Capturing the Work of Patients' Family Members in the Medical Intensive Care Unit Using Naturalistic Observations

Abstract

Background: The contributions of cognitive and behavioral work of patients' family members in intensive care units remain largely unrecognized. Objective: The objective of this study was to develop a framework of outwardly observable family work, with specific focus on describing the physical space. Methods: We conducted approximately 50 hrs of naturalistic observations of family activities on a medical intensive care unit (MICU) at a large, Midwestern teaching hospital. Results: We created a framework of activities that include requesting, receiving, or delivering either information or action, along with examples. Further, we identified clinician and staff roles with whom families interact and characterized the physical spaces in which interactions take place. Conclusions: Knowledge contribution is a proposed framework of family activities in the MICU. It has the potential to guide and be further described by future research and to inform development of human-centered family-facing interventions to support cognitive and behavioral cognitive and behavioral work.