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Improving communication in the ICU using daily goals.

Peter Pronovost1, Sean Berenholtz, Todd Dorman

  • 1Departments of Anesthesiology & Critical Care Medicine, Surgery and Health Policy & Management, Center for Innovations in Quality Patient Care, The Johns Hopkins University, Baltimore, MD 21287, USA. ppronovo@jhmi.edu

Journal of Critical Care
|June 12, 2003
PubMed
Summary

Implementing a daily goals form significantly improved understanding of patient care goals among intensive care unit (ICU) teams, reducing ICU length of stay (LOS). This communication tool enhances patient care efficiency.

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Area of Science:

  • Healthcare communication strategies
  • Patient safety and quality improvement
  • Intensive care unit (ICU) management

Background:

  • Communication failures are a major cause of errors across industries, estimated at 85%.
  • Effective communication is crucial for team performance and improvement in healthcare settings.

Purpose of the Study:

  • To assess and enhance communication effectiveness during intensive care unit (ICU) patient care rounds.
  • To evaluate the impact of a daily goals form on team communication and patient outcomes.

Main Methods:

  • A prospective cohort study was conducted in a 16-bed surgical oncology ICU.
  • Key outcome measures included ICU length of stay (LOS) and the percentage of residents and nurses understanding daily goals of care.
  • Data were collected before and after the implementation of a daily goals form.

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Main Results:

  • Understanding of daily goals of care increased from less than 10% to over 95% among ICU residents and nurses.
  • The average ICU length of stay (LOS) decreased from 2.2 days to 1.1 days post-implementation.
  • Significant improvements were observed in both team communication and patient length of stay.

Conclusions:

  • The daily goals form implementation led to substantial improvements in goal understanding and reduced ICU LOS.
  • This communication tool demonstrates broad applicability and effectiveness in acute care medicine settings.
  • Enhanced team communication through structured tools can positively impact patient outcomes and resource utilization.