go back to reference Education Committee on Measuring the Impact of Interprofessional. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes. Washington, D.C.: The National Academies Press; 2015. Education Committee on Measuring the Impact of Interprofessional. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes. Washington, D.C.: The National Academies Press; 2015.
3.
go back to reference Berwick DM, Nolan TW, and Whittington J. The triple aim: care, health, and cost. Health Aff 2008;27(3):759–769.CrossRef Berwick DM, Nolan TW, and Whittington J. The triple aim: care, health, and cost. Health Aff 2008;27(3):759–769.CrossRef
4.
go back to reference Institute of Medicine. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes. Washington, D.C.: The National Academies Press; 2015. Institute of Medicine. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes. Washington, D.C.: The National Academies Press; 2015.
5.
go back to reference Reeves S, Fletcher S, Barr H, et al. A BEME Systematic Review of the Effects of Interprofessional Education: BEME Guide No. 39. Med Teach 2016;38(7):656–668.CrossRefPubMed Reeves S, Fletcher S, Barr H, et al. A BEME Systematic Review of the Effects of Interprofessional Education: BEME Guide No. 39. Med Teach 2016;38(7):656–668.CrossRefPubMed
6.
go back to reference Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework. Vancouver, BC: Her Majesty the Queen in Right of Canada; 2010. Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework. Vancouver, BC: Her Majesty the Queen in Right of Canada; 2010.
7.
go back to reference Davidson JE, Powers K, Hedayat KM, et al. Clinical practice guidelines for support of the family in patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 2007;35(2):605–622.CrossRefPubMed Davidson JE, Powers K, Hedayat KM, et al. Clinical practice guidelines for support of the family in patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 2007;35(2):605–622.CrossRefPubMed
8.
go back to reference Burr G. Contextualizing critical care family needs through triangulation: an Australian study. Intensive Crit Care Nurs 1998;14(4):161–169.CrossRefPubMed Burr G. Contextualizing critical care family needs through triangulation: an Australian study. Intensive Crit Care Nurs 1998;14(4):161–169.CrossRefPubMed
9.
go back to reference Al-Mutair AS, Plummer V, O’Brien A, Clerehan R. Family needs and involvement in the intensive care unit: a literature review. J Clin Nurs 2013;22:1805–1817.CrossRefPubMed Al-Mutair AS, Plummer V, O’Brien A, Clerehan R. Family needs and involvement in the intensive care unit: a literature review. J Clin Nurs 2013;22:1805–1817.CrossRefPubMed
10.
go back to reference Quinn JR, Schmitt M, Baggs JG, Norton SA, Dombeck MT, Sellers CR. Family members’ informal roles in end-of-life decision making in adult intensive care units. Am J Crit Care 2012;21(1):43–51.CrossRefPubMedPubMedCentral Quinn JR, Schmitt M, Baggs JG, Norton SA, Dombeck MT, Sellers CR. Family members’ informal roles in end-of-life decision making in adult intensive care units. Am J Crit Care 2012;21(1):43–51.CrossRefPubMedPubMedCentral
11.
go back to reference Lyons KJ, Giordano C, Speakman E, Smith K, Horowitz JA. Jefferson Teamwork Observation Guide (JTOG): an instrument to observe teamwork behaviors. J Allied Health 2016;45(1):49–53.PubMed Lyons KJ, Giordano C, Speakman E, Smith K, Horowitz JA. Jefferson Teamwork Observation Guide (JTOG): an instrument to observe teamwork behaviors. J Allied Health 2016;45(1):49–53.PubMed
12.
go back to reference Interprofessional Education Collaborative Expert Panel. Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. Washington, D.C.: Interprofessional Education Collaborative; 2011. Interprofessional Education Collaborative Expert Panel. Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. Washington, D.C.: Interprofessional Education Collaborative; 2011.
13.
go back to reference Interprofessional Education Collaborative. Core Competencies for Interprofessional Collaborative Practice: 2016 Update. Washington, D.C.: Interprofessional Education Collaborative; 2016. Interprofessional Education Collaborative. Core Competencies for Interprofessional Collaborative Practice: 2016 Update. Washington, D.C.: Interprofessional Education Collaborative; 2016.
14.
go back to reference LaNoue M, Collins LG, Sicks S, Asensio A, and Silverio A. Validation study of patient version of the Jefferson Teamwork Observation Guide (JTOG©). J Interprofessional Educ Pract. (Accepted, at press). LaNoue M, Collins LG, Sicks S, Asensio A, and Silverio A. Validation study of patient version of the Jefferson Teamwork Observation Guide (JTOG©). J Interprofessional Educ Pract. (Accepted, at press).
15.
go back to reference Molter NC. Needs of relatives of critically ill patients: a descriptive study. Heart Lung 1979;8:332–339.PubMed Molter NC. Needs of relatives of critically ill patients: a descriptive study. Heart Lung 1979;8:332–339.PubMed
16.
go back to reference Heyland DK, Rocker GM, Dodek PM, et al. Family satisfaction with care in the intensive care unit: Results of a multiple center study. Crit Care Med 2002;30(7):1413–1418.CrossRefPubMed Heyland DK, Rocker GM, Dodek PM, et al. Family satisfaction with care in the intensive care unit: Results of a multiple center study. Crit Care Med 2002;30(7):1413–1418.CrossRefPubMed
17.
go back to reference Wallau RA, Guimaraes HP, dos Reis Falcao LF, et al. Qualidade e Humanização do Atendimento em Medicina Intensiva. Qual a Visão dos Familiares? Rev Bras Ter Intensiva 2006;18(1):45–51.CrossRefPubMed Wallau RA, Guimaraes HP, dos Reis Falcao LF, et al. Qualidade e Humanização do Atendimento em Medicina Intensiva. Qual a Visão dos Familiares? Rev Bras Ter Intensiva 2006;18(1):45–51.CrossRefPubMed
18.
go back to reference National Center for Interprofessional Practice and Education. Assessing Teamwork: Stories from the Field, A Practical Guide: Volume 4. Regents of the University of Minnesota; 2017. National Center for Interprofessional Practice and Education. Assessing Teamwork: Stories from the Field, A Practical Guide: Volume 4. Regents of the University of Minnesota; 2017.
19.
go back to reference Scherzer R, Dennis M, Swan BA, Kavuru MS, and Oxman D. A Comparison of usage and outcomes between nurse practitioner and resident-staffed medical ICUs. Crit Care Med 2017;45(2):e132-e137.CrossRefPubMed Scherzer R, Dennis M, Swan BA, Kavuru MS, and Oxman D. A Comparison of usage and outcomes between nurse practitioner and resident-staffed medical ICUs. Crit Care Med 2017;45(2):e132-e137.CrossRefPubMed
Metadata
Title
Interprofessional Collaborative Practice in the Medical Intensive Care Unit: a Survey of Caregivers’ Perspectives
Authors
Debbie W. Chen, MD
Angela M. Gerolamo, PhD, RN
Elissa Harmon, RN, DNP, CCRN, PHNA-BC
Anna Bistline, BS
Shoshana Sicks, EdM
Lauren Collins, MD
Publication date
01-10-2018
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 10/2018
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-018-4623-3

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