The Acute and Critical Care Research Group at the School of Health and Medical Sciences, City St. George's, University of London welcome Dr Andreas Xyrichis to present his study that provides timely insight into ICU teamworking in a post-pandemic landscape, as part of the SHMS research seminar series.
Abstract
Background
Teamwork among healthcare professionals is fundamental to staff wellbeing, retention, patient safety and satisfaction, yet evidence from the UK National Health Service (NHS) Staff Survey indicates declining perceptions of teamwork, with variation across professional groups.
These challenges have intensified since the COVID-19 pandemic, particularly in intensive care units (ICUs), where demands for flexible, ad hoc teams and cross-boundary working have disrupted established practices. In this post-pandemic context, such pressures are associated with increased stress, staff turnover and patient safety concerns, undermining clinical and system resilience.
Objectives: The 'fostering teamwork for resilient staff and safe care in ICU' (FEARLESS ICU) study aims to: (A) examine how teamwork in ICUs has changed in the post-pandemic period; and (B) identify key facilitators and barriers to effective teamworking.
Methods: An ethnographic study is being conducted across eight purposively selected ICUs in the United Kingdom, reflecting variation in geography, size, speciality and NHS Staff Survey teamwork scores. Data collection includes non-participant observations, staff shadowing and one-to-one semi-structured interviews. Digital fieldnotes and interview transcripts are analysed using ethnographic thematic coding, categorisation and abstraction to explore interprofessional interactions and contextual influences on collaborative work.
Results: While the study is ongoing, initial findings highlight significant post-pandemic challenges to teamwork. Staff described frequent short-notice redeployment between ICUs due to workforce and skill shortages, affecting collaboration within established teams and when integrating into new teams. Changes to organisational processes since the pandemic further disrupted teamworking practices. Physical separation of professional spaces within ICUs hindered interprofessional communication, alongside observed differences in communication styles across professional groups. Intersectional demographic characteristics appeared to shape team dynamics. Facilitators of effective teamwork included opportunities for interprofessional teaching and learning and the adoption of more inclusive leadership approaches.
Conclusion: This study provides timely insight into ICU teamworking in a post-pandemic landscape. By identifying factors that hinder and support effective teamwork, it aims to offer practical guidance to strengthen collaboration, support staff wellbeing and retention, and improve patient outcomes within increasingly pressured ICU settings.
About the Speaker
Dr Andreas Xyrichis, PhD, is an intensive care nurse and Reader at King’s College London. His research centres on strengthening interprofessional, team-based approaches in healthcare, encompassing workforce preparation and training, and the development and evaluation of interprofessional interventions.
Andreas is the Chief Investigator of the FEARLESS ICU study, the largest NIHR-funded ethnographic study examining interprofessional teamwork in intensive care units in England. He co-leads on education for the European Society of Intensive Care Medicine (ESICM) nursing and allied health professionals committee, and is the Editor-in-Chief of the Journal of Interprofessional Care.
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