Delivering interprofessional care in intensive care: a scoping review of ethnographic studies.
BACKGROUND
The sustained clinical and policy interest in the United States and worldwide in quality and safety activities initiated by the release of To Err Is Human has resulted in some high-profile successes and much disappointment. Despite the energy and good intentions poured into developing new protocols and redesigning technical systems, successes have been few and far between, leading some to argue that more attention should be given to the context of care.


OBJECTIVE
To examine the insights provided by qualitative studies of interprofessional care delivery in intensive care.


METHODS
A total of 532 article abstracts were reviewed. Of these, 24 met the inclusion criteria.


RESULTS
Articles focused on the nurse-physician relationship, patient safety, patients' families and end-of-life care, and learning and cognition. The findings indicated the complexities and nuances of interprofessional life in intensive care and also that much needs to be learned about team processes.


CONCLUSIONS
The fundamental insight that interprofessional interactions in intensive care do not happen in a historical, social, and technological vacuum must be brought to bear on future research in intensive care if patient safety and quality of care are to be improved.
Elise Paradis is an assistant professor and Scott Reeves is a professor in the Department of Social and Behavioral Sciences, Kathleen Puntillo is a professor emerita, Physiological Nursing, and Michael Gropper is professor and executive vice chair, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California. Myles Leslie is a faculty research associate and Hanan J. Aboumatar is a member of the core faculty, Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland. Simon Kitto is director of research, Office of Continuing Education and Professional Development, University of Toronto, Toronto, Ontario.
Elise
E
Paradis
Myles
M
Leslie
Kathleen
K
Puntillo
Michael
M
Gropper
Hanan J
HJ
Aboumatar
Simon
S
Kitto
Scott
S
Reeves
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D003422:Critical Care / Q000458:organization & administration*; D005195:Family Relations; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D011361:Professional Competence; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D013727:Terminal Care