ICUs are dangerous places.1– One widely quoted study2 suggested an incidence of two errors per patient per day, and virtually all patients are exposed to risk for serious harm. If it were not for the potential of the ICU to prolong and occasionally save the lives of critically ill patients, no sane person would place themselves so squarely in harm’s way.
One reason why is that so many things are done to the patient by so many different people. Much of the problem stems from problems in communication and teamwork.3–4 Too often, people are operating in their “own silos,” ignorant of crucial information known by other caregivers just feet away. Although teamwork has received a good deal of lip service, much of the care occurs without real partnership between physicians and other members of the care team. Some of these physicians, in fact, define good teamwork as “they do what I tell them.” In this issue of CHEST (see page 1571), by joining forces in a single article on making the ICU safer, the past presidents of the American Association of Critical Care Nurses and the American College of Chest Physicians practice what their organizations have begun to preach.5