Perspectives on Implementing a Communication Facilitator Intervention From a Critical Care Setting

Critically-ill patients and their families often experience communication challenges during their ICU stay and across care transitions. An intervention using communication facilitators may help address these challenges. Using clinicians’ perspectives, we identified facilitators and barriers to imple...

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Published in:Journal of pain and symptom management Vol. 69; no. 4; pp. 361 - 369.e4
Main Authors: Im, Jennifer, Blakeney, Erin Abu-Rish, Dotolo, Danae, Ungar, Anna, Barton, Rebecca, Weiner, Bryan J., Pollak, Kathryn I., Nielsen, Elizabeth, Hudson, Lisa, Kentish-Barnes, Nancy, Creutzfeldt, Claire, Engelberg, Ruth A., Curtis, J. Randall
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.04.2025
Subjects:
Adult
Anesthesia
Attitude of Health Personnel
Communication
COVID-19
Critical Care - methods
Critical Illness
Female
Humans
Intensive Care Units
Interviews as Topic
Male
Pain Medicine
Professional-Family Relations
ISSN:0885-3924, 1873-6513, 1873-6513
Online Access:Get full text
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Summary:Critically-ill patients and their families often experience communication challenges during their ICU stay and across care transitions. An intervention using communication facilitators may help address these challenges. Using clinicians’ perspectives, we identified facilitators and barriers to implementing a communication intervention. Using purposive sampling, we conducted semi-structured interviews with 17 clinicians from an intensive care unit at an academic health center that participated in a randomized trial of communication facilitators. We used the Consolidated Framework for Implementation Research (CFIR) to guide data collection and analysis. CFIR constructs of relative advantage, communication, and critical incidents facilitated the intervention's implementation. CFIR constructs of access to knowledge and information, relational connections, and clinician knowledge and belief hindered its implementation. Clinicians reported that facilitators provided continuity to patients and families, support in a trusting and proactive manner over transitions of care, and bridged communication between families and clinicians particularly during the Covid-19 pandemic. Limited information about the intervention prevented clinicians from working with facilitators earlier in the course of the intervention. Differences in beliefs regarding facilitator involvement during family meetings also hampered the intervention's implementation. Future studies should incorporate implementation strategies that help connect facilitators to clinicians early in the intervention period which may improve role clarity and enhance collaboration.
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ISSN:0885-3924
1873-6513
1873-6513
DOI:10.1016/j.jpainsymman.2024.12.020