Improving Family Satisfaction and Participation in Decision Making in an Intensive Care Unit

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Abstract

Background

Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together.

Objectives

To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families.

Methods

A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm.

Results

Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation.

Conclusions

Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together. (Critical Care Nurse. 2013;33[5]:56–69)

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