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Clinicians' perceptions of the usefulness of a communication facilitator in the intensive care unit
Abigail A Howell1, Elizabeth L Nielsen1, Anne M Turner1
1Abigail A. Howell and Elizabeth L. Nielsen are both researchers with the end-of-life care research program in the Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle. Ruth A. Engelberg is a research associate professor in the Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle. Anne M. Turner is an assistant professor in the Department of Health Services, School of Public Health, and an assistant professor in the Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle. J. Randall Curtis is a professor, the A. Bruce Montgomery-American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine in the Division of Pulmonary and Critical Care, Department of Medicine and an adjunct professor in the Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle.
Background:
Despite its documented importance, communication between clinicians and patients' families in the intensive care unit often fails to meet families' needs, and interventions to improve communication are needed. Use of a communication facilitator-an additional staff member-to improve communication between clinicians and patients' families is the focus of an ongoing randomized trial. The clinical team's acceptance of the communication facilitator as an integral part of the team is important.
Objectives:
To explore clinicians' perceptions of the usefulness of a communication facilitator in the intensive care unit.
Methods:
Fourteen semistructured qualitative interviews to assess perspectives of physicians, nurses, and social workers who had experience with the communication facilitator intervention on the intervention and the role of the facilitator. Methods based on grounded theory were used to analyze the data.
Results:
Clinicians perceived facilitators as (1) facilitating communication between patients' families and clinicians, (2) providing practical and emotional support for patients' families, and (3) providing practical and emotional support for clinicians. Clinicians were enthusiastic about the communication facilitator but concerned about overlapping or conflicting roles.
Conclusions:
Clinicians in the intensive care unit saw the facilitator intervention as enhancing communication and supporting both patients' families and clinicians. They also identified the importance of the facilitator within the interdisciplinary team. Negative perceptions about the use of a facilitator should be addressed before the intervention is implemented, in order to ensure its effectiveness.
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