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Measuring communication quality in the Neonatal Intensive Care Unit
Katherine F Guttmann1, Kristina Orfali2, Amy S Kelley3
1Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY, USA. katherine.guttmann@mssm.edu.
Insights
High-quality communication in neonatal intensive care units (NICUs) is crucial but poorly measured. This review highlights the urgent need for validated instruments to assess communication quality for parents of critically ill infants.
Area of Science:
- Neonatal intensive care
- Pediatric palliative care
- Healthcare communication
Background:
- Effective communication between healthcare providers and parents of critically ill neonates is vital but not well understood.
- Improving communication is a priority in pediatric palliative care, yet measuring relevant outcomes remains a challenge.
- Specifically, assessing communication quality in neonatology is problematic and understudied.
Purpose of the Study:
- To review existing validated instruments for measuring communication quality in adult patients and surrogates.
- To identify the gap in validated measures for communication quality specifically within the neonatal intensive care unit (NICU) setting.
- To highlight the critical need for further research and development in this area.
Main Methods:
- Conducted a focused literature review using PubMed.
- Searched the Palliative Care Research Cooperative (PCRC) instrument library.
- Included studies measuring communication quality and/or satisfaction with communication.
Main Results:
- Identified five validated instruments measuring communication quality/satisfaction in adult patients or surrogates.
- PubMed search yielded 249 unique results, with only two meeting inclusion criteria.
- No comprehensive overview of existing communication quality measures in the NICU was found.
Conclusions:
- Development and rigorous testing of a validated, comprehensive measure of communication quality for neonates is essential.
- Without such a measure, advancing prognostic communication quality for parents of critically ill infants will be difficult.
- This review underscores the need for dedicated research into NICU communication assessment tools.
Background:
High quality communication between providers and parents of seriously ill neonatal patients is vital and yet poorly understood. Feudtner summarized five challenges and seven priorities to the study and advancement of pediatric palliative care. Improvement of communication is a priority, while lack of specification and measurement of outcomes relevant to the pediatric population remains a challenge. Specifically, measurement of communication quality in pediatrics, and especially neonatology, is problematic.
Methods:
We conducted a focused review of this topic which we hope will serve to support further research. We reviewed the current literature in Pubmed and searched the Palliative Care Research Cooperative (PCRC) instrument library.
Results:
We found five validated instruments which met our criteria, relied on patient or surrogate report, and were developed to measure quality of communication and/or satisfaction with communication with adult patients or their surrogates. Our Pubmed search yielded 249 unique results, only two of which met our inclusion criteria.
Conclusion:
We conclude that development and exhaustive testing of a validated, comprehensive measure of communication quality for the neonatal population is needed. Without such a measure, it will be difficult to advance the field and achieve high quality prognostic communication for the parents of seriously ill babies.
Impact:
Measurement of communication quality in pediatrics, and especially neonatology, is problematic, understudied, and yet critical to the advancement of the field. There has not been an overview of existing measures of communication quality in the NICU published, nor has there been a comprehensive discussion of this important topic. Our paper provides such an overview and initiates such a discussion. We present a narrative review of existing measures of communication quality in the NICU in order to highlight the need for further study.
