OBJECTIVE Complex and fluctuating care teams are a known obstacle to optimal patient care in the pediatric intensive care unit (PICU), particularly for long stay patients (LSP). Overcoming this obstacle requires understanding more about how PICU teams are structured and function. Our objective is to empirically define the dynamic composition of PICU care teams for LSP and non-LSP. PATIENTS AND METHODS We conducted a retrospective chart review of patients aged 0 to 21 years admitted to medical/surgical and cardiovascular PICUs of a Midwestern tertiary care academic children’s hospital in March and September 2019. Patients were divided between PICU LOS of 7 days or fewer and LOS of more than 7 days. Patients who were admitted for cardiac surgery and those patients who had opted out of research were excluded. The main outcome of the study was the number and specialty composition of teams caring for long stay vs short stay patients. RESULTS A total of 35 patients were identified (51.4% female, median age 1.8 years); 20 patients were identified with LOS of greater than 7 days (“long stay”) and 15 patients with LOS of 7 days or fewer (“short stay”). We present sociometric network models to visualize the complexity of team composition and structure over time. CONCLUSIONS As illustrated by the complex web of physician interactions revolving around the patients, PICU teams are dynamic and members are ever changing, highlighting the importance of transmitting accurate, relevant and timely information when caring for complex patients. This work clearly demonstrates why it is vital to study both the structure and processes of these dynamic PICU teams.
Shapiro et al. (Thu,) studied this question.