Family Engagement During Patient- and Family-Centered Interdisciplinary Rounds in the Adult Intensive Care Unit

Background Family engagement in interdisciplinary rounds is a patient- and family-centered approach to critical care that allows family members to be present and participate in information sharing and clinical decision-making with the health care team. However, this approach has not been adopted as standard practice in adult critical care units. Thus, family engagement in care for critically ill patients remains an inconsistent practice. Moreover, it remains an underresearched family-centered care intervention. Research is needed to understand health care professionals’ perspectives on feasible ways of integrating family inclusion and engagement into clinical practice flow to potentially shape the future of family engagement in care for critically ill patients. Objectives This qualitative exploratory research study aimed to (1) explore and understand the registered nurses’ and physicians’ perspectives on current practices and feasible approaches to family inclusion and engagement during patient- and family-centered interdisciplinary rounds and (2) identify the facilitators and barriers to implementing this vital practice. Methods A qualitative exploratory research study was conducted to inform the main study, a randomized controlled trial that tested the impact of the Nurse-TECH-Family program during patient- and family-centered interdisciplinary rounds in the intensive care unit. For this focus group study, 7 health care providers working in an adult critical care unit were recruited via email, referrals, and personal contact. The focus group included 4 registered nurses and 3 physicians working in the intensive care unit. It was conducted using structured questions via videoconferencing. The discussions were recorded and transcribed verbatim. A rigorous data analysis method was conducted using Braun and Clarke’s constructionist and contextualist approach for thematic analysis. Findings Two essential themes that reflected health care providers’ perspectives on current critical care practice and feasible ways of integrating family inclusion and engagement into clinical practice were illuminated. The first theme conveys that rounds are “information-giving” that addresses family members’ questions, transparency, shared decision-making, and less uncertainty among family members. The second theme denotes that rounds are a “safe space” for caring and compassion, which helps build trust. The health care providers also identified that the barriers to family engagement in patient- and family-centered interdisciplinary rounds include diverse perceptions and practices of family inclusion and engagement during rounds, difficulty establishing logistics in integrating family engagement in interdisciplinary rounds to clinical practice, and anxiety related to disclosure of information and uncertainty about family response. The identified facilitators are clear, consistent, realistic, and feasible interdisciplinary rounds logistics and information. Discussion This qualitative exploratory research study provided a deeper understanding of the registered nurses’ and physicians’ perspectives on current practices and feasible ways regarding family engagement during patient- and family-centered interdisciplinary and identified barriers to and facilitators for implementing this vital practice. The study’s findings informed the researchers in the sampling, design, and plan for the intervention and setting for the randomized controlled trial. The findings can pave the way for a more focused, multifaceted approach and interventions to address family inclusion and engagement during interdisciplinary rounds in the critical care unit. This offers hope for improved patient outcomes and family experiences.