Written Communication in the Intensive Care Unit

Study Overview
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Brief Summary
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The goal of this study is to compare the experience of intensive care unit (ICU) families and care providers before and after the implementation of an approach whereby clinicians initiate written communication with families The main questions it aims to answer are Is ICU care-provider initiated written communication feasible and acceptable to participants? Does ICU care-provider initiated written communication affect the experience of families and care providers? Participants will complete surveys and participate in interviews during a 3 month pre-implementation phase and a 3 month post-implementation phase

Official Title
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Impact of WRitten Communication on the ICU Team Experience

Conditions
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Burnout, Communication, Satisfaction, Patient

Intervention / Treatment
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* Other: Written Communication


Participation Criteria
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Eligibility Criteria
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Inclusion criteria (family members or surrogates) • Self-identify as one of the patient's decision makers Exclusion criteria (family members or surrogates) Cannot read or understand English Unwilling to participate in study procedures Inclusion criteria for care providers (physicians, physician assistants, and nurses) • Work during the day shift Exclusion criteria for care providers (physicians, physician assistants, and nurses) • None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Written Communication<br>ICU care providers will initiate the process for providing written communication to families. Study investigators will facilitate the creation and distribution of written communication | Other: Written Communication<br>* Written patient care updates provided to families of ICU patients each day<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Family Inpatient Communication Survey (FICS) | The Family Inpatient Communication Survey (FICS) is a 30-item survey measuring of the quality of communication with the treatment team from the perspective of families of hospitalized patients. Items on this survey measure the informational and emotional aspects of communication, and each item of this survey is rated on a 5-point Likert scale from strongly agree to strongly disagree. The FICS has been validated in a study of 350 surrogates of hospitalized adults demonstrating the high internal reliability, predictive validity, and high item completion rates of this survey. | 5 days after ICU admission | 
| Family Inpatient Communication Survey (FICS) | The Family Inpatient Communication Survey (FICS) is a 30-item survey measuring of the quality of communication with the treatment team from the perspective of families of hospitalized patients. Items on this survey measure the informational and emotional aspects of communication, and each item of this survey is rated on a 5-point Likert scale from strongly agree to strongly disagree. The FICS has been validated in a study of 350 surrogates of hospitalized adults demonstrating the high internal reliability, predictive validity, and high item completion rates of this survey. | 10 days after ICU admission | 
| Nurse-Physician Collaboration Scale (NPCS) | The Nurse-Physician Collaboration Scale (NPCS) is a 27-item survey measuring the level of collaboration between nurses and physicians based on three categories: joint participation in the decision-making process, the sharing of patient information, and cooperativeness.Items on this survey are rated on a 5-point scale with responses ranging from always to never. The NPCS has been validated in a study of 446 physicians and 1217 nurses at 27 hospitals. | 3 months before the intervention | 
| Nurse-Physician Collaboration Scale (NPCS) | The Nurse-Physician Collaboration Scale (NPCS) is a 27-item survey measuring the level of collaboration between nurses and physicians based on three categories: joint participation in the decision-making process, the sharing of patient information, and cooperativeness.Items on this survey are rated on a 5-point scale with responses ranging from always to never. The NPCS has been validated in a study of 446 physicians and 1217 nurses at 27 hospitals. | 3 months after the intervention | 
| Maslach Burnout Inventory (MBI) | The Maslach Burnout Inventory (MBI) is a 22-item survey measuring symptoms of burnout. The MBI has been validated for a variety of professions. The MBI has been used in past studies in the ICU to evaluate the level of burnout present among critical care clinicians and to assess for the effectiveness of interventions attempting to alleviate the degree of burnout syndrome. This survey examines the participant's perception of their work, physical and emotional exhaustion, sense of personal accomplishment, and degree of depersonalization. Items are presented as single statements, such as I feel worn out at the end of a working day, and are rated on a scale of 0 to 6 with 0 being never and 6 being every day. | 3 months before the intervention | 
| Maslach Burnout Inventory (MBI) | The Maslach Burnout Inventory (MBI) is a 22-item survey measuring symptoms of burnout. The MBI has been validated for a variety of professions. The MBI has been used in past studies in the ICU to evaluate the level of burnout present among critical care clinicians and to assess for the effectiveness of interventions attempting to alleviate the degree of burnout syndrome. This survey examines the participant's perception of their work, physical and emotional exhaustion, sense of personal accomplishment, and degree of depersonalization. Items are presented as single statements, such as I feel worn out at the end of a working day, and are rated on a scale of 0 to 6 with 0 being never and 6 being every day. | 3 months after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Acceptability, Appropriateness and Feasibility of Intervention Survey (AIM, IAM and FIM) | Care providers will complete this 12-item psychometric assessment. Implementation science researchers have established the benchmarks and acceptance of this scale. | 3 months after the intervention | 
| The Post Study System Usability Questionnaire (PSSUQ) | The Post Study System Usability Questionnaire (PSSUQ) is a 16-item PSSUQ survey that measures the acceptance of new technology. PSSUQ measures perception of information quality, interface quality, and overall intervention usefulness. Lewis et al have published on the high internal validity and sensitivity of this scale since 1992. | 3 months after the intervention | 
| The User Experience Questionnaire (UEQ) | The User Experience Questionnaire (UEQ) is a 8-item scale to measure the overall user experience of the family member(s) who used the communication intervention. The UEQ measures user experience on items including attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty. UEQ has high internal validity and has been benchmarked across numerous usability and user experience evaluation studies. | 3 months after the intervention |