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Working Together in the Neonatal Intensive Care Unit: Provider Perspectives

Journal of Perinatology volume 24, pages 552–559 (2004)Cite this article

Abstract

OBJECTIVES: To elicit healthcare provider perceptions of working together in a neonatal intensive care unit (NICU).

STUDY DESIGN: We conducted focus groups to elicit descriptions of how providers work together. The groups included one each of transport nurses, staff nurses, residents, fellows, attending physicians and two multiple provider groups. To identify themes and their descriptive elements we performed qualitative data analysis.

RESULTS: There were three to seven participants per group for a total sample of 36. Provider responses to questions about working together centered around three major themes: (1) Provider Characteristics; (2) Workplace Factors and; (3) Group Influences. Provider Characteristics were defined by personal attributes, reputation, and expertise. Workplace Factors included staffing, work organization, and work environment. Group Influences were described by communication and relationships.

CONCLUSIONS: Providers in this NICU described three broad organizational and interpersonal factors that influence how they work together, yet no consistent descriptions of teams or teamwork were found. The organizational factors, often far removed from bedside, should be considered when evaluating how providers work together.

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Author notes

  1. Eric J Thomas: Dr. Thomas is a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar.

Authors and Affiliations

  1. University of Texas Health Science Center at Houston Medical School, and School of Nursing, TX, USA

    Eric J Thomas MD, MPH, Gwen D Sherwood RN, PhD, FAAN & Jennipher L Mulhollem MA

  2. The University of Texas at Department of Psychology and Human Factors Research Project, TX, USA

    J Bryan Sexton PhD & Robert L Helmreich PhD

  3. The University of Texas Center of Excellence for Patient Safety Research and Practice (Agency for Healthcare Research and Quality grant # 1PO1HS1154401, TX, USA

    Eric J Thomas MD, MPH, Gwen D Sherwood RN, PhD, FAAN, Jennipher L Mulhollem MA, J Bryan Sexton PhD & Robert L Helmreich PhD

Authors
  1. Eric J Thomas MD, MPH
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  2. Gwen D Sherwood RN, PhD, FAAN
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  3. Jennipher L Mulhollem MA
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  4. J Bryan Sexton PhD
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  5. Robert L Helmreich PhD
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Additional information

The study was supported by a grant from the Agency for Healthcare Research and Quality (#U18HS11164-01)

Appendix 1

Appendix 1

NICU Focus Group Interview Guide

  1. 1)

    Tell me your observations about how providers work together in NICU?

    1. a

      To give focus to the topic working together, use the process of admitting an infant to the NICU. Tell me the process and who is involved. Or use another process that comes to mind.

    2. b

      What is your role in getting a baby into the unit?

    3. c

      What influences the way you are able to carry out your role?

    4. d

      What happens when things go well in the admissions process?

    5. e

      What happens when things do not go well during the admissions process?

    6. f

      How do you compare/differentiate when things go well and when things do not go well?

    7. g

      What is essential for an admission to go smoothly?

  2. 2)

    What influences the way people work together?

    1. a

      What enhances the way people work together?

    2. b

      What limits the way people work together?

    3. c

      What behaviors help providers perform well?

  3. 3)

    How do you define collaboration among providers?

    1. a

      Are there other words that you could use besides collaboration?

    2. b

      When comparing when things go well and do not go well, what are your observations about collaboration in NICU?

    3. c

      When have you observed collaboration in NICU?

    4. d

      What happens when collaboration breaks down?

    5. e

      How does this influence care?

  4. 4)

    What other processes become important in describing how providers work together in NICU?

  5. 5)

    What other observations do you have about the way providers work together in NICU?

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Thomas, E., Sherwood, G., Mulhollem, J. et al. Working Together in the Neonatal Intensive Care Unit: Provider Perspectives. J Perinatol 24, 552–559 (2004). https://doi.org/10.1038/sj.jp.7211136

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