PURPOSE:Collaborative interaction amongst health care team members in the Intensive Care Unit (ICU) is important for patient care. Non-physician team members’ satisfaction with ICU physician performance is important for the delivery of quality medical care, and their perspective of “open” versus “closed” models is unknown. We wished to evaluate the effect of changing a medical ICU model from an “open” system to a “closed” system on non-physician members of the health care team's perspectives on the quality of care.
METHODS:The medical ICU model at a community teaching hospital was changed from an “open” format to a “closed” format on July 1, 2006. An anonymous survey was conducted amongst the hospital's ICU nurses and respiratory therapists during May and June of 2006 and was repeated in May and June of 2007. The survey asked the non-physician members to score the physician medical team, on a scale of 1 to 5 on availability, ease of communication, level of care provided, perceived communication between the medical team and the families of patients, and overall satisfaction with care. Independent samples t-test was performed to compare scores between the open and closed models.
RESULTS:A total of 23 staff members completed the survey during the “open” ICU period and 20 completed the survey during the “closed” ICU period. For each survey item, there was a statistically significant improvement in satisfaction of non-physician members of the physician team after the ICU model was changed from an “open” format to a “closed” format. Overall the satisfaction score was higher following the implementation of the “closed” ICU (20.1, +/− 3.74) then it was for the “open” ICU (13.2, +/− 4.3, p<0.001).
CONCLUSION:The non-physician staff was more satisfied with the physician members of the medical team in a “closed” ICU model than in a more traditional “open” model.
CLINICAL IMPLICATIONS:Given the importance of all members of a health care team, improved satisfaction of non-physician members of the team could translate to improved patient care.
DISCLOSURE:Reetu Singh, No Financial Disclosure Information; No Product/Research Disclosure Information