A Randomized Trial of an Interdisciplinary Communication Intervention to Improve Patient and Family Outcomes in the Intensive Care Unit
Principal Investigators: JR Curtis and RA Engelberg
Research Grant: National Institute of Health / NINR, May 2008 to April 2013
The primary aim of the study is to demonstrate the value of a generalizable, facilitator-assisted interdisciplinary communication intervention in the ICU on family and patient outcomes. Outcomes include improvements in: family members’ symptoms of anxiety and depression, the quality of a patient’s dying and death, ICU length of stay prior to death, and the quality of family-clinician communication. The second long term objective of this study is to demonstrate the feasibility of making this intervention a routine part of clinical practice in the ICU setting. The study is a randomized trial of the use of a facilitator to improve end-of-life communication and decision-making among physicians, nurses, and families for patients who are critically ill and in the ICU. The intervention involves incorporating the facilitator into ICU family conferences. The facilitators will assist families of patients in the intervention group to improve communication between family and clinicians by adapting this communication to meet the needs of individual family members. Facilitators will be trained in mediation techniques, relationship styles, and interdisciplinary communication. The families of patients in the control group will receive usual care and will not have the assistance of this facilitator. The methodology of the study includes baseline data collection, the implementation of the intervention (recording and surveying of family conferences), and post-intervention data collection.
clinicaltrials.gov: http://clinicaltrials.gov/ct2/show/NCT00720200
Publications from this study include:
Khandelwal N, Benkeser D, Coe NB, Engelberg RA, Curtis JR. Economic Feasibility of Staffing the Intensive Care Unit with a Communication Facilitator. Ann Am Thorac Soc. 2016 Dec;13(12):2190-2196.
Curtis JR, Treece PD, Nielsen EL, Gold J, Ciechanowski PS, Shannon SE, Khandelwal N, Young JP, Engelberg RA. Randomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-life Care. Am J Respir Crit Care Med. 2016 Jan 15;193(2):154-62. Epub 2015 Sep 17.
Howell AA, Nielsen EL, Turner AM, Curtis JR, Engelberg RA. Clinicians’ perceptions of the usefulness of a communication facilitator in the intensive care unit. Am J Crit Care. 2014 Sep;23(5):380-6.
Curtis JR, Ciechanowski PS, Downey L, Gold J, Nielsen EL, Shannon SE, Treece PD, Young JP, Engelberg RA. Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU. Contemp Clin Trials. 2012 Nov;33(6):1245-54. Epub 2012 Jul 6.