Objective: There is a growing literature on the relationship between teamwork and patient outcomes in intensive care, providing new insights into the skills required for effective team performance. The purpose of this review is to consolidate the most robust findings from this research into an ICU team performance framework. 'team decision making'. A prototype framework explaining team performance in the ICU was developed using these categories. The purpose of the framework is to consolidate the existing ICU teamwork literature, and to guide the development and testing of interventions for improving teamwork.
Data
Conclusions:Effective teamwork is shown as crucial for providing optimal patient care in the ICU. In particular, team leadership appears vital for guiding the way in which ICU team members interact and coordinate with others.
Key words: ICU; Teamwork; Team performance framework; Training interventions; Patient safety; LeadershipPublished as: Reader, T., Flin, R., Mearns, K., & Cuthbertson, B. (2009). Developing a team performance framework for the Intensive Care Unit. Critical Care Medicine, 35, 1789-1793 3 Teamwork refers to the way in which team members function and coordinate to produce 'synchronised' output (1). Patient safety research has demonstrated that poor teamwork is a causal factor underlying critical incidents in the intensive care unit (ICU) (2). Due to this, a growing amount of research has been conducted within the ICU in order to identify the specific components of teamwork that influence patient outcomes (3,4). The main purpose of this research is to guide the design of training materials and workplace interventions to improve teamwork. However, at present the findings from studies investigating ICU teamwork are disparate and lack synthesis, therefore the extent to which they can influence practice, training and future research is limited. This review takes an industrial psychology perspective to summarise the ICU teamwork literature, and develops a conceptual team performance framework tailored for intensive care medicine.
Team performance frameworksPsychology researchers in high-risk industries (e.g. aviation, military, nuclear power) have found effective teamwork as crucial for maintaining safety within these domains (5,6). In order to better understand the relationship between teamwork and performance in these settings, team performance frameworks (or models) have been developed. These show team outputs (e.g. team effectiveness, performance, errors) to be influenced by group 'processes' related to team communication, leadership, coordination and decision-making (7-11). Furthermore, group processes are influenced by a range of 'inputs' (e.g. group structures, member characteristics, work tasks) (12)(13)(14). The purposes of team performance frameworks are three-fold. Firstly, they systematise the mechanisms that predict team performance, thus facilitating the Published as: Reader, T., Flin, R., Mearns, K., & Cuthbertson, B. (2009)
MethodThe identification of ICU teamwork ...
