We instituted several interventions in our trauma and surgical ICU aimed at improving communication and teamwork between RNs and MDs. Informal feedback indicated greater satisfaction among RNs and MDs with the working environment. However, these results were not reproduced on a subsequent national survey, reflecting the difficulty of measuring intervention effectiveness using standardized surveys. The fundamental elements of our approach that may be used in future interventions include: accurately defining the problem, choosing an appropriate setting for an intervention, getting feedback from all stakeholders, implementing a limited number of carefully chosen interventions, and measuring the effectiveness of the interventions. We believe that this process can be a model for nursing units in other hospitals that wish to make improvements. A post-intervention survey focusing on cooperation, teamwork, and appreciation between nurses and physicians revealed improvement in these domains. A SICU Task Force studied communication practices and identified areas for improvement, leading to several interventions.

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