Promoting Family Engagement in the ICU: Experience From a National Collaborative of 63 ICUs.
Crit Care Med
; 47(12): 1692-1698, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31567354
ABSTRACT
OBJECTIVES:
As part of an improvement program targeting ICU, a national collaborative was launched to help hospitals implement patient- and family-centered care engagement initiatives.DESIGN:
Ten-month quality improvement collaborative.SETTING:
Guided by a national patient and family advisory group, participating teams implemented an individual project including open visitation; integrating families on rounds; establishing a patient and family advisory committee; using patient and family diaries, among others.SUBJECTS:
Sixty-three adult and PICU teams from both academic and community hospitals in 34 states participated.INTERVENTIONS:
Monthly team calls, quarterly webinars, newsletters, an online eCommunity, and team reporting assignments were used to facilitate project implementation. MEASUREMENTS AND MAINRESULTS:
The Family Satisfaction with Care in the ICU 24 was used to assess family satisfaction. Clinician perceptions were assessed with the Institute for Patient- and Family-Centered Care Self-Assessment Inventory. Thematic analysis was used to explore narrative data captured from team reports of project barriers, facilitators, and the experience of participating in the collaborative. A total of 2,530 family member and 3,999 clinician surveys were completed. Postimplementation, family members reported statistically significant increases in overall family satisfaction, satisfaction with decision-making, and satisfaction with quality of care (Family Satisfaction with Care in the ICU mean score change range 0.83-1.24; p ≤ 0.027). Clinicians reported that opportunities for families to participate as members of the care team increased. Major barriers included lack of buy-in and ability to promote change in the clinical setting, managing the workload of implementation, and funding to support initiatives.CONCLUSIONS:
A national collaborative format was useful to assist ICU teams to implement patient- and family-engagement initiatives. Enlisting stakeholder support, engaging unit-based champions, and highlighting benefits of family engagement can help ICU teams to promote family member involvement and engagement.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Família
/
Cuidados Críticos
/
Unidades de Terapia Intensiva
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Tunísia