Team model: Advocating for the optimal method of care delivery in the intensive care unit

Abstract

Current and looming shortages of all ICU healthcare providers is a barrier to universal implementation of the team model. Advocating for the ICU team model for critical care delivery requires local, regional, national, and international activities for success.

Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units

“…Previous research in the ICU has documented the generally high prevalence of interprofessional and intraprofessional conflict (Danjoux Meth et al 2009;Lingard et al 2004), despite continued recognition of the importance of team care by leaders in the field (Brilli et al 2001;Durbin 2006;Weil 1973). Quantitative, outcomes-based studies demonstrating the positive impact of interprofessional rounds on costs, length-of-stay, and adverse events in the ICU (Kim et al 2010;Leape et al 1999;Pronovost et al 2003) have been published alongside critical, qualitative studies of their mixed impact on collaborative behavior.…”

Two Decades (1993-2012) of Adult Intensive Care Unit Design

“…They help improve quality of care in ICUs [57]. Therefore, staff work areas should include adequate spaces for team interaction with convenient access to computer, data, and telecommunication devices.…”

The Effects of Advanced Practice Nurses (APNs) as Intensivists in a Surgical Intensive Care Unit (SICU) on Patient Outcomes, Healthcare Charges, and APN Intensivist Services in the SICU

“…The team model has been advocated as the optimal method to deliver care in the ICUs (Durbin, 2006). Resulting collaboration has been documented extensively and places the intensivist at the helm of this enterprise (Durbin, 2006). Nursing as a discipline has also been instrumental in the development and specialization of ICUs and critical care medicine (Binnekade, Vroom, de Mol, & de Haan, 2003).…”

“…The team model has been advocated as the optimal method to deliver care in the ICUs (Durbin, 2006). Resulting collaboration has been documented extensively and places the intensivist at the helm of this enterprise (Durbin, 2006).…”

“…Published literature documents the role of nurses' education and qualifications, and staffing ratios in improved patient outcomes (Aiken, Clarke, Cheung, Sloane, & Silber, 2003;Aiken, Clarke, Sloane, Sochalski, & Silber, 2002;Blegen, Goode, & Reed, 1998;Cho, Ketefian, Barkauskas, & Smith, 2003;Giraud et al, 1993;Lichtig, Knauf, & Milholland, 1999;McGillis Hall, Doran, & Pink, 2004;Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002a;Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002b;Person et al, 2004;Pronovost et al, 2001; Several studies have advocated for the physician intensivist model (Hanson et al, 1999;Pronovost et al, 2002;Reynolds, Haupt, Thill-Bahazorian, & Carlson, 1988) in ICUs. Durbin (2006), in advocating for care in ICUs through an intensivist-lead Team Model, pointed to an estimated 30% -50% reduction in mortality when intensivists rounded daily on critically ill patients, and to the shortening of the length of stay, reduction in cost, and prevention of complications with the implementation of this model. However the role of physician intensivists remains a source of debate among practicing critical care medicine physicians and throughout the medical profession in general.…”