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Evaluating Teamwork in the Neonatal Intensive Care Unit

A Survey of Providers and Parents

Masten, Marjorie MSN, CRNP, NNP-BC, CPNP-AC/PC; Sommerfeldt, Susan PhD, BScN, MN, RN; Gordan, Suzanne BA; Greubel, Elizabeth; Canning, Caroline BA; Lioy, Janet MD; Chuo, John MD, MSBI, IA

Section Editor(s): Samra, Haifa A.

doi: 10.1097/ANC.0000000000000604
Professional Growth and Development

Background: A unified vision of team mission, psychologically safe practice environment, effective communication, and respect among team members are key characteristics of an effective interdisciplinary neonatal intensive care unit (NICU) team.

Purpose: A quality improvement team in a quaternary NICU surveyed parents, physicians, and nurses on perceptions of teamwork to identify opportunities for improvement.

Design/Methods: Parents and healthcare staff (n = 113) completed an anonymous survey from May to July of 2014 to assess team roles and membership, team qualities, shared mission, psychological safety, hierarchy, communications, and conflict awareness. An expert panel assigned questions into one or more characteristics of team intelligence.

Results: Physicians, nurses, and parents perceive their roles and the composition of the healthcare team differently. Most providers reported a shared mission and having a cooperative spirit as their teams' best attributes. While most nurses chose safety as most important, the majority of doctors chose treatment plan. Parents consider tenderness toward their infant, providing medical care and answers to their questions important. All expressed varying concerns about psychological safety, conflict resolution, and miscommunications.

Implications for Practice: This survey identifies strengths and gaps of teamwork in our NICU and provides insight on necessary changes that need to be made to improve collaboration among the interdisciplinary care team including parents.

Implications for Research: This quality improvement report identifies aspects of team care delivery in NICUs that require further study. The concept of team intelligence and its impact on team effectiveness invites in-depth exploration.

Children's Hospital of Philadelphia, Philadelphia (Ms Masten and Drs Lioy and Chuo); University of Pennsylvania School of Nursing, Philadelphia (Ms Masten); Faculty of Nursing, University of Alberta, Edmonton, Canada (Dr Sommerfeldt); Drexel University, Philadelphia, Pennsylvania (Ms Greubel); Darmouth College, Hanover, New Hampshire (Ms Canning); and University of Pennsylvania Perelman School of Medicine, Philadelphia (Drs Lioy and Chuo).

Correspondence: Marjorie Masten, MSN, CRNP, NNP-BC, CPNP-AC/PC, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 (

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses