Abstract
Paired direct observations of a physician and nurse caring for 11 challenging patients at four Intensive Care Units (ICUs) were conducted to identify structured interdisciplinary communication strategies. Providers employed the following strategies at all four ICUs: 1) nurses listening to bedside (but not closed) rounds, 2) nurses cross-checking physician plans, and 3) physicians and nurses providing “heads-up” alerts. Providers employed the following at some of the ICUs: 1) nurses and physicians speaking privately following rounds (3/4 ICUs), and 2) nurses speaking during bedside rounds (2/4 ICUs). None (0/4 ICUs) conducted pre-round interdisciplinary briefings. None (0/4 ICUs) used artifacts explicitly designed to aid interdisciplinary communication (e.g., Morning Briefing Tools), although shared electronic and paper resources were used by both nursing and physician personnel. Implications of the findings are discussed.
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