Hospitals make ICUs 'family-centered' to improve outcomes

One way hospitals are working to improve outcomes for patients in the intensive care unit is by taking steps to better include family members and caregivers in care decisions and accommodate them in the ward.

Giora Netzer, M.D., a critical care specialist at the University of Maryland Medical Center, told The Baltimore Sun that a focus on patients’ families can lead to shorter hospital stays and can better prepare family members to provide care after discharge, a claim supported by recent research.

“It’s not just more humane care, it ends up being better healthcare,” Netzer said.

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Netzer was involved in developing guidelines (PDF) for the Society of Critical Care Medicine, which offer strategies providers can use to better include family members in ICU patient care.

The guidelines say that families should have an “open or flexible” place at the patient’s bedside, and sleeping options should be provided to prevent sleep deprivation.

Clinicians also should include family education as part of clinical care, according to the guidelines. One option is to have routine family conferences to share information and engage family members in decision-making when appropriate. Such meetings can improve families' satisfaction with their loved ones' care and their trust in the clinicians overseeing it.

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A “family-centered” care approach can also include offering spiritual and emotional support to patients’ families to reduce anxiety, stress, depression or risk for post-traumatic stress disorder in certain cases, the guidelines say.

The University of Maryland Medical Center, for instance, has implemented these changes by offering bigger rooms to accommodate family members and inviting them to visit at any time, according to The Sun article. Social workers now also serve as navigators to facilitate discussions with clinicians or connect families with outside services, and the hospital is testing pilot programs to determine if patients benefit from having family members attend rounds.