ABSTRACT
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%, pâ¯=â¯.025) and the consistency of information provided (92.5% vs 77.5%, pâ¯=â¯.057). There was better correlation between physicians' and relatives' expectations in the intervention group regarding hospital survival (Kappa 0.322 vs 0.054, pâ¯=â¯.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.
