Healthcare is provided by a team of extremely qualified professionals performing complex tasks that require a high degree of collaboration and coordination. However, when teams do not function properly, breakdowns in communication can result in serious medical errors.

Studies show that 70-80% of medical errors are due to interpersonal interaction issues. The Intensive Care Unit (ICU) with its diverse activities, arrays of specialists, dynamic change and time stress, is a very complex unit that is prone to team lapses. Evidence suggests that communication between nurses and physicians in the ICU account for only 2% of all the activities, yet is responsible for 37% of all the errors.

Another important factor that has been shown to improve care in the ICU is the availability of a full-time doctor called an “intensivist,” who specializes in the care of critically-ill patients. These professionals “are familiar with the complications that can occur in the ICU and, thus, are better equipped to minimize errors.”

A new study suggests that daily rounds by a multidisciplinary team and the presence of an intensivist are associated with lower mortality among patients in the ICU. The study assessed care provided to 107,324 patients that were admitted to 112 Pennsylvania hospitals between 2004 and 2006.

The best performing ICUs in terms of mortality rates within 30 days were those that had high-intensity physician staffing and multidisciplinary care teams (22% reduction in mortality). These were followed by ICUs which had low-intensity physician staffing and multidisciplinary care teams (12% reduction in mortality). ICUs with low-intensity physician staffing and without multidisciplinary care teams performed the worst. These results applied to all groups of patients, including those with sepsis, those requiring invasive mechanical ventilation, and those that were very severely ill.

It appears that multidisciplinary “may facilitate implementation of best practices, including the application of evidence-based treatments, pharmacists identifying potential adverse drug indications, and implementation of respiratory therapy and nurse-driven protocols to reduce ventilation time and shorten ICU length of stay.”

Given that the healthcare system is suffering from a severe shortage of specially-trained intensivists, the study seems to provide some hope for critically-ill patients. According to study author Dr. Jeremy Kahn, from the University Of Pennsylvania School Of Medicine, “hospitals without intensivists can still achieve significant reductions in mortality in their ICUs by implementing a multidisciplinary, team-based approach. Patient outcomes are improved when physicians, nurses, respiratory therapists, clinical pharmacists and other staff members work together to provide critical care as a team."