Meredith Vanstone1, Marina Sadik1, Orla Smith2, Thanh H Neville3, Allana LeBlanc4, Anne Boyle1,5, France J Clarke6,7, Marilyn E Swinton7, Alyson Takaoka6,7, Feli Toledo8, Andrew J Baker2, Peter Phung9, Deborah J Cook6,7. 1. Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. 2. Critical Care Department, St. Michael's Hospital, Toronto, ON, Canada. 3. Division of Pulmonary & Critical Care, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 4. Department of Nursing, Vancouver Coastal Health, Vancouver, BC, Canada. 5. Department of Palliative Care, St. Joseph's Healthcare, Hamilton, ON, Canada. 6. Department of Critical Care, St. Joseph's Healthcare, Hamilton, ON, Canada. 7. Departments Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. 8. Department of Spiritual Care, St. Joseph's Healthcare, Hamilton, ON, Canada. 9. Division of General Internal Medicine, Department of Medicine, Palliative Care Program, University of California, Los Angeles, Los Angeles, CA, USA.
Abstract
BACKGROUND: The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. AIM: To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. DESIGN: Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. SETTING/PARTICIPANTS: Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. RESULTS: The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. CONCLUSIONS: Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.
BACKGROUND: The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. AIM: To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. DESIGN: Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. SETTING/PARTICIPANTS: Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. RESULTS: The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. CONCLUSIONS: Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.
Entities:
Keywords:
Intensive care units; burnout; empathy; palliative care; psychological; qualitative research
Authors: Thanh H Neville; Zachary Taich; Anne M Walling; Danielle Bear; Deborah J Cook; Chi-Hong Tseng; Neil S Wenger Journal: J Gen Intern Med Date: 2022-05-17 Impact factor: 6.473
Authors: Brittany Dennis; Meredith Vanstone; Marilyn Swinton; Daniel Brandt Vegas; Joanna C Dionne; Andrew Cheung; France J Clarke; Neala Hoad; Anne Boyle; Jessica Huynh; Feli Toledo; Mark Soth; Thanh H Neville; Kirsten Fiest; Deborah J Cook Journal: BMJ Open Date: 2022-01-19 Impact factor: 2.692