title: Implementing potentially better practices for multidisciplinary team building: creating a neonatal intensive care unit culture of collaboration.
abstract: OBJECTIVE
  Part of the process of deriving and refining the CARE (communication, accountability, respect, empowerment) focus group's potentially better practices (PBPs) for multidisciplinary teamwork was to evaluate and experience the PBPs through implementation.
  
  
  METHODS
  The 4 neonatal intensive care units (NICUs) in the CARE focus group each worked with implementation of the PBPs. The choice of initial PBP and method of implementation was left up to each NICU's core team.
  
  
  RESULTS
  The experience of each of the PBPs that is reported was selected from only 1 of the NICUs. These are summarized and described in a plan-do-study-act type of format.
  
  
  CONCLUSIONS
  There was no ideal PBP with which to start. The intertwined nature of all of the PBPs provided additional opportunities to implement other PBPs. A change seemed to be a matter first of vocabulary, then of tentative acceptance, followed by gradual integration into the culture. Change was facilitated when there was acknowledgment of a need to do things differently by the NICU leadership. Although the validity of the PBPs and their importance in cultural change have yet to be confirmed, once there was a persisting intent to change, the makeup of the NICU culture moved to embrace change as part of its culture.
authors.affiliation: Presbyterian St Luke's Medical Center, Denver, Colorado, USA. marksbrown@compuserve.com
authors.forename: Mark S
authors.initials: MS
authors.lastname: Brown
authors.forename: Judy
authors.initials: J
authors.lastname: Ohlinger
authors.forename: Connie
authors.initials: C
authors.lastname: Rusk
authors.forename: Paula
authors.initials: P
authors.lastname: Delmore
authors.forename: Patricia
authors.initials: P
authors.lastname: Ittmann
mesh_terms: D019985:Benchmarking; D003142:Communication; D003299:Cooperative Behavior; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000592:standards; D007857:Leadership; D009936:Organizational Innovation; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000379:methods*; D014481:United States