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This study was a trial of a formal system of family meetings to support family decision makers of chronically critically ill patients in the intensive care unit.
Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We implemented an "intensive communication system" to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients
The design was a pre-post, tandem assignment of patients (n=217) receiving usual care and communication, followed by enrollment of intervention patients (n=354), from 5 ICUs. The "intensive communication system" included: (1) family meeting within 5 days of ICU admission and weekly thereafter; (2) each meeting addressed medical update, values and preferences, goals of care; treatment plan, and milestones for judging effectiveness of treatment.
We measured differences between control and intervention patients in indicators of aggressiveness of care or timing of treatment limitation decisions (ICU mortality, LOS, duration of ventilation, treatment limitation orders, or use of tracheostomy or percutaneous gastrostomy). Difference in outcomes among patients who died or who had treatment limitation orders, comparing control and intervention groups, was also examined.
Control: Historical Control, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Intensive Communication System
University Hosptials Case Medical center
Case Western Reserve University
Published on BioPortfolio: 2014-07-23T21:10:59-0400
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A measure of the mortality and morbidity rates among patients who receive CRITICAL CARE and INTENSIVE CARE as determined from the date of hospital discharge or release.
Hospital units providing continuous surveillance and care to acutely ill infants and children. Neonates are excluded since INTENSIVE CARE UNITS, NEONATAL is available.
Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.
Critical care treatment using intensive monitoring and aggressive management of perioperative hemodynamics in high risk patients,
Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.