Assessing the utility of the Team SA instrument in measuring the effectiveness of communication across disciplines during ICU rounds.

Multidisciplinary rounds are events that occur daily in Intensive care units. During these events, practitioners from multiple disciplines meet at a pre-specified time to discuss current medical condition and plans of care. At the conclusion of these discussions, all practitioners are expected to understand the plan of care well enough to execute defined tasks, but also coordinate as circumstances change. In order to coordinate under changing circumstances practitioners must have a broader understanding of the current state of the patient and how likely certain deteriorations are. This synthetic understanding of patient risks across multi-provider groups has been described as anticipatory team situational awareness (Team SA). One instrument has been validated in the ICU as feasible and informative. This Team SA survey successfully identified that the time spent in "training" discussions improved Team SA across physician groups. The investigators' goal is to implement this survey across the investigators' medical ICU service to obtain a baseline estimate of how effective current communication patterns are for achieving concordant Team SA. If gaps in communication are encountered future interventions will be developed

Inclusion Criteria:

• Nurses, primary clinicians (resident or NP) and Critical Care physicians (Staff or Fellow in Critical Care Medicine) will be approached for interview. All subjects will be approached individually and asked to participate outside of the presence of the other potential study subjects.

Exclusion Criteria:

• N/A

Daily census rosters of the MICU and 8ICU nursing units will be reviewed for occupancy. At 8am on survey days occupied beds will be tallied (up to 39 beds). Beds occupied by a non-MICU service patient and those with active DNR-CC orders will be excluded. From the remaining patients, ten bed numbers will be randomly selected for review. Randomization will be stratified by MICU service sub-unit (MICU 40, MICU 90, 8ICU). If fewer than ten patients are eligible on an assigned survey day, all patients in the ICU on that day will be surveyed.