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Best Practices Toolkit for Family Participation in ICU Rounds
  • +1
  • Selena Au,
  • Amanda Roze des Ordons,
  • Kenneth Blades,
  • Thomas Stelfox
Selena Au
University of Calgary Cumming School of Medicine
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Amanda Roze des Ordons
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Kenneth Blades
Ward of the 21st Century (W21C)
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Thomas Stelfox
University of Calgary
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Peer review status:UNDER REVIEW

15 Apr 2020Submitted to Journal of Evaluation in Clinical Practice
20 Apr 2020Assigned to Editor
20 Apr 2020Submission Checks Completed
29 Apr 2020Reviewer(s) Assigned

Abstract

Rationale, Aims and Objectives: Guidelines recommend inviting family members of intensive care unit (ICU) patients to rounds. We aimed to create a toolkit to support family participation in ICU bedside rounds, based upon evidence from research and in collaboration with ICU family member representatives and healthcare providers. Methods: A multi-method qualitative research program was conducted to provide an evidence-base. Ethnographic observations of rounds and interviews and focus groups with family members and ICU healthcare providers were analyzed for key themes, barriers and facilitators of participation, and suggestions. A full day workshop with family representatives and providers (physicians, nurses, social workers, and unit managers) from a diverse range of adult ICUs in Western Canada, including several community ICUs and a majority of large, urban ICUs enabled the collaborative development of key toolkit elements. Results: We have developed an evidence-informed approach to patient-and-family-centered rounds that highlights the importance of 6 key elements foundational to patient and family centered rounds: Invitation, Orientation, Engagement, Summary, Questions, and Communication Follow-Up. We describe strategies, techniques, and templates to optimize these elements and interactions so that communication is more meaningful, and to facilitate the ability of family members to adopt a meaningful role as contributing members of the care team. Conclusion: There is consensus on general strategies for facilitating family participation in rounds and meaningful communication between family and the healthcare team during rounds as an important element of the continuum of communication in the ICU. The incorporation of these elements should be standardized, though tailored to user needs.