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Implementing family communication pathway in neurosurgical patients in an intensive care unit

Published online by Cambridge University Press:  10 July 2014

Sashikanth Kodali ,
Rebecca Stametz ,
Deserae Clarke ,
Amanda Bengier ,
Haiyan Sun ,
A.J. Layon  and
Jonathan Darer
Sashikanth Kodali*
Affiliation:
Division of Clinical Innovation, Geisinger Health System, Danville, Pennsylvania
Rebecca Stametz
Affiliation:
Division of Clinical Innovation, Geisinger Health System, Danville, Pennsylvania
Deserae Clarke
Affiliation:
Division of Clinical Innovation, Geisinger Health System, Danville, Pennsylvania
Amanda Bengier
Affiliation:
Division of Clinical Innovation, Geisinger Health System, Danville, Pennsylvania
Haiyan Sun
Affiliation:
Center for Health Research, Geisinger Health System, Danville, Pennsylvania
A.J. Layon
Affiliation:
Division of Critical Care, Geisinger Medical Center, Danville, Pennsylvania
Jonathan Darer
Affiliation:
Division of Clinical Innovation, Geisinger Health System, Danville, Pennsylvania
*
Address correspondence and reprint requests to: Sashikanth Kodali, Medical Director, Geisinger Health System, 100 North Academy Avenue, Danville, Pennsylvania 17822. E-mail: skodali@geisinger.edu
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Abstract

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.

Keywords

Clinical reengineeringIntensive care unit (ICU)Family conferenceMultidisciplinary teamsChecklist for communication
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 961 - 967
Copyright
Copyright © Cambridge University Press 2014 

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