In conducting this review of the literature, we realized that both some researchers and we were missing potentially relevant studies. They were missed when researchers did not see the full relevance of their work to collaboration or to the interdisciplinary team, for example, when one discipline neglected to consider the involvement of the other or to consider the patient/family as part of the team. They were also missed when relevant key words for indexing (eg, team or collaboration) were not used. At the end of this compilation, however, we believe we have a clear view of where the research base is today concerning the role of the interdisciplinary team in care for dying patients in the ICU and areas of future research needed. Interdisciplinary team care of the dying ICU patient does not just happen, but the early empirical data demonstrate that it is a worthwhile endeavor and achievable. Researchers have demonstrated improvement in ICU care through collaboration [43-47,53]. A few investigators have begun to examine whether the application of collaborative models of care for the dying ICU patient delivered by the ICU team [3,41,62] or with the help of ethics [75-77] or palliative care consultation [17,37,81] improves outcomes for this subset of ICU patients. Initial results are encouraging. However, none of the models described to date have been assessed in randomized trials, extended beyond a single unit, or involved comparing units to each other. Present studies also lack evaluation of the impact of the intervention on family members themselves, both short and longer term. Further research is needed to replicate and expand these studies from both process and outcome perspectives.
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine