Bedside Communication Tool Did Not Improve the Alignment of a Multidisciplinary Team's Goals for Intensive Care Unit Patients.

摘要

The delivery of modern intensive care unit (ICU) services is a complex process that requires a multidisciplinary approach to improve patient outcomes[1], This multi-disciplinary approach represents a team of clinicians and support staff that work closely together, but often without shared priorities. This can lead to clinical situations in which a multi-disciplinary team is a team of experts, [but] not an expert team"[2]. Ideally, all healthcare providers should share the same strategic vision for a patient's daily care plan. This shared vision should include goal alignment and should provide the most efficient and effective patient care. It makes sense that increasing the personnel involved in a patient's care increases the chance for communication errors[3]. Communication errors remain a major patient safety issue [4,5]. The ICU is a high-risk environment in which medical errors occur frequently[5-7]. This performance improvement project was conducted in a 20-bed, surgical ICU in a 450-bed academic military medical center from December 2009 to April 2010. This unit functions as a transitional type ICU, [10] where surgical services admit their patients to the unit and remain the service of record; all patients receive a mandatory critical care consult. In this environment, patients are co-managed by the surgical team and the ICU team. Alignment of daily patient care goals among HCT members is low overall and did not improve after implementing a DCC available to all team members. Further study to elucidate the mechanism by which daily goals forms improve patient care is required.