Feasibility and acceptability of a toolkit to guide patient and family participation in intensive care unit rounds

BACKGROUND: Engaging families in multidisciplinary bedside patient care rounds in the intensive care unit (ICU) can improve communication, shared decision-making, and family satisfaction, yet few interventions support structured family involvement. OBJECTIVE: We evaluated the feasibility and acceptability of an ICU rounds toolkit designed to promote family participation in rounds. METHODS: We conducted a pilot prospective study using a before-and-after quasi-experimental design combined with structured rounds observations in a 12-bed general systems ICU in Calgary, Alberta. The intervention consisted of printed materials and a brief educational video outlining six toolkit elements: invitation, orientation, active engagement, summary, question-asking, and structured communication. Surveys assessed perceptions of rounds, and observations documented family participation and toolkit use. Quantitative data were summarised descriptively; qualitative responses underwent content analysis. Consistent with the pilot objectives, analyses were descriptive and intended to assess feasibility and acceptability. RESULTS: We enrolled 17 families and 22 healthcare providers before education and 15 family members and 16 healthcare providers post education (total of 70 participants) and observed 46 rounds before education and 37 rounds post education. Most family members reported reviewing the printed toolkit (13/15, 87%), and 73% (11/15) reported that the toolkit increased their confidence participating in ICU rounds. Families reported that the toolkit improved their understanding of the rounds process and helped them prepare questions. Healthcare providers familiar with the toolkit viewed it positively and described it as practical and consistent with family-centred care practices. Median rounding time per patient remained similar between study periods (pre-education: 14 min [interquartile range: 10-19]; post-education: 15 min [interquartile range: 13-19]). Staff awareness and engagement with toolkit materials varied. CONCLUSIONS: This pilot study demonstrated that a structured ICU rounds toolkit was feasible to introduce and acceptable to participating family members and healthcare providers who engaged with the materials. However, healthcare provider awareness and uptake were variable. Future studies should evaluate strategies to improve uptake and sustainability, alongside the toolkit's impact on family engagement, communication, and patient- and family-centred outcomes.