Optimizing the interdisciplinary team in a neuroscience ICU

Introduction: A high-functioning interdisciplinary team is needed to achieve optimal team and patient outcomes in the provision of care for intensive care patients. The difference between a high functioning and suboptimal interdisciplinary team manifest as variations in team outputs. Identification of key characteristics of high functioning teams can be used to assess and evaluate current interdisciplinary teams for potential areas of optimization. Methods: This study is a quality improvement needs assessment of the current interdisciplinary team performance in the neuroscience intensive care unit (NSICU) at a large academic medical center. This project employed a mixed method design, using quantitative methods for collected survey data and qualitative methods for thematic analysis of open-ended responses. Results: The survey had a 59.5% response rate, with 84 team members completing the survey. The majority of participants were registered nurses (n=51), followed by providers (n=21), and then other therapist members (n=12). Five themes were identified from open-ended responses regarding strengths and barriers to team effectiveness: structure, roles, the rounding processes, engagement, and team interactions. Within these themes, the needs of the team included: a shared decision-making model, improved engagement of staff members, improved team stability, clearly defined roles, interventions to improve the rounding process, and further evaluation of team interactions. Discussion: Assessment and diagnosis are the first steps in approaching optimization of the interdisciplinary team. Each interdisciplinary team is unique. Understanding the needs of the team is essential to creating a high functioning team. Key words: Interdisciplinary, Multidisciplinary, Team, Quality improvement, Team processes