Potential Barriers to implementation

Time commitment

  • Consider developing an informal presentation process that limits the need for additional prep work.
  • Consider requesting that all attendees conduct a profession specific chart review. This could capitalize on expertise and share the work of understanding all aspects of the patient’s care.
  • Write the action plan during the meeting and upload it into the patient’s chart to decrease the paperwork burden.
  • Consider the needs of your facility. Develop or adopt an evaluation strategy that could provide information on the impact of PACT-ICU on important elements that stakeholders care about
  • Pay attention to the attendees engagement. Strive to facilitate a conference the promotes feedback form all professions an discourages the focus on one individual or profession.

Customizable options

Interprofessional ownership

  • Consider the implicit message provided by interprofessional faculty responsibility for the case conference. Shared ownership from multiple professions may demonstrate clear interprofessional values to trainees.

Case Example:  Two PACT-ICU sites have interprofessional facilitators for the conference. One site splits the role of facilitation between medicine and psychology, while the other site has three facilitators that include faculty from nurse practitioners, medicine, and psychology. These sites indicated that the shared facilitation role models interprofessional collaboration for their trainees.

Case Example:  One site has chosen to focus their PACT-ICU on collaboration between mental health and primary care providers. Their conference is structured to alternate between PCP and MH trainee patient presentations.

Documentation of the plan with identification of who owns aspects of the plan

  • Consider how the care plan will be documented and how individuals responsible for specific actions will be notified.

Preconference patient interviews

Case Example:  At the Boise PACT-ICU the psychology postdoctoral residents attempt to contact the patient by phone prior to the case presentation. They inform that patient that their PCP is conducting a case conference to discuss strategies to improve their care and interview the patient on their perception of their care needs and treatment goals. This information is documented in the patient’s chart and the psychology resident discusses their interview with the team during PACT-ICU. (reference location for this resource)

Previously presented patient check up

Case Example:  At the Boise PACT-ICU before the current patient is discussed, the team takes 5-10 min to review the status a patient the PCP provider presented previously. This gives time for the team member to review what worked and did not work. Trainees have shared that reviewing patients is a morale booster for care of these complex high-risk patients.

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