Nicholas G Wysham1, Richard A Mularski2, David M Schmidt3, Shirley C Nord4, Deborah L Louis5, Elizabeth Shuster6, J Randall Curtis7, David M Mosen8. 1. Department of Medicine, Oregon Health and Science University, Portland, OR, USA. Electronic address: Nicholas.Wysham@gmail.com. 2. Kaiser Permanente, Sunnyside Medical Center, Portland, OR, USA; The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA. Electronic address: Richard.A.Mularski@kpchr.org. 3. Kaiser Permanente, Sunnyside Medical Center, Portland, OR, USA. Electronic address: David.M.Schmidt@kp.org. 4. Kaiser Permanente, Sunnyside Medical Center, Portland, OR, USA. Electronic address: Shirley.C.Nord@kp.org. 5. Kaiser Permanente, Sunnyside Medical Center, Portland, OR, USA. Electronic address: Deborah.L.Louis@kp.org. 6. The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA. Electronic address: Elizabeth.Shuster@kpchr.org. 7. The University of Washington & Harborview Medical Center, Seattle, WA, USA. Electronic address: JRC@u.washington.edu. 8. The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA. Electronic address: David.M.Mosen@kpchr.org.
Abstract
PURPOSE: Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. MATERIALS AND METHODS: We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. RESULTS: Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. CONCLUSIONS: Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements.
PURPOSE: Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically illpatients. MATERIALS AND METHODS: We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. RESULTS: Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. CONCLUSIONS: Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements.
Authors: Leopoldo M Amendola; Alessandro Galazzi; Irene Zainaghi; Ivan Cortinovis; Anna Zolin; Rik T Gerritsen; Ileana Adamini; Maura Lusignani; Dario Laquintana Journal: Int J Environ Res Public Health Date: 2020-11-28 Impact factor: 3.390
Authors: Jessalyn K Holodinsky; Marilynne A Hebert; David A Zygun; Romain Rigal; Simon Berthelot; Deborah J Cook; Henry T Stelfox Journal: PLoS One Date: 2015-12-23 Impact factor: 3.240