Objective: To study the implementation of multidisciplinary structured work shift evaluations at a pediatric intensive care unit (PICU) to enhance team communication.
Design and setting: Prospective, repeated measurements design, comparison of pre/post measurements and process measures in a Dutch tertiary care, university-affiliated PICU.
Participants: All 61 PICU staff members.
Interventions: Implementing multidisciplinary structured work shift evaluations. Before the implementation phase the PICU team received feedback training and eight participants (four physicians, four nurses) were trained as "work shift evaluation leader."
Measurements and results: Outcome measures covered: (a) quality and process of the implementation through prestructured checklists during the 3 months of implementation, (b) a subjective evaluation of a feedback training on team communication as anticipated action and on the level of communication (about patients and with colleagues), and (c) emotional exhaustion complaints and work-related fatigue. The interdisciplinary structured work shift evaluations were implemented successfully as planned during the work shift; all staff were trained ahead, and the process was followed almost completely. Almost two-thirds (62%) of the staff felt a positive influence on team communication. Almost all staff members (92%) were satisfied regarding communication with their colleagues after the intervention, compared to 76% before. Emotional exhaustion in the PICU team decreased significantly after the implementation, but no differences in work-related fatigue levels were found.
Conclusions: As organizational change the implementation of a multidisciplinary structured work shift evaluation at a PICU was successful and team communication improved. Emotional exhaustion decreased during the study period.