A qualitative study of how team characteristics and leadership are associated with information sharing in multidisciplinary intensive care units.

Autor: Abahuje E; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: abegid@gmail.com., Diaz CM; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL., Lin KA; Department of Surgery, Mayo Clinic, Rochester, MN., Tesorero K; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL., Bushara O; Department of Surgery, University of Pennsylvania, Philadelphia, PA., Yang S; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL., Berry ABL; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL., Rafferty MR; Shirley Ryan Ability Lab, Northwestern University, Chicago, IL., Johnson JK; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL., Stey AM; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2023 Aug; Vol. 174 (2), pp. 350-355. Date of Electronic Publication: 2023 May 19.
DOI: 10.1016/j.surg.2023.03.017
Abstrakt: Background: Better information sharing in intensive care units has been associated with lower risk-adjusted mortality. This study explored how team characteristics and leadership are associated with information sharing in 4 intensive care units in a single large urban, academic medical center.
Methods: A qualitative study was conducted to understand how team characteristics and leadership are associated with information sharing. Qualitative data were conducted through ethnographic observations. One postdoctoral research fellow and one PhD qualitative researcher conducted nonparticipant observations of a Medical, Surgical, Neurological, and Cardiothoracic intensive care unit morning and afternoon rounds, as well as nurse and resident handoffs from May to September 2021. Field notes of observations were thematically analyzed using deductive reasoning anchored to the Edmondson Team Learning Model. This study included nurses, physicians (ie, intensivists, surgeons, fellows, and residents), medical students, pharmacists, respiratory therapists, dieticians, physical therapists, physician assistants, and nurse practitioners.
Results: We conducted 50 person-hours of observations involving 148 providers. Three themes emerged from the qualitative analysis: (1) team leaders used variable leadership techniques to involve team members in discussions for information sharing related to patient care, (2) predefined tasks for team members allowed them to prepare for effective information sharing during intensive care unit rounds, and (3) a psychologically safe environment allowed team members to participate in discussions for information sharing related to patient care.
Conclusion: Inclusive team leadership is foundational in creating a psychologically safe environment for effective information sharing.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: