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Improvement of the Multidisciplinary Team-based Critical Care Service for Patient in the Surgical Intensive Care Unit: A Qualitative Exploration of Healthcare Professional Needs
J. Kor. Soc. Health-syst. Pharm. 2019;36:173-188
Published online May 31, 2019;  https://doi.org/10.32429/jkshp.2019.36.2.001
© 2019 Korean Society of Health-System Pharmacists

Ji Eun Choia, Eunyoung Saa, Su Hyun Ryua, Minjung Kima, Kwi Suk Kima, Nayoung Hanb, Yoonsook Choa, and Jung Mi Oha,b,

Department of Pharmacy, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Koreaa,
College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Koreab
Correspondence to: 조윤숙 Tel:02-2072-2590 E-mail:joys99@snuh.org
오정미 Tel:02-880-7997 E-mail:jmoh@snu.ac.kr
Received November 23, 2018; Revised December 17, 2018; Accepted March 15, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : As a member of the multidisciplinary team, the pharmacist can play an essential role in patient care in the intensive care unit (ICU). Although the number of critical care pharmacists has gradually increased and their role has expanded, there continues to be a need for improving the quality of care for critically ill patients. The aim of this study was to evaluate the status of clinical pharmacy practices in the surgical ICU (SICU) and suggest improvements in pharmaceutical care service reflecting the needs of the multidisciplinary team members.
Methods : We identified the activities of pharmacists in the SICU and compared them to those previously reported in US hospitals for fundamental, desirable, and optimal activities. Based on these results, in-depth semi-structured interviews were conducted with key stakeholders to evaluate their needs for collaborative team care services improvement. The data from transcribed interviews were analyzed using thematic analysis techniques and the themes were clustered to derive the concept of service.
Results : When the pharmacists’ activities were compared to those of US hospitals the need for improvements in education, research, and administration were identified. Six physicians, and seven nurses were included in in-depth interviews. Most of them were satisfied with the current service of the pharmacist in the SICU and considered it necessary. However, needs for a better multidisciplinary team care service, including enhancement of pharmacists’ participation, improvement of the communication system, etc., were identified. Based on the thematic analysis results, service concepts were developed, which were “patient-centered collaborative team care”,“ persistent and longitudinal care”, and “professional and evidence-based care”.
Conclusions : An improvement service for critical care patients was derived from this qualitative analysis process. This concept can be used to guide the improvement of the overall quality of patient care in the SICU and to inform healthcare policy decisions.
Keywords : Surgical intensive care unit, Multidisciplinary team care, Pharmaceutical care service, Qualitative study