title: Development of potentially better practices for the neonatal intensive care unit as a culture of collaboration: communication, accountability, respect, and empowerment.
abstract: OBJECTIVE
  The Vermont Oxford Network (VON) CARE Group was formed in response to the need to create organizational cultures supportive of change and quality improvement.
  
  
  METHODS
  The CARE Group consisted of team members from 4 participating neonatal intensive care units (NICUs). All CARE Group members chose to work on multidisciplinary teamwork for the duration of the Neonatal Intensive Care Quality Improvement Collaborative Year 2000. A questionnaire was developed by the CARE Group and administered to the 4 focus group NICUs. The survey focused on 6 domains of the organization: unit coordination, working in the NICU, leadership, management of disagreements, authority, and unit culture. Benchmarking visits were completed to supplement the information found in the survey and the literature.
  
  
  RESULTS
  Seven potentially better practices (PBPs) were developed on the basis of the surveys, benchmark visits, and literature reviews. The PBPs include 1) a clear, shared NICU purpose, goals, and values; 2) effective communication among and between teams and team members; 3) leaders lead by example; 4) nurture a collaborative NICU environment with trust and respect; 5) live principled standards of conduct and standards of excellence; 6) nurture competent and committed teams and team members; and 7) commit to effective and positive conflict management.
  
  
  CONCLUSIONS
  The CARE Group successfully used quality improvement methods and collaboration to delineate principles and practices of multidisciplinary teamwork.
authors.affiliation: Children's Hospital Medical Center of Akron, Akron, Ohio 44308, USA. johlinger@chmca.org
authors.forename: Judy
authors.initials: J
authors.lastname: Ohlinger
authors.forename: Mark S
authors.initials: MS
authors.lastname: Brown
authors.forename: Sue
authors.initials: S
authors.lastname: Laudert
authors.forename: Sue
authors.initials: S
authors.lastname: Swanson
authors.forename: Ona
authors.initials: O
authors.lastname: Fofah
mesh_terms: D019985:Benchmarking; D003142:Communication; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D017144:Focus Groups; 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*; D016730:Program Development; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000379:methods*; D014481:United States