Rationale: Organizing ICU interprofessional teams is a high priority because of workforce needs, but the role of interprofessional familiarity remains unexplored. Objectives: Determine if mechanically ventilated patients cared for by teams with greater familiarity have improved outcomes, such as lower mortality, shorter duration of mechanical ventilation (MV), and greater spontaneous breathing trial (SBT) implementation. Methods: We used electronic health records data of five ICUs in an academic medical center to map interprofessional teams and their ICU networks, measuring team familiarity as network coreness and mean team value. We used patient-level regression models to link team familiarity with patient outcomes, accounting for patient and unit factors. We also performed a split-sample analysis by using 2018 team familiarity data to predict 2019 outcomes. Measurements and Main Results: Team familiarity was measured as the average number of patients shared by each clinician with all other clinicians in the ICU (i.e., coreness) and the average number of patients shared by any two members of the team (i.e., mean team value). Among 4,485 encounters, unadjusted mortality was 12.9%, average duration of MV was 2.32 days, and SBT implementation was 89%; average team coreness was 467.2 (standard deviation [SD], 96.15), and average mean team value was 87.02 (SD, 42.42). A 1-SD increase in team coreness was significantly associated with a 4.5% greater probability of SBT implementation, 23% shorter MV duration, and 3.8% lower probability of dying; the mean team value was significantly associated with lower mortality. Split-sample results were attenuated but congruent in direction and interpretation. Conclusions: Interprofessional familiarity was associated with improved outcomes; assignment models that prioritize familiarity might be a novel solution.

中文翻译：

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轮班团队的熟悉程度与成人机械通气患者预后的改善相关。


理由：由于劳动力需求，组织 ICU 跨专业团队是当务之急，但跨专业熟悉度的作用仍有待探索。目标：确定由更熟悉的团队护理的机械通气患者的预后是否有所改善，例如较低的死亡率、较短的机械通气 (MV) 持续时间和更多的自主呼吸试验 (SBT) 实施。方法：我们使用学术医疗中心五个 ICU 的电子健康记录数据来绘制跨专业团队及其 ICU 网络的地图，以网络核心度和平均团队价值来衡量团队熟悉度。我们使用患者层面的回归模型将团队熟悉程度与患者结果联系起来，并考虑患者和单位因素。我们还使用 2018 年团队熟悉度数据进行了分割样本分析，以预测 2019 年的结果。测量和主要结果：团队熟悉度的衡量标准是每个临床医生与 ICU 中所有其他临床医生共享的患者平均数量（即核心度）以及团队中任意两名成员共享的平均患者数量（即平均团队）价值）。在 4,485 次遭遇中，未经调整的死亡率为 12.9%，MV 平均持续时间为 2.32 天，SBT 实施率为 89%；平均团队核心度为 467.2（标准差 [SD]，96.15），平均团队价值为 87.02（SD，42.42）。团队核心度增加 1-SD 与 SBT 实施概率提高 4.5%、MV 持续时间缩短 23% 以及死亡概率降低 3.8% 显着相关；平均团队价值与较低的死亡率显着相关。分割样本的结果有所减弱，但方向和解释一致。 结论：跨专业熟悉度与改善结果相关；优先考虑熟悉度的分配模型可能是一种新颖的解决方案。