Organizational strategies for improving evidence-uptake in intensive care

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ABSTRACT In recent decades multiple high-profile clinical trials have provided a rigorous evidence base for the care of patients with acute respiratory failure requiring mechanical ventilation. Yet many patients still do not receive these evidence-based treatments proven to save lives. The overarching goal of our research program is to address this issue by defining the relationship between ICU organizational behavior and evidence-uptake in critical care. Drawing off the rapidly evolving fields of organizational psychology, decision science, and biomedical informatics, we will broadly investigate the ways in which the interactive behaviors of the ICU team members can both facilitate and hinder efficient translation of evidence into practice. We will pursue three integrated and complimentary lines of research: (1) developing and refining novel strategies for measuring critical care performance; (2) investigating the role of collective intelligence and transactive memory as key sociological mediators of evidence-uptake in critical care; and (3) improving the value of novel decisional support tools such as checklists and electronic prompting for the use of evidence-based practice. To perform this research we will leverage existing collaborations with state and regional health systems as well as the expertise of the principal investigator, a physician-scientist with over 15 years’ experience studying the link between ICU organization and outcome for patients with critical illness. Together, our results will provide hospitals and clinicians with innovative tools for improving critical care performance on a national scale, directly leading improved outcomes for patients with acute respiratory failure and other forms of critical illness.