Family-Physician Communication in the Intensive Care Unit

Abstract

PURPOSE: Discussions regarding the care of critically ill patients are difficult for patients and clinicians alike. Based on our observation that these encounters are frustrating, we initiated a qualitative evaluation of perceptions of barriers to optimized discussions. METHOD(S): We conducted a series of focus groups separated into family members of ICU patients with length of stay greater than 3 days , ICU nurses, and ancillary staff (Social Worker, Spiritual Care, Palliative Medicine, and Bio Ethics). Additionally, we administered a gap analysis survey to Pulmonary/Critical Care staff physicians and fellows. RESULT(S): In general, nursing and ancillary staff perceptions aligned with those of families. Physician perceptions focused on entirely different issues. Family members perceived lack of availability, multiple subspecialty services, and lack of focus on overall status of patient. Physicians focused on lack of family availability, unrealistic family expectations which were attributed to religious beliefs and physician workload as major barriers. CONCLUSION(S): There are major perceptual gaps between ICU physicians and everyone else involved in communication between families of critically ill patients and physicians. There are both structural and communication barriers.