Beyond the Team: Understanding Interprofessional Work in Two North American ICUs

Area of Science:

• Healthcare delivery
• Interprofessional collaboration
• Intensive care unit (ICU) studies

Background:

• Teamwork is often emphasized for patient safety in ICUs.
• Existing models may not fully capture the complexity of interprofessional work.

Purpose of the Study:

• To examine interprofessional collaboration in the ICU.
• To consider contextual, organizational, processual, and relational factors impacting collaboration.

Main Methods:

• Ethnographic observation (350+ hours) and semistructured interviews (35) with clinicians.
• Study conducted in medical-surgical ICUs at two urban research hospitals.
• Data collected over 6 months by two medical anthropologists.

Main Results:

• Interprofessional interactions in ICUs extend beyond teamwork.
• Collaboration, coordination, and networking are key forms of interprofessional work.
• Teamwork is primarily observed during crisis situations.

Conclusions:

• A singular concept of 'team' is insufficient to describe ICU work.
• Quality improvement initiatives must acknowledge diverse interprofessional dynamics.
• Adapting interventions to local ICU contexts is vital for safe and effective patient care.