{"id":16971,"date":"2015-01-18T11:00:40","date_gmt":"2015-01-18T16:00:40","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=16971"},"modified":"2015-01-18T16:37:42","modified_gmt":"2015-01-18T21:37:42","slug":"opening-the-icu-doors-to-family-report-from-virginia-mason","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2015\/01\/opening-the-icu-doors-to-family-report-from-virginia-mason.html","title":{"rendered":"Opening the ICU doors to family: report from Virginia Mason"},"content":{"rendered":"
\"Screen<\/a>

Click to view article PDF (open access)<\/p><\/div>\n

Cross-posted from my personal blog yesterday<\/em><\/p>\n

On Twitter Friday night\u00a0I learned from Dr. Sachin Jain of a November article that should be of interest to all of us who want to work toward full patient and family engagement in all aspects of medicine. To be sure, the changes we’d like are not always simple, and one example is expanding family access to the ICU.<\/p>\n

Virginia Mason Medical Center (VMMC) is widely known for being far far more patient-centered and quality-oriented than most medical institutions – including, in this case, even the really challenging parts. \u00a0I hope I don’t get in copyright trouble for pasting too much in here, but the whole article is Open Access (no charge) so have a look, under the heading “Problem: Despite tradition, genuine need to open doors”<\/strong>:<\/p>\n

Over time we became more aware that this traditional model\u00a0was badly disconnected from the needs of our patients. The\u00a0Institute of Medicine emphasized that families serve as a healing\u00a0influence by providing comfort, connectedness, energy, self-esteem\u00a0and wisdom; there is little or no evidence to indicate\u00a0that the practice of family member presence is detrimental to the\u00a0patient, the family or the health care team. Indeed family\u00a0member presence during invasive procedures or resuscitation\u00a0should be offered as an option to appropriate family members.<\/p><\/blockquote>\n


\nWow. If you’ve ever tried to break through to see a relative in hospital when the staff says it’s\u00a0their\u00a0<\/em>time and you should come back tomorrow, you’ll know what I mean when I say wow. That’s a real commitment to better care – and to the evidence and expert opinion, even when it’s not easy.<\/p>\n

The abstract at start of article includes this summary of the process\u00a0they developed:<\/p>\n

(1) enlist support of administrative and local leaders;
\n(2) create a collective aim;
\n(3) test on a small scale, and
\n(4) scale up after initial successes.
\nPreparing ICU staff so that they are comfortable with more \u201con stage\u201d time (i.e., greater family presence) was critical to our success. \u201cOpening the doors\u201d now serves as a guiding vision to organizing the ICU\u2019s work.”<\/span><\/p><\/blockquote>\n

The article continues with how they made the change and a summary of what they learned, even including sample scripts for how staff actually says to family members. (Talk about “thank you for sharing”…) \u00a0And this, in the conclusion:<\/p>\n

Today the doors to our ICU remain open to family members,\u00a0and the old, red sign has been replaced with welcoming information.\u00a0\u201cOpening the doors\u201d has helped to minimize the barriers that\u00a0physically separated patients and their loved ones, impeded access\u00a0to regular exchanges of information, and interfered with decisionmaking.\u00a0Our experiences add to an evolving standard of practice\u00a0focused on the needs of families of ICU patients such hat the ICU\u2019s\u00a0\u201cunit of care\u201d has become both patient and family.<\/p><\/blockquote>\n

You yourself may want to share this paper with people. If you work in a hospital, it would be in your workplace. If you’re a patient or family member, you might even want to raise this with your local hospital long before you actually need it.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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