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A Bedside Communication Tool Did Not Improve the Alignment of a Multidisciplinary Team's Goals for Intensive Care Unit Patients
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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The delivery of modern intensive care unit ICU services is a complex process that requires a multidisciplinary approach to improve patient outcomes1, This multi-disciplinary approach represents a team of clinicians and support staff that work closely together, but often without shared priorities. This can lead to clinical situations in which a multi-disciplinary team is a team of experts, but not an expert team2. Ideally, all healthcare providers should share the same strategic vision for a patients daily care plan. This shared vision should include goal alignment and should provide the most efficient and effective patient care. It makes sense that increasing the personnel involved in a patients care increases the chance for communication errors3. Communication errors remain a major patient safety issue 4,5. The ICU is a high-risk environment in which medical errors occur frequently5-7. This performance improvement project was conducted in a 20-bed, surgical ICU in a 450-bed academic military medical center from December 2009 to April 2010. This unit functions as a transitional type ICU, 10 where surgical services admit their patients to the unit and remain the service of record all patients receive a mandatory critical care consult. In this environment, patients are co-managed by the surgical team and the ICU team. Alignment of daily patient care goals among HCT members is low overall and did not improve after implementing a DCC available to all team members. Further study to elucidate the mechanism by which daily goals forms improve patient care is required.
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