Measuring Family Satisfaction With Care Delivered in the Intensive Care Unit

Abstract

Background In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families’ needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families’ satisfaction with care in this setting. Objective To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit. To assess the feasibility of the selected tool for measuring family satisfaction and to make recommendations that are based on the results. Method A descriptive survey design using the Family Satisfaction in the Intensive Care Unit 24-item questionnaire to measure satisfaction with care and decision-making. Results Forty family members completed the survey. Overall, the mean score for families’ satisfaction with care was 72.24% (SD, 14.87%) and the mean score for families’ satisfaction with decision-making was 72.03% (SD, 16.61%). Families reported that nurses put them at ease and provided understandable explanations. Collaboration, inclusion of families in clinical discussions, and timely information regarding changes in the patient’s condition were the most common points brought up in free-text responses from family members. Written communication, including directions and expectations, would have improved the families’ experience. Conclusion Although patients’ family members reported being satisfied with their experience in the intensive care unit, there is room for improvement. Effective communication among the health care team, patients’ families, and patients will be targeted for quality improvement initiatives.

Families of patients in ICU: A Scoping review of their needs and satisfaction with care

“…Seven studies, four of which were large multicentre studies, investigated family satisfaction with care and decision‐making in the ICU. Three studies used quantitative methods (Heyland, Rocker, & Dodek, ; Hunziker et al, ; Hwang et al, ) and four were mixed methods studies (Clark, Milner, Beck, & Mason, ; Hendrich et al, ; Karlsson, Tisell, Engrstom, & Andershed, ; Schwarzkopf et al, ). No qualitative studies of family satisfaction with care in ICU were found (Table ).…”

“…Research study findings suggest that families of the critically ill are highly satisfied with the care their relative receives, especially with aspects of care about skill and competence of staff and the respect given to the patient (Clark et al, ; Hendrich et al, ; Heyland et al, ; Hunziker et al, ; Hwang et al, ; Schwarzkopf et al, ). Families were less satisfied with emotional support, the provision of understandable, consistent information and coordination of care (Clark et al, ; Hendrich et al, ; Heyland et al, ; Hunziker et al, ; Hwang et al, ; Schwarzkopf et al, ). Families felt more satisfied when clear, honest information was delivered to them in understandable language as this enables them to actively participate in the decision‐making process (Heyland et al, ; Hunziker et al, ; Hwang et al, ).…”

“…Reporting on the three open‐ended questions in the FS‐ICU, three of the six studies provided further knowledge of family member's experiences with care delivery in the ICU (Clark et al, ; Hendrich et al, ; Schwarzkopf et al, ). In the free‐text responses, families expressed the need for better communication with healthcare staff and the need for timely, accurate and up‐to‐date information about changes in their relative's condition.…”

“…Key areas for improvement identified were including the family as part of the ICU team, increasing open communication and assessing and potentially revisiting their level of understanding of the information they have been given (Clark et al, ; Hendrich et al, ; Heyland et al, ; Hunziker et al, ; Hwang et al, ; Schwarzkopf et al, ). Nurses who are in constant close contact with families are in an ideal position to ensure that family information and assurance needs are met.…”

“…Three studies used quantitative methods (Heyland, Rocker, & Dodek, 2002;Hunziker et al, 2012;Hwang et al, 2014) and four were mixed methods studies (Clark, Milner, Beck, & Mason, 2016;Hendrich et al, 2011;Karlsson, Tisell, Engrstom, & Andershed, 2011;Schwarzkopf et al, 2013). No qualitative studies of family satisfaction with care in ICU were found ( Table 2).…”