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An Integrated Framework for Effective and Efficient Communication with Families in the Adult Intensive Care Unit

机译:成人重症监护病房与家人进行有效有效沟通的综合框架

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摘要

The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician–family communication beyond traditional interdisciplinary family meetings (family meetings)—including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician–family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings. We argue that although each of these platforms is useful in some circumstances, there remains an important role for family meetings. We outline five goals of clinician–family communication—establishing trust, providing emotional support, conveying clinical information, understanding the patient as a person, and facilitating careful decision making—and we examine the extent to which various communication platforms are likely to achieve the goals. We argue that because no single platform can achieve all communication goals, an integrated strategy is needed. We present a model that integrates multiple communication platforms to effectively and efficiently support families across the arc of an ICU stay. Our framework employs bedside/telephone conversations and family-centered rounds throughout the admission to address high informational needs, along with well-timed family meetings that attend to families’ emotions as well as patients’ values and goals. This flexible model uses various communication platforms to achieve consistent, efficient communication throughout the ICU stay.
机译:成人重症监护病房(ICU)对患者和以家庭为中心的护理的关注日益增加,已经为临床医生与家庭之间的交流提供了多种平台,超越了传统的跨学科家庭会议(家庭会议),包括以家庭为中心的诊疗,床边或电话更新以及电子家庭门户。一些临床医生和管理人员现在正在使用这些平台,而不是进行家庭会议。例如,一些机构正朝着使用以家庭为中心的巡回活动作为临床医生与家庭之间交流的主要平台,而一些医生则依靠在床边或通过电话向家庭进行每日的简短更新来代替家庭会议。我们认为,尽管每个平台在某些情况下都是有用的,但家庭会议仍然扮演着重要角色。我们概述了临床医生-家庭沟通的五个目标-建立信任,提供情感支持,传达临床信息,理解患者为人并促进仔细的决策-我们研究了各种沟通平台在多大程度上可以实现目标。我们认为,因为没有一个平台可以实现所有通信目标,所以需要一个集成策略。我们提出了一个模型,该模型集成了多个通信平台,以有效地为ICU住院期间的家庭提供支持。我们的框架在整个招生过程中采用床边/电话交谈和以家庭为中心的回合,以解决高信息需求,以及安排恰当的家庭会议来关注家庭的情感以及患者的价值观和目标。这种灵活的模型使用各种通信平台来在整个ICU停留期间实现一致,高效的通信。

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