Alison E Turnbull1, Sarina K Sahetya2, Dale M Needham3. 1. Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary & Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: turnbull@jhmi.edu. 2. Division of Pulmonary & Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. 3. Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary & Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Abstract
OBJECTIVE: To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals. BACKGROUND: A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when "making major treatment decisions that may be affected by personal values, goals, and preferences." METHODS: A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U.S. mid-Atlantic region. RESULTS: Recommendations about 8 interventions achieved consensus among respondents. CONCLUSIONS: Clinical and patient/family participants in a modified Delphi consensus process were able to identify preference-sensitive decisions that should trigger clinicians to clarify patient goals and consider initiating shared decision-making.
OBJECTIVE: To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals. BACKGROUND: A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when "making major treatment decisions that may be affected by personal values, goals, and preferences." METHODS: A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U.S. mid-Atlantic region. RESULTS: Recommendations about 8 interventions achieved consensus among respondents. CONCLUSIONS: Clinical and patient/family participants in a modified Delphi consensus process were able to identify preference-sensitive decisions that should trigger clinicians to clarify patient goals and consider initiating shared decision-making.
Authors: Judith E Nelson; J Randall Curtis; Colleen Mulkerin; Margaret Campbell; Dana R Lustbader; Anne C Mosenthal; Kathleen Puntillo; Daniel E Ray; Rick Bassett; Renee D Boss; Karen J Brasel; Jennifer A Frontera; Ross M Hays; David E Weissman Journal: Crit Care Med Date: 2013-10 Impact factor: 7.598
Authors: Ivan R Diamond; Robert C Grant; Brian M Feldman; Paul B Pencharz; Simon C Ling; Aideen M Moore; Paul W Wales Journal: J Clin Epidemiol Date: 2014-04 Impact factor: 6.437
Authors: Alexander A Kon; Judy E Davidson; Wynne Morrison; Marion Danis; Douglas B White Journal: Am J Respir Crit Care Med Date: 2016-06-15 Impact factor: 21.405
Authors: Vanessa N Madrigal; Karen W Carroll; Kari R Hexem; Jennifer A Faerber; Wynne E Morrison; Chris Feudtner Journal: Crit Care Med Date: 2012-10 Impact factor: 7.598
Authors: Alison E Turnbull; Kristin A Sepulveda; Victor D Dinglas; Caroline M Chessare; Clifton O Bingham; Dale M Needham Journal: Crit Care Med Date: 2017-06 Impact factor: 7.598