A 6-y retrospective cohort study of family satisfaction with critical care and decision-making in an Australian intensive care unit |
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| Affiliation: | 1. School of Nursing&Midwifery, Deakin University, Geelong, Australia;2. Centre for Quality and Patient Safety Research–Alfred Health Partnership, Institute for Health Transformation, Deakin University, Australia;3. Nursing Services, Alfred Health, Melbourne, Australia;4. Intensive Care Unit, Alfred Health, Australia;1. Service de Médecine Intensive Réanimation, Centre Hospitalier Régional d’Orléans, Orléans, France;2. Ecole Universitaire de Kinésithérapie Centre Val de Loire, Orléans, France;1. The George Institute for Global Health, Sydney, Australia;2. University of New South Wales, Sydney, Australia;3. Medical Research Institute of New Zealand, Wellington, New Zealand;4. Intensive Care Unit, Wellington Hospital, Wellington, New Zealand;5. The Princess Alexandra Hospital, University of Queensland, Brisbane, Australia;6. The Wesley Hospital, Brisbane, Australia;7. Imperial College, London, UK;8. Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia;9. St George Clinical School, University of New South Wales, Sydney, Australia;10. Faculty of Medicine and Health, University of Sydney, Sydney, Australia;11. Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand;1. Discipline of Acute Care Medicine, The University of Adelaide, AHMS, North Terrace, Adelaide, SA 5000, Australia;2. 4G751 Intensive Care Unit Research Department, The Royal Adelaide Hospital, Port Rd, Adelaide, SA 5000, Australia;3. Hugo Centre for Population and Housing, University of Adelaide, Napier Building, North Terrace, Adelaide, SA 5000, Australia;4. Intensive Care Unit, The Royal Melbourne Hospital, 300 Grattan St, Parkville, Melbourne, VIC 3010, Australia;5. The University of Melbourne, Melbourne Medical School, Department of Medicine and Radiology, Royal Melbourne Hospital, Parkville, Australia, VIC 3050;1. Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia;2. Intensive Care and Anaesthesia, Ziekenhuis Oost-Limburg, Genk, Belgium;3. School of Public Health, University of Adelaide, Adelaide, South Australia, Australia;4. Intensive Care Unit, Barwon Health, Geelong, Victoria, Australia;5. School of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, Australia;6. Australia and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia;7. Department of Physiotherapy, The Alfred Hospital, Melbourne, Victoria, Australia;1. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia;2. Primary Health Care Nursing, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia;1. Prehospital Emergency Medical Service of Madrid Region, SUMMA112, Spain;2. Autónoma University of Madrid, Spain;3. Politécnica de Madrid University, Spain;4. Infanta Leonor of Vallecas Hospital Emergency Service, Madrid, Spain;5. Emergency Medical Service of Fuenlabrada, Madrid, Spain;6. Jimenez Díaz Hospital Emergency Service, Madrid, Spain;7. Puerta de Hierro Hospital Emergency Service, Madrid, Spain;8. Fundación Alcorcón Hospital Emergency Service, Madrid, Spain;9. Gregorio Marañón Hospital Emergency Service, Madrid, Spain |
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| Abstract: | BackgroundPartnering with patients and families to make decisions about care needs is a safety and quality standard in Australian health services that is often not assessed systematically.ObjectiveThe objective of this study was to retrospectively evaluate satisfaction with care and involvement in decision-making among family members of patients admitted to the intensive care unit (ICU).MethodsA retrospective cohort analysis of a satisfaction survey administered to family members of patients admitted to an ICU in an Australian metropolitan tertiary care hospital from 2014 to 2019 was conducted. The Family Satisfaction in the Intensive Care Unit questionnaire (FSICU) questionnaire was used to assess overall satisfaction, satisfaction with care, and satisfaction with decision-making on a scale from “poor” (0) to “excellent” (100).ResultsIn total, 1322 family members fully completed the survey. Respondents were typically direct relatives of ICU patients (94.2%) with an average age of 52.6 years. Most patients had an ICU length of stay <7 d (56.8%), with most patients being discharged to the ward (96.8%). The overall mean satisfaction score was high among respondents (90.26%). Similarly, mean satisfaction with care (93.06%) and decision-making (89.71%) scores were high. Satisfaction with decision-making scores remained lower than satisfaction with care scores. Multivariable modeling indicated that those younger than 50 years reported higher satisfaction scores (p = 0.006) and those with prolonged lengths of stay in the ICU were associated with lower overall satisfaction scores (p = 0.039). Despite some criticism of waiting times and noise levels, responses showed sincere gratitude for patients’ treatment in the ICU and appreciation for the care, skill, and professionalism of the staff.ConclusionVery high satisfaction levels were reported by family members during this study. Routine, prospective evaluations of family member satisfaction with ICU experiences are feasible and can be leveraged to provide insight for clinicians and administrators seeking to improve family satisfaction with decision-making and care in ICU settings and meet national standards. |
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| Keywords: | Clinical decision-making Family experience Satisfaction Intensive care unit Critical care |
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