Multidisciplinary Care in the ICU: Who’s in Charge?
The solution is not to neglect personal responsibility for patient care, they argue, but as “ICU environments involve a complicated dance of overlapping team-based care activities” the suggested solution is that physicians with highly specialised skills “must interact in a collegial but nonhierarchical fashion.”
See Also: Zoom On: Michael Nurok, Medical Director Cardiac-Surgical ICU, Cedars-Sinai
The “ship’s captain” model still prevails in some ICUs and becomes obvious when conflicts arise as communication breaks down. It is also pertinent to the informed consent model. The authors recommend that patients should be told that they will receive care from many professionals in the care team. Good handoff between caregivers is crucial, they argue.
Hospital leaders need to invest in skill development for physicians in communication and coordination and incentivise and reward good teamwork and communication. Teams should ideally be co-located, for example a heart institute housing surgery, cardiology, cardiac anaesthesiology and cardiac ICU.
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Published on : Mon, 8 Feb 2016
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