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Identifying System Constraints and Adaptive Strategies for Effective Provider-Patient Family Conversations in the ICU

DescriptionProvider-Patient Family (PPF) conversations in Intensive Care Units (ICUs) often involve critical decisions that patient’s kin or surrogates must make on their behalf. Ineffective communication during these conversations can delay decisions, increase emotional burden, and escalate healthcare costs. This study uses the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 framework and concepts of Resilience Engineering to examine factors contributing to the effectiveness of PPF conversations and to identify the challenges, facilitators, factors supporting information flow, and coordination gaps existing in the system at the Neurological ICU of a large hospital system in South Carolina. In-site observations, surveys assessing perceived communication quality and provider workload, and semi-structured interviews with family members and providers are being conducted to understand the system’s processes and the variabilities influencing the effectiveness of PPF conversations. Both qualitative and quantitative methods will be employed to analyze the data and develop insights. The findings will inform a multi-user-centered design framework that can better support the planning, coordination, and execution of PPF conversations in the ICU, ultimately enhancing decision-making processes and improving outcomes for patients, families, and providers.

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