Team working in intensive care: current evidence and future endeavors.
OBJECTIVE
It has recently been argued that the future of intensive care medicine will rely on high quality management and teamwork. Therefore, this review takes an organizational psychology perspective to examine the most recent research on the relationship between teamwork, care processes, and patient outcomes in intensive care.


RESULTS
Interdisciplinary communication within a team is crucial for the development of negotiated shared treatment goals and short-team patient outcomes. Interventions for maximizing team communication have received substantial interest in recent literature. Intensive care coordination is not a linear process, and intensive care teams often fail to discuss how to implement goals, trigger and align activities, or reflect on their performance. Despite a move toward interdisciplinary team working, clinical decision-making is still problematic and continues to be perceived as a top-down and authoritative process. The topic of team leadership in intensive care is underexplored and requires further research.


CONCLUSIONS
Based on findings from the most recent research evidence in medicine and management, four principles are identified for improving the effectiveness of team working in intensive care: engender professional efficacy, create stable teams and leaders, develop trust and participative safety, and enable frequent team reflexivity.
Richardson
Joanne
J
Aston Business School, Aston University, Birmingham, UK. J.Richardson3@aston.ac.uk
West
Michael A
MA
Cuthbertson
Brian H
BH
D003142:Communication; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D003657:Decision Making; D006126:Group Processes; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D024382:Professional Role; D011785:Quality Assurance, Health Care / Q000458:organization & administration*