• Critical care medicine · Jun 2018

    Review

    Interprofessional Care and Teamwork in the ICU.

    • Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Lipshutz Angela K M AKM Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA., and University of California, San Francisco Critical Care Innovations Group.
    • Division of Critical Care Medicine, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA.
    • Crit. Care Med. 2018 Jun 1; 46 (6): 980-990.

    ObjectivesWe describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success.Data SourcesStudies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles.Study SelectionOriginal articles, review articles, and systematic reviews were considered.Data ExtractionManuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles.Data Synthesis"Interprofessional care" refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils, end-of-life care, coordinated sedation awakening and spontaneous breathing trials, intrahospital transport, and transitions of care.ConclusionsA robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.

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