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Abstract

members (advisors), nurses, social workers, spiritual care providers as well as medical and nursing leadership. Led by an ICU nurse and an advisor, the group meets monthly and helps lead quality improvement projects. Specifically, projects have included creation of an open visitation policy, bedside rounds and a quiet ICU. Two specific examples of the impact of PFAC advisors are the end-of-life training and the ICU liaison programs. Through personal experience, PFAC advisors brought to light multiple opportunities to improve support of families when a patient is dying. Advisors collaborated with ICU nurses to develop, implement and help teach an end-of-life course for ICU nurses. Additionally, advisors identified the need for additional support for families by those who had been in the same situation; former patients and families, and so developed the ICU liaison program. Liaisons receive formal volunteer training and spend time in the early evenings rounding on patients and families. They listen, empathize, identify unmet family needs and provide information on resources the ICU provides to support these needs. Measurement of the impact of the PFAC has been through patient satisfaction surveys and an internally designed on-line ICU waiting room survey. Results: Since implementing these efforts, ICU HCAHPS scores have dramatically improved. Nursing communication scores rose from the 4th to the 66th percentile and satisfaction with quiet has improved from the 2nd percentile to the 56th. From the internal survey, 50% of respondents find the ICUs "very quiet" compared to 10% prior to efforts for a Quiet ICU. 89% find "Quiet Time" beneficial. Conclusions: Through partnership with an ICU PFAC quality of care can be dramatically improved.Learning Objectives: Concerns exist that family presence on rounds (FCR) negatively impact teaching and rounding efficiency (J of Crit Care -10.1016/j. jcrc.2014.07.015). The hypothesis of this study is that FCR will decrease rounding efficiency and time spent on teaching. Methods: The study was approved as nonhuman subject research by the institutional review board and was performed in a 30 bed medical-surgical pediatric ICU. The PICU underwent a process change allowing FCR. Human factors (observational data collection) techniques were used to shadow physician led rounds before and after the process change. Each rounding "event" was defined as one attending physician led morning rounds with the multidisciplinary team (including residents, fellows, and students) for either of 2 PICU teams. The impact of FCR was determined by comparing the total rounding time and time spent on teaching pre and post process change. Data were analyzed for statistical significance (p<0.05) using a two-tailed T-test. Results: Fourteen rounding events were shadowed pre-process change and 16 post. Mean duration of rounds decreased (148.64 ± 31.25 to 139.60 ± 60.11;p=0.62). Mean time spent on teaching decreased as well (16.62 ± 12.22 to 7.99 ± 7.19; p=0.07). The average number of patients per rounding event wa...