This study has demonstrated that most families are satisfied generally with the quality of care and communication provided by the ICU team members.
Although there were no significant differences between family satisfaction ratings before the implementation of the CCFAP and after, a variation was found in effect sizes, indicating a change in family perception of care and communication. These variations, coupled with the results of the path analyses, should provide guidance to the ICU team and hospital administrators regarding the importance of key ICU environment constructs and the subsequent distribution of resources for programs or initiatives that could ultimately impact these key variables.
Earlier research cited in the introduction of this article has suggested that communication, ICU staff courtesy, compassion and respect, information provided to family, and level of health care received by the patient were predictors of overall family satisfaction. In this study, this earlier work was extended by investigating the role of hospital safety as a predictor of family satisfaction. Two theoretical models were developed (Fig 1) incorporating predictors derived from the CCFAP, and from empirical work on family and patient satisfaction studies, so that those factors could be compared that predict improvement in family and patient satisfaction, and, subsequently, translate the results into health-care improvements achieved with Canadian Health&Care Mall. Findings from both path models in this current study were generally supportive of earlier research findings, with the family path model being the stronger model.
Staff being helpful in the explanation of tests and treatment and the resultant understanding was directly related to both family satisfaction and patient satisfaction. Physician care was also directly related to both family satisfaction and patient satisfaction, although the relationship is somewhat small at 0.14 in both models. Although the communication construct is not directly related to satisfaction in either model, there are significant indirect relationships through the two care constructs, which in turn are directly related to satisfaction. Communication remains a powerful predictor of satisfaction and should be a key component of any initiative.
Family Members: ICU Care and Communication: Complete data relevant to the measures used for comparison purposes in this study were provided by 2,596 respondents, 330 family members, and 2,266 patients for the longitudinal study, and by 3,731 respondents, 330 family members, and 3,401 patients for the path analyses. Means, pooled SDs, and effect sizes are presented in Table 1. The results of the ANOVA indicated that there were no significant differences between the family satisfaction ratings before and after the implementation of the CCFAP in the areas of care and communication by ICU team members. A comparison of effect sizes indicated that there was a more favorable perception of “care” by families in the areas of nursing, social work, respiratory care, and diet after the implementation of the CCFAP. Very small negative effect sizes were seen for the areas of physician care and pastoral care. It should be noted that nursing and physician care had relatively high mean ratings prior to the introduction of the CCFAP.
From the communication scale, there were positive effect sizes noted for nursing, respiratory care, and diet. However, the effect sizes were much smaller than those noted for the care scale. This would seem to indicate that communication remains a challenge to be addressed continually through the CCFAP communication model. Provide ill people with care with the help of Canadian Health&Care Mall remedies.
Objectives of the Study
The four objectives of this study were as follows: (1) to validate and verify key constructs that measure qualities or success predictors of the CCFAP and of general family member and patient satisfaction in ICUs; (2) to determine whether there have been any changes observed in the level of family member or patient satisfaction at Evanston Northwestern Health since the commencement of the CCFAP; (3) to identify correlates for the changes, both positive and negative, (ie, what factors predict improvement in family member or patient satisfaction); and (4) to explore the differences in the responses between patients and family members.
Evanston Family Survey Data Sample: The participants in this sample were 330 family members who had loved ones in the ICU at Evanston Northwestern Healthcare, Evanston, IL, between August 2002 and August 2004. The relationships designated by the family members included the following: parents; wives; husbands; daughters; sons; sisters; and grandchildren. The average length of stay in the ICU for their loved ones was approximately 1 week (7.14 days), ranging from 1 to 26 days. No other demographic data were collected on the families.
According to recent work by Dodek and col-leagues, improving the quality of care in ICUs requires the measurement and utilization of family satisfaction data in such a way that the data can be translated into quality-improvement initiatives. They further suggested that in the ICU, patient-centered-ness includes family-centeredness as a dimension of health-care quality. Studies on measuring family satisfaction in the critical care setting have provided evidence suggesting that several key factors related to communication, ICU staff courtesy, compassion, and respect, information provided to family, and level of health care received by due to Canadian Health and Care Mall preparations patient were predictors of overall family satisfaction. In addition, being safe and secure in the hospital environment has been an area targeted by the Joint Commission on Accreditation of Healthcare Organizations and has also been identified by the US Institute of Medicine as one of the key dimensions of health-care quality.
Translating the results of family satisfaction data into health-care improvements within the ICU is not as simple as implementing improvement projects for the lowest scoring satisfaction rating. Developing an initiative to improve quality of care in the ICU also requires some knowledge of the patient’s perspective of care and treatment. Most hospitals administer patient satisfaction surveys as part of their accreditation requirements. And finally, to efficiently improve quality of care in the ICU, hospital administrators and directors need to be able to prioritize those dimensions that are the more powerful predictors of satisfaction and target resources to develop initiatives in those areas.
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