Evaluating an interprofessional team coaching program to promote a human-centered ICU environment

Technology-driven ICU environments can be dehumanizing for critically ill patients, their families, and team members who care for them. Prior educational efforts to humanize the ICU have focused on training clinicians to provide human-centered care for patients and families, with relatively little attention on promoting human-centered environments for team members.

We used the framework of team coaching to develop an interprofessional educational program focused on humanizing the ICU. We sought to evaluate whether this program improves participants' perceived capability to promote a human-centered environment for the ICU team.

We conducted a 3-year, mixed-methods evaluation of a novel interprofessional ICU team coaching program in a medical/surgical/trauma ICU within an academic medical center. The 3-session program is led by a certified coach, and annual cohorts are a subset of the ICU team. Session topics are: role identification, end-of-life care, and practices of dignity and respect. We conducted pre- and post-coaching participant surveys and qualitative content analysis of coaching reflections, open-ended survey responses, and an audio-recorded debriefing session.

Over 3 years, 43 ICU team members representing 7 professional roles (advanced practice providers, attending physicians, chaplains, fellow physicians, nurses, respiratory therapists, social workers) participated. The overall session attendance rate was 70%. Before participation, most reported a need for training to promote a human-centered environment for patients (78.1%), families (81.3%), and other members of the team (81.3%). After coaching, this unmet need decreased to 28.6% for patients (P < .01), 42.9% for families (P < .01), and 33.3% for team members (P < .01). Participants' self-reported ability to provide optimal human-centered care was similar pre-(84.4%) and post-coaching (81.8%; P = .80). Participants' scores on the interprofessional version of the Consultation and Relational Empathy (CARE) measure improved from 37.1 (95% CI 34.3-39.9) pre-coaching to 40.7 post-coaching (95% CI 38.8-42.6; P = .047). Qualitative analysis revealed commitment to growth in interprofessional relationships among participants and a desire to expand the program's reach.

Our findings confirm an unmet need among ICU team members for training in how to promote human-centered ICU environments and suggest that interprofessional team coaching is a promising tool to help meet this need.