ICU Management & Practice, ICU Volume 14 - Issue 1 - Spring 2014

Appendix 2c. ICU Observations. Work Process/ Work Flow.

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Your Role:

Your role is to be a neutral observer, with fresh eyes, of what you see during your ICU visit. We would like you to pay particular attention to the WORK PROCESSES: how patients, staff and family visitors interact and flow through the ICU, and how they affect the care and safety of patients. If you have questions, please check with your guide or host before approaching staff members. Keep your questions pretty open--‐ended (e.g., not Yes--‐No questions) and continually ask "Why?" to get to the root causes of what you hear. Please write your observations in this pad.


Please look around you and observe what is happening: These are your personal observations based on your visit as well as your questioning of staff, patients and family. Think about, and jot down observations on:

• What surprises you about the ICU? Why?

• What Do you see as some of the issues that staff, patients, and families face in the ICU?

• What are some work--‐arounds that you have seen (e.g., improvised ways to work around problems)?

• What are some of the ways you think we could fix the problems you have seen? Why?

• How would you feel if you were a staff member in the ICU? Why?

• How Do you think patients and families feel? Why?


Here are some questions that may help you dig deeper: Feel free to improvise and create your own questions.

• How would you describe what it is like to be a staff member in the ICU? Why?

• What surprises you about being in the ICU? What do you think most people who have not been here wouldn’t know about it? Why?

• What are the best experiences you’ve had working here?

• What are some things that concern you about working in here?

• If you could fix the biggest problem in the ICU, what is it, and what would you do? Is there any way you can think of to improve the work processes and workflow of the ICU? What might they be?

• Do you see any risks to patient safety in this ICU that you would want to fix? What are they? How would you fix them?

• How do you think families of patients feel about visiting the ICU? What could be done to improve that? Why?

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Your Role: Your role is to be a neutral observer, with fresh eyes, of what you see during your ICU vis

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