Researchers from the University of Michigan have shed new light on the complexities of interprofessional collaboration (IPC) in intensive care units (ICUs), detailing specific behaviors that constitute engagement in the IPC process. The paper, titled “Identifying the Unique Behaviors Embedded in the Process of Interprofessional Collaboration in the ICU,” reveals a deeper understanding of the mechanisms behind high-quality care delivery in ICUs.
Led by Emily Boltey, Theodore Iwashyna, Amy Cohn, Deena Costa, and several Center for Healthcare Engineering and Patient Safety (CHEPS) undergraduate students, the two-year study utilized an innovative clinical ethnographic approach in two southeastern Michigan ICUs from March 2017-19.
Through observations, clinician shadowing, and interviews with ICU personnel, the research team identified 18 distinct IPC behaviors, which they divided into two categories labeled: ‘enablers’ and ‘collaborative activities’. Enablers facilitate the process of collaboration, while collaborative activities are deployed to directly collaborate with other professionals.
Ten ‘enablers’ were spotlighted, among which are active listening, coordinating work, reflexive questioning, and validation. ‘Collaborative activities’ include correction, information exchange, negotiation, providing help, and troubleshooting.
“One of the things I liked most about this project was how engineering undergraduate students from the Center for Healthcare and Engineering Patient Safety were able to step up and support a nursing doctoral student in her research,” said Cohn. “They all learned so much from each other, and I think everyone involved will carry forward new skills and new ways of looking at problems.”
This research contributes to our understanding of IPC in ICUs and offers a guide for clinician behaviors that can enhance their collaborative processes. Furthermore, it provides invaluable advice for ICU operations to maximize collaboration, promote learning and improve patient care.
“We had the unique opportunity to work as an interdisciplinary team in nursing, engineering and medicine to study interprofessional collaboration which allowed us to gain a deeper understanding of the process,” said Boltey. “Unpacking the ambiguity of what participating in the process of interprofessional collaboration looks like provides a framework for observing IPC in practice so we can have a better understanding of its impact on system, clinician and patient outcomes”
Emily Boltey is now a Simulation Nurse Educator at the VA Pittsburgh Healthcare System. During the time of this study, she was a doctoral student at the University of Michigan School of Nursing.
Theodore Iwashyn is the Bloomberg Distinguished Professor of Social Science and Justice in Medicine at Johns Hopkins Medicine.
Amy Cohn is the Arthur F. Thurnau Professor at the University of Michigan Industrial and Operations Engineering Department. She is also the Faculty Director for the Center for Healthcare and Patient Safety (CHEPS) and the Chief Transformation Officer at Michigan Medicine.
Deena Costa is an Associate Professor of Nursing at the Yale School of Nursing. She is also an Associate Professor in the Section of Pulmonary, Critical Care & Sleep Medicine at Yale School of Medicine.