Interprofessional shared decision-making in the ICU: A systematic review and recommendations from an expert panel

Andrej Michalsen, Ann C. Long, Freda DeKeyser Ganz, Douglas B. White, Hanne I. Jensen, Victoria Metaxa, Christiane S. Hartog, Jos M. Latour, Robert D. Truog, Jozef Kesecioglu, Anna R. Mahn, J. Randall Curtis*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Objectives: There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision- making. The aim of this project is to use systematic review and normative analysis by experts to examine existing evidence regarding interprofessional shared decision-making, describe its principles and provide ICU clinicians with recommendations regarding its implementation. Data Sources: We conducted a systematic review using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases and used normative analyses to formulate recommendations regarding interprofessional shared decision- making. Study Selection: Three authors screened titles and abstracts in duplicate. Data Synthesis: Four papers assessing the effect of interprofessional shared decision-making on quality of care were identified, suggesting that interprofessional shared decision-making is associated with improved processes and outcomes. Five recommendations, largely based on expert opinion, were developed: 1) interprofessional shared decision-making is a collaborative process among clinicians that allows for shared decisions regarding important treatment questions; 2) clinicians should consider engaging in interprofessional shared decision-making to promote the most appropriate and balanced decisions; 3) clinicians and hospitals should implement strategies to foster an ICU climate oriented toward interprofessional shared decision-making; 4) clinicians implementing interprofessional shared decision-making should consider incorporating a structured approach; and 5) further studies are needed to evaluate and improve the quality of interprofessional shared decision-making in ICUs. Conclusions: Clinicians should consider an interprofessional shared decision-making model that allows for the exchange of information, deliberation, and joint attainment of important treatment decisions.

Original languageEnglish
Pages (from-to)1258-1266
Number of pages9
JournalCritical care medicine
Issue number9
Publication statusPublished - Sept 2019


  • Intensive care unit team
  • Intensive care units
  • Interprofessional collaboration
  • Interprofessional communication
  • Interprofessional decision-making
  • Shared decision-making
  • Humans
  • Cooperative Behavior
  • Interprofessional Relations
  • Patient Care Team/organization & administration
  • Group Processes
  • Clinical Decision-Making/methods
  • Intensive Care Units/organization & administration
  • Communication
  • interprofessional communication
  • interprofessional decision-making
  • intensive care unit team
  • intensive care units
  • interprofessional collaboration
  • shared decision-making


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