Speaking up about care concerns in the ICU: patient and family experiences, attitudes and perceived barriers

BMJ Quality & Safety
Sigall K BellSamuel M Brown

Abstract

Little is known about patient/family comfort voicing care concerns in real time, especially in the intensive care unit (ICU) where stakes are high and time is compressed. Experts advocate patient and family engagement in safety, which will require that patients/families be able to voice concerns. Data on patient/family attitudes and experiences regarding speaking up are sparse, and mostly include reporting events retrospectively, rather than pre-emptively, to try to prevent harm. We aimed to (1) assess patient/family comfort speaking up about common ICU concerns; (2) identify patient/family-perceived barriers to speaking up; and (3) explore factors associated with patient/family comfort speaking up. In collaboration with patients/families, we developed a survey to evaluate speaking up attitudes and behaviours. We surveyed current ICU families in person at an urban US academic medical centre, supplemented with a larger national internet sample of individuals with prior ICU experience. 105/125 (84%) of current families and 1050 internet panel participants with ICU history completed the surveys. Among the current ICU families, 50%-70% expressed hesitancy to voice concerns about possible mistakes, mismatched care goals, confusing/c...Continue Reading

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Citations

Nov 24, 2018·BMJ Quality & Safety·Sigall K Bell, William Martinez
May 31, 2019·Clinical Obstetrics and Gynecology·Audrey Lyndon
Oct 4, 2019·Journal of the American Medical Informatics Association : JAMIA·Shefali HaldarWanda Pratt
Nov 15, 2019·BMJ Quality & Safety·Kimberly A FisherKathleen M Mazor
Jun 10, 2020·JAMA Network Open·Sigall K BellCatherine M DesRoches
Jun 5, 2020·Annals of the American Thoracic Society·Kirsten M FiestHenry T Stelfox
Jun 13, 2019·Obstetrics and Gynecology·Mary HerlihySigall K Bell
May 7, 2019·Scandinavian Journal of Caring Sciences·Julian Rodriguez-AlmagroAntonio Hernandez-Martinez
Apr 3, 2020·BMC Health Services Research·Yoon-Sook KimHyeran Kim
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Jan 19, 2021·Journal of Patient Experience·Richard L StreetKathleen M Mazor
Dec 29, 2020·BMJ Quality & Safety·Rachel ThompsonKirsten McCaffery
Oct 23, 2020·BMJ Open·Anu VenesojaVeronica Lindström
Dec 29, 2020·Journal of the American Medical Informatics Association : JAMIA·Barbara D LamSigall K Bell
Feb 13, 2021·Archives of Disease in Childhood·Charles A VincentMike English
Mar 17, 2020·Journal of Patient Safety·Kumiko O SchnockSarah Collins Rossetti

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