A Communication Tool to Improve Communication in the ICU

Summary

The purpose of this study is to test the effectiveness of the Best Case/Worst Case-ICU communication tool on quality of communication, clinician moral distress, and ICU length of stay for older adults with serious traumatic injury. Investigators will follow an estimated 4500 patients aged 50 years and older who are in the ICU for 3 or more days and survey 1500 family members and up to 1600 clinicians from 8 sites nationwide.

Conditions

• Serious Injury
• Communication

Interventions

OTHER

Best Case/Worst Case-ICU Communication Tool

This intervention uses scenario planning and a daily report of the interplay between major events and prognosis to illustrate a range of long-term outcomes and treatment experiences. By using a graphic aid to illustrate "what we are hoping for," "what we are worried about," and the evolution of the patient's story over time, the tool aims to facilitate dialogue among older adult trauma patients, their families, and the trauma team. Because the tool delivers critical prognostic information over the longitudinal course of care, subsequent treatment decisions can be made within the context of the patient's overall health status. This information alerts patients and families to the life-limiting nature of serious injury and provides an entrée for them to consider how comfort-focused strategies might better align with patients' end-of-life goals. All clinicians will be trained to create, use, and/or reference the graphic aids with patients depending on their roles in the trauma ICU.

Sponsors & Collaborators

• National Institute on Aging (NIA)

  collaborator NIH

• University of Maryland, Baltimore

  collaborator OTHER

• University of California, Davis

  collaborator OTHER

• Harborview Injury Prevention and Research Center

  collaborator OTHER

• Lehigh Valley Health Network

  collaborator OTHER

• Grady Memorial Hospital

  collaborator OTHER

• Froedtert Hospital

  collaborator OTHER

• University of Alabama at Birmingham

  collaborator OTHER

• Rhode Island Hospital

  collaborator OTHER

• American College of Surgeons

  collaborator OTHER

• Coalition for National Trauma Research

  collaborator OTHER

• University of Wisconsin, Madison

  lead OTHER

Principal Investigators

• Margaret L Schwarze, MD, MPP · University of Wisconsin, Madison

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-01

Primary Completion

2025-08-31

Completion

2026-12-31

Countries

• United States

Study Locations