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.