Researchers: Sigal Sviri¹, Vernon vanHeerden¹

Background: An important task of intensive care unit (ICU) physicians is to provide relatives of critically ill patients with appropriate and clear information, so that they should understand the prognosis, treatment options and have realistic expectations.

Objectives: To assess whether a structured communication tool used by ICU physicians, improves satisfaction with care and engender 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.

Method: First, we interviewed forty relatives of patients who received usual communication from medical staff (control group), regarding their satisfaction with care and their outcome expectations for their relative. We then provided the physicians a structure communication tool and another forty family members were interviewed (intervention group). We also interviewed the ICU physician who was responsible for the patient regarding their assessment of the patient's' prognosis. We collected data on actual outcome.

Findings: Satisfaction in the intervention group was higher compared to the control group regarding the ease of obtaining the information from the medical staff (90% versus 70% very satisfied, respectively, p=0.025) and the consistency of information provided (92.5% vs 77.5%, very satisfied, respectively, p= 0.057). There was a better correlation between physicians' and relatives' expectations in the intervention group regarding hospital survival (Kappa 0.322 vs 0.054, p=0.01). Physicians predicted more accurately the patients' actual survival compared to family members.

Conclusions: A structured communication tool improves family satisfaction regarding the ease of receiving the information and its consistency and expectations regarding hospital survival, which may indicate better comprehension about prognosis.

Recommendations: As a structured communication tool is easy to use, it should be implemented by physicians in ICU to improve transfer of information to relatives of critically ill patients.

Research end date: 08/2019