Understanding the distributed cognitive processes of intensive care patient discharge.
BACKGROUND The benefits of improved interdisciplinary collaboration in the health care section are well documented in the literature, including fewer errors and shorter delays and thus enhanced effectiveness and maximised patient safety. Given that the first step in improving teamwork involves uncovering individual team member's attitudes, this study was planned to investigate the level of collaboration, as part of organizational culture in the environment of ICU in Hippokratio Hospital. METHODS Considering as team all the medical and nursing stuff necessary for the integraded care of the ICU-patient, all the ICU personnel was included in the study, as well as that of other cooperating clinical departments and labs of Hippokratio hospital. For the purpose of the study a questionnaire was adopted and was given to 250 individuals, 196 of which responded (response rate 78.4%). RESULTS Responders, in general, valued teamwork as crucial for the performance of ICU. However, the study revealed a relative low consensus regarding the level of teamwork within each unit and inadequate collaboration between certain departments and ICU. Interestingly enough, most of the responders were willing to share responsibility but unwilling to share decision making or accept questioning of their actions. Finally, low consensus was also observed regarding the composition of the team, some responders (mostly clinicians) undervaluing the contribution of labs. Certain differences were detected across departments, as well as between physicians and nurses, the statistical significance of which is indicated. CONCLUSION Although the benefits of teamwork are well understood, realization of effective cooperation seems to be yet too far from our interdisciplinary practice. Teaching of teamwork skills and team concepts should become part of our medical or nursing education and training, if we should want to achieve a substantial improvement of quality of healthcare services, especially in high risk areas such as the ICUs.