Family Satisfaction using the family satisfaction in intensive care unit – 24 tool in the multidisciplinary Intensive Care Unit of a teaching hospital

Abstract

Introduction: Patient centred care and Family engagement are the norm now. Patient and family satisfaction are key quality indicators. Several validated tools are freely available at the present time.Communication skill is an art and science. It has not been a part of regular training for doctors or nurses, although it is a learned skill and not inherent as perceived commonly. Structured training modules are available but not commonly availed.Quality of care is defined as care which produces the greatest expected improvement in health status.Critical care environments are complex and diverse. Because of the continued challenges and debate on the rationale for selection and supporting evidence for use, no one set of established metrics has been identified for the ICU. Instead, institutions and critical care units have individually chosen metrics and formulated individual quality plans.

Materials and Methods: We planned a prospective before and after study. Study was conducted in the Department of Critical Care Medicine, NRI Medical college and Hospital, Guntur from January 2023 to October 2023. The study plan was formulated. We did a pilot study to confirm feasibility. The Pre intervention data was collected from consecutive patients from January 2023 to March 2023.Intervention programme was held in July 2023. Post intervention data collection was performed from August 2023 to October 2023.

Results: Patient outcomes were categorised as improved, dead or patients who left the hospital against medical advice. In the pre-intervention group, 92 patients improved, 344 died and 14 left against medical advice whereas in the post intervention group, 85 patients improved, 30 died and 25 patients were discharged by family against medical advice. There was no difference pre and post intervention with regard to the first family contact with the ICU team. The Chi-square value was 3.583 with a P-value of 0.310. The mean Apache 2 Score was 18.65 in the pre intervention group and 22.43 in the post intervention group. This difference was statistically significant. Patients were more severely ill in the later group. We further grouped patients into three classes of score.

Conclusions: Our study showed that a structured educational initiative comprising of training in communication skills and conflict management for ICU nurses and doctors increases family satisfaction. Patient factors such as severity of illness and outcome and  Family factors such as number of ICU visits and payment mode affect the family satisfaction levels.