Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice

ABSTRACT

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was “balancing intertwined responsibilities.” In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon’s contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.

KEYWORDS:

• Grounded theory
• intensive care unit
• interprofessional care
• interviews
• practice
• roles
• teamwork

Acknowledgements

The authors thank the participants who shared their experiences and provided data for the study, and also Eva Johansson and Hamid Reza Khankeh for methodological support.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

Funding was provided by the Centre for Clinical Research Sörmland Uppsala University, Grant number 75568.

Additional information

Funding

Funding was provided by the Centre for Clinical Research Sörmland Uppsala University, Grant number 75568.