TY - JOUR
T1 - Implementing family communication pathway in neurosurgical patients in an intensive care unit
AU - Kodali, Sashikanth
AU - Stametz, Rebecca
AU - Clarke, Deserae
AU - Bengier, Amanda
AU - Sun, Haiyan
AU - Layon, A. J.
AU - Darer, Jonathan
N1 - Publisher Copyright:
Copyright © Cambridge University Press 2014.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Objective: Family-centered care provides family members with basic needs, which includes information, reassurance, and support. Though national guidelines exist, clinical adoption often lags behind in this area. The Geisinger Health System developed and implemented a program for reliable delivery of best practices related to family communication to patients and families admitted to the intensive care unit (ICU). Method: Using a quasiexperimental study design and the 24-item Family Satisfaction in the Intensive Care Unit questionnaire (FSICU-24©) to determine family satisfaction, we measured the impact of a family communication pathway facilitated by tools built into the electronic health record on the family satisfaction of neurosurgical patients admitted to the ICU. Results: There was no statistically significant difference noted in family satisfaction as determined by FSICU-24 scores, including the Care and Decision Making constructs between the pre- and post-intervention pilot population. The percentage of families reporting the occurrence of a family conference showed only minimal improvement, from 46.5% before to 52.5% following the intervention (p = 0.565). This was mirrored by low numbers of documented family conferences by providers, suggesting poor uptake despite buy-in, use of electronic checklists, and repeated attempts at education. Significance of results: This paper reviews the challenges to and implications for implementing national guidelines in the area of family communication in an ICU coupled with the principles of clinical reengineering.
AB - Objective: Family-centered care provides family members with basic needs, which includes information, reassurance, and support. Though national guidelines exist, clinical adoption often lags behind in this area. The Geisinger Health System developed and implemented a program for reliable delivery of best practices related to family communication to patients and families admitted to the intensive care unit (ICU). Method: Using a quasiexperimental study design and the 24-item Family Satisfaction in the Intensive Care Unit questionnaire (FSICU-24©) to determine family satisfaction, we measured the impact of a family communication pathway facilitated by tools built into the electronic health record on the family satisfaction of neurosurgical patients admitted to the ICU. Results: There was no statistically significant difference noted in family satisfaction as determined by FSICU-24 scores, including the Care and Decision Making constructs between the pre- and post-intervention pilot population. The percentage of families reporting the occurrence of a family conference showed only minimal improvement, from 46.5% before to 52.5% following the intervention (p = 0.565). This was mirrored by low numbers of documented family conferences by providers, suggesting poor uptake despite buy-in, use of electronic checklists, and repeated attempts at education. Significance of results: This paper reviews the challenges to and implications for implementing national guidelines in the area of family communication in an ICU coupled with the principles of clinical reengineering.
KW - Checklist for communication
KW - Clinical reengineering
KW - Family conference
KW - Intensive care unit (ICU)
KW - Multidisciplinary teams
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U2 - 10.1017/S1478951514000650
DO - 10.1017/S1478951514000650
M3 - Article
C2 - 25008250
AN - SCOPUS:84946473710
SN - 1478-9515
VL - 13
SP - 961
EP - 967
JO - Palliative and Supportive Care
JF - Palliative and Supportive Care
IS - 4
ER -