Identifying improvement opportunities for patient- and family-centered care in the ICU: Using qualitative methods to understand family perspectives

Anne Sophie Ågård; José G M Hofhuis; Matty Koopmans; Rik T Gerritsen; Peter E Spronk; Ruth A Engelberg; J Randall Curtis; Jan G Zijlstra; Hanne Irene Jensen

doi:10.1016/j.jcrc.2018.10.008

Identifying improvement opportunities for patient- and family-centered care in the ICU: Using qualitative methods to understand family perspectives

J Crit Care. 2019 Feb:49:33-37. doi: 10.1016/j.jcrc.2018.10.008. Epub 2018 Oct 12.

Authors

Anne Sophie Ågård¹, José G M Hofhuis², Matty Koopmans³, Rik T Gerritsen⁴, Peter E Spronk⁵, Ruth A Engelberg⁶, J Randall Curtis⁷, Jan G Zijlstra⁸, Hanne Irene Jensen⁹

Affiliations

¹ Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Århus N, Denmark; Department of Science in Nursing, Institute of Public Health, Aarhus University, Building 1260, Bartholins Allé 2, 8000 Aarhus C, Denmark. Electronic address: [email protected].
² Department of Intensive Care Medicine Gelre Hospitals Apeldoorn, Apeldoorn, the Netherlands. Electronic address: [email protected].
³ Center of Intensive Care, Medisch Centrum Leeuwarden, PO Box 888, 8901 BR Leeuwarden, the Netherlands. Electronic address: [email protected].
⁴ Center of Intensive Care, Medisch Centrum Leeuwarden, PO Box 888, 8901 BR Leeuwarden, the Netherlands. Electronic address: [email protected].
⁵ Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: [email protected].
⁶ Division of Pulmonary, Critical Care and Sleep Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA 98104, USA; Cambia Palliative Care Center of Excellence, University of Washington, Seattle, USA. Electronic address: [email protected].
⁷ Division of Pulmonary, Critical Care and Sleep Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA 98104, USA; Cambia Palliative Care Center of Excellence, University of Washington, Seattle, USA. Electronic address: [email protected].
⁸ University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. Electronic address: [email protected].
⁹ Department of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, Beriderbakken 4, 7100 Vejle, Denmark; Institute of Regional Health Research, University of Southern Denmark, J.B.Winsløwsvej 19, 5000 Odense, Denmark. Electronic address: [email protected].

PMID: 30359923
DOI: 10.1016/j.jcrc.2018.10.008

Abstract

Purpose: The purposes of the study were to provide richer context for families' quantitative assessments of the quality of ICU care, and to describe further quality areas of importance for family members.

Materials and methods: Free-text comments from 1077 family members of 920 patients focusing on family evaluation of ICU quality of care were analyzed using content analysis. Twenty-one Danish and Dutch ICUs participated from October 2014 to June 2015.

Results: Four themes emerged as important to families: information, clinician skills, ICU environment, and discharge from the ICU. Families highlighted the importance of receiving information that was accessible, understandable and honest. They indicated that quality care was ensured by having clinicians who were both technically and interpersonally competent. The ICU environment and the circumstances of the transfer out of the ICU were described as contributing to quality of care. The comments identified room for improvement within all themes.

Conclusions: The study highlights the importance of including both technical and emotional care for patients and families and the consequent need to focus on clinicians' mastery of interpersonal skills.

Keywords: Content analysis; Family satisfaction; Family-centred care; ICU; Quality of care; euroFS-ICU; euroQ2; euroQODD.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Clinical Competence / standards
Denmark
Family / psychology*
Female
Humans
Intensive Care Units / standards*
Male
Middle Aged
Netherlands
Patient Discharge / standards
Patient-Centered Care / standards*
Professional-Family Relations
Quality Improvement / organization & administration*
Quality of Health Care / standards*