Interprofessional Team Member Communication Patterns, Teamwork, and Collaboration in Pre–family Meeting Huddles in a Pediatric Cardiac Intensive Care Unit

• Published in: Journal of pain and symptom management Vol. 58; no. 1; pp. 11 - 18
• Main Authors: Walter, Jennifer K., Schall, Theodore E., DeWitt, Aaron G., Faerber, Jennifer, Griffis, Heather, Galligan, Meghan, Miller, Victoria, Arnold, Robert M., Feudtner, Chris
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2019; Elsevier Limited
• Subjects: Attitude of Health Personnel; cardiac intensive care unit; Clinical decision making; Collaboration; Communication; Decision making; Female; Group performance; Heart Diseases - therapy; Humans; Intensive care; Intensive Care Units, Pediatric; Interdisciplinary aspects; Interpersonal communication; Interprofessional communication; Male; Meetings; Patient admissions; Patient Care Team; Pediatrics; Perceptions; Physicians; Prospective Studies; Qualitative Research; team communication; Teamwork; United States > US; cardiac intensive care unit; Interprofessional communication; teamwork; team communication; pediatrics
• ISSN: 0885-3924; 1873-6513; 1873-6513
• DOI: 10.1016/j.jpainsymman.2019.04.009

Interprofessional teams often develop a care plan before engaging in a family meeting in the pediatric cardiac intensive care unit (CICU)—a process that can affect the course of the family meeting and alter team dynamics but that has not been studied. To characterize the types of interactions that interprofessional team members have in pre–family meeting huddles in the pediatric CICU by 1) evaluating the amount of time each team member speaks; 2) assessing team communication and teamwork using standardized instruments; and 3) measuring team members' perceptions of collaboration and satisfaction with decision making. We conducted a prospective observational study in a pediatric CICU. Subjects were members of the interprofessional team attending preparation meetings before care meetings with families of patients admitted to the CICU for longer than two weeks. We quantitatively coded the amount each team member spoke. We assessed team performance of communication and teamwork using the PACT-Novice tool, and we measured perception of collaboration and satisfaction with decision making using the Collaboration and Satisfaction About Care Decisions questionnaire. Physicians spoke for an average of 83.9% of each meeting's duration (SD 7.5%); nonphysicians averaged 9.9% (SD 5.2%). Teamwork behaviors were present and adequately performed as judged by trained observers. Significant differences in physician and nonphysician perceptions of collaboration were found in three of 10 observed meetings. Interprofessional team members' interactions in team meetings provide important information about team dynamics, revealing potential opportunities for improved collaboration and communication in team meetings and subsequent family meetings.