Our surgical intensive care unit (ICU) is part of an urban, academic territory medical center. Referrals are sent from all over the Southeast in order to access the high level technology and specialty services our organization provides. Our critical care team members are trained in disciplines that are relatively constant, such as respiratory and intensive care, anesthesia, surgery, pharmacy, and operating room and pain management. Our exemplar, however, focuses on a situation in which a mother-child dyad drove our critical care unit to more complex interactions with almost every service available in our organization. Team competence was demonstrated at new levels because our healthcare system was driven by the needs of the mother and her unborn child. Our exemplar is organized around the information that Debbie Brinker presented in her opening address at NTI 2006.1
The mother entered our system as a referral from a small, outlying rural area....