Implementation of a structured communication tool improves family satisfaction and expectations in the intensive care unit.
Communication
Expectations
Intensive-care
Relatives
Satisfaction
Tool
Journal
Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
17
10
2018
revised:
12
01
2019
accepted:
13
01
2019
pubmed:
25
1
2019
medline:
25
6
2020
entrez:
25
1
2019
Statut:
ppublish
Résumé
Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations. To assess whether a structured communication tool improves satisfaction with care and engenders realistic expectations among relatives of critically ill patients. A controlled, pre-post intervention design was implemented in the General and Medical ICUs in the Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Forty relatives of patients who received usual communication from the medical staff (control group) were interviewed. We then implemented a structured communication tool and another forty family members were interviewed (intervention group). The ICU physicians who participated in the family meeting were also interviewed. Satisfaction in the intervention group was higher regarding ease of obtaining the information (90% vs 70%, p = .025) and the consistency of information provided (92.5% vs 77.5%, p = .057). There was better correlation between physicians' and relatives' expectations in the intervention group regarding hospital survival (Kappa 0.322 vs 0.054, p = .01). Physicians predicted more accurately patients' actual hospital survival. A structured communication tool was associated with improved family satisfaction with communication and expectations regarding hospital survival. Further research is required to evaluate this promising intervention.
Sections du résumé
BACKGROUND
Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations.
OBJECTIVES
To assess whether a structured communication tool improves satisfaction with care and engenders realistic expectations among relatives of critically ill patients.
STUDY DESIGN
A controlled, pre-post intervention design was implemented in the General and Medical ICUs in the Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
METHODS
Forty relatives of patients who received usual communication from the medical staff (control group) were interviewed. We then implemented a structured communication tool and another forty family members were interviewed (intervention group). The ICU physicians who participated in the family meeting were also interviewed.
RESULTS
Satisfaction in the intervention group was higher regarding ease of obtaining the information (90% vs 70%, p = .025) and the consistency of information provided (92.5% vs 77.5%, p = .057). There was better correlation between physicians' and relatives' expectations in the intervention group regarding hospital survival (Kappa 0.322 vs 0.054, p = .01). Physicians predicted more accurately patients' actual hospital survival.
CONCLUSIONS
A structured communication tool was associated with improved family satisfaction with communication and expectations regarding hospital survival. Further research is required to evaluate this promising intervention.
Identifiants
pubmed: 30677620
pii: S0883-9441(18)31438-2
doi: 10.1016/j.jcrc.2019.01.011
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
6-12Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.