Emotional Intelligence in Critical Care Medicine

2015 - 1 February – Team Science
David E. Procaccini, PharmD, BCPS, CACP; Cheryl Connors, RN, MS
Two experts discuss the vital importance of emotional intelligence as it pertains to collaboration and patient care in critical care settings.

 

The Society of Critical Care Medicine’s (SCCM) In-Training Section is dedicated to assisting and guiding trainees as they progress through training into independent practice. It also aims to foster career development following this transition. To further this mission, members contribute articles addressing emerging issues in critical care training and career development; these submissions are authored by in-training professionals under the guidance of a mentor. For additional information about the In-Training Section or this project, please e-mail SCCM In-Training Section Chair Utpal Bhalala, MD, at ubhalal1@jhmi.edu or Member-at-Large Erik Vakil, MD, at erikvakil@hotmail.com.

The need for more patient-centered care has been a primary focus of operations among many healthcare systems.(1,2) Patient-centered care is a multidimensional concept that addresses patients’ needs for information, views the patient as a whole person, promotes concordance, and enhances the provider–patient relationship.(3) However, there is variability in the proficiency of healthcare professionals to achieve an understanding of patient and coworker perspectives in the delivery of patient-centered care.(4,5) Individual differences in the personal characteristics of professionals may  account for at least some of this variation. Common complaints about healthcare providers relate to poor communication rather than clinical competence. Optimizing communication is consistently targeted for policy and practice changes in healthcare.
 
Work-related stress and stress-filled environments may lead to error, poor morale, poor concentration, fatigue, absenteeism, impaired team function, communication breakdown, failure to collaborate, and suboptimal patient-centered care. In particular, intensive care units (ICUs) are one of the most stressful environments in healthcare, due in part to the high patient acuity and frequent need for end-of-life care.(6,7) These stresses may have negative effects on care delivery in the ICU and the mental health and performance of healthcare professionals.(6-10)
 
Emotional intelligence (EI) is the ability to monitor one's own and other people's emotions, to discriminate between different emotions and label them appropriately and to use this information to guide thinking and behavior.(11,12) Although many definitions of EI have been postulated, one of the most accepted is a set of abilities (verbal and nonverbal) that enable a person to generate, recognize, express, understand, and evaluate emotions in order to guide thinking and action and successfully cope with environmental demands and pressures(12); this is a concept that can be divided into five core areas(12):

• Self-awareness – the ability to know one's emotions, strengths, weaknesses, drives, values, and goals, and recognize their impact on others while using gut feelings to guide decisions
• Self-regulation – controlling or redirecting one's disruptive emotions and impulses and adapting to changing circumstances
• Self-motivation – being driven to achieve for the sake of achievement
• Social skill – managing relationships to move people in the desired direction
• Social awareness (empathy) – considering other people's feelings, especially when making decisions
 
Fernandez et al stated that EI skills are grounded in personal competence, upon which are built the skills for social competence, including social awareness and relationship management.(13) EI is one such personal characteristic and is commonly discussed as having a potential role in healthcare.(8) It has been suggested that it is important for effectively delivering patient-centered care.(8-16) Outside of healthcare, EI has been widely cited as an attribute that can improve the quality of work and increase productivity and success.(17-21)

While the evidence for applications of EI in real-world settings is sparse, some data suggest EI may be related to job performance and satisfaction.(22,23) Evidence shows that provider satisfaction is linked with enhanced ability to identify emotional expressions, higher ratings of social support and satisfaction with social support, more effective mood management,(24)  better adaptation to stress(25) and better social interaction, and patient satisfaction.(26) Studies have shown that people with high EI have greater mental health, exemplary job performance and more potent leadership skills. For the most senior team members, almost 80% of variation in performance is predicted by EI.(27) Top performers average 30% higher in markers of EI, and methods of developing these skills have become more widely coveted in the past few decades. In addition, data characterizing neural mechanisms of emotional intelligence are evolving.(27-31)

Insights into one’s own and others’ emotions, as described by models of EI, may be why some practitioners appear to be better at delivering patient-centered care than others.(32) Skills in EI help healthcare leaders in the ICU understand, engage and motivate their teams. They are essential for dealing with conflict and creating workable solutions to complex problems. EI skills strongly impact the culture of multidisciplinary medicine.(12)


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