Institutional Challenges and Solutions to Evidence-Based, Patient-Centered Practice: Implementing ICU Diaries

Area of Science:

• Healthcare quality improvement
• Patient and family centered care

Background:

• Patient diaries are evidence-based, improving ICU patient and family quality of life.
• US centers face challenges implementing and sustaining ICU diary programs.
• Limited guidance exists for effective ICU diary program implementation and sustainability.

Purpose of the Study:

• Discuss challenges in implementing ICU patient diary programs at two US institutions.
• Identify operationalized solutions to overcome implementation difficulties.
• Provide insights for successful ICU diary program adoption.

Main Methods:

• Two institutions identified local barriers to diary implementation in their ICUs.
• Standard operating procedures were developed for execution and evaluation.
• Collaborative problem-solving approach to address identified obstacles.

Main Results:

• Key barriers include liability, patient privacy, program development, and sustainability.
• Strategies were identified to maintain clinical and family engagement.
• Successful implementation requires addressing specific institutional challenges.

Conclusions:

• Sustained team dedication is crucial for ICU diary program implementation.
• Diligent assessment of perceived obstacles facilitates program success.
• ICU diary programs are achievable with focused effort and strategic planning.