November 2007 Press Release
ICU SURVIVAL DETERMINES FAMILY’S SATISFACTION WITH CARE
Families of Nonsurvivors More Satisfied With Their ICU Experience
(NORTHBROOK, IL, November 12, 2007)—New research reveals that the families of patients
who died in the intensive care unit (ICU) had higher satisfaction of care ratings than families of
patients who survived their time in the ICU. The study, which appears in the November issue of
CHEST, the journal of the American College of Chest Physicians (ACCP), shows that while the
families of ICU survivors and nonsurvivors were equally satisfied with the treatment that their
loved one received, the families of nonsurvivors were two to three times more likely to give higher
ratings regarding family-centered aspects of care. In contrast, the families of ICU survivors were
shown to be less pleased with their overall ICU experience.
"For several years, our research team has focused on improving the quality of care delivered
to critically ill patients and their families. When we began this study, we had assumed that families
of dying patients would be less satisfied with their ICU experience because their loved ones didn’t
make it home alive. So, we were initially surprised to find that the opposite was true," said study
author Richard J. Wall, MD, MPH, an intensivist at Valley Medical Center in Renton, WA.
"However, when we looked more closely at the specific reasons for this, the findings made sense."
To identify specific aspects of care that lead to family member satisfaction, Dr. Wall and his
colleagues from the University of Washington, Seattle, mailed a survey packet to the homes of
patient families 4 to 8 weeks after ICU discharge. Included were a cover letter explaining the study,
the 24-item Family Satisfaction in the Intensive Care Unit questionnaire, and demographic
questions about the patient and respondent. A total of 539 family members responded, of which
51% had a loved one die in the ICU.
"Up to 20% of all deaths in the United States occur in or shortly after an ICU stay. Many of
these patients are surrounded by family members who must act as surrogate decision-makers, and
who experience stress, fear, anxiety, and depression," Dr. Wall explained. "It’s for these reasons
that it was important for us to determine and understand the aspects of care that can and need to be
improved."
Results showed that families of patients who died in the ICU were much more satisfied with
their ICU experience than the families of ICU survivors. The largest differences were shown in the
areas of inclusion in decision-making, clinician communication, emotional support, respect and
compassion shown to family, willingness of staff to answer questions, and consideration of family
needs. Each of these items were classified as an aspect of family-centered care, and none of the
items revealed higher satisfaction among family members of survivors. The study says that, while
these findings do not indicate that families of dying patients received "better" care, the findings
suggest that ICU clinicians may devote extra effort toward addressing family-centered needs when a
patient’s death is imminent.
"The desire for information and emotional support is a common theme among all ICU
families, regardless of whether a patient lives or dies," Dr. Wall said. "So, clinicians should try to
recognize that they may be less likely to provide communication and emotional support to the
families of ICU survivors, and they should do what they can to change that." He concluded that
clinician-family communication is possibly the most important factor driving family satisfaction in
the ICU.
Researchers point out that in order to deliver high quality critical care, physicians must meet
the needs of not only the patients but of their families, as well. They also note that patients need to
make their medical care wishes known to their family members, and family members must be sure
to relay these wishes to physicians, should a critical care situation arise.
ACCP represents 17,000 members who provide patient care in the areas of pulmonary,
critical care, and sleep medicine in the United States and throughout the world. The ACCP’s
mission is to promote the prevention and treatment of diseases of the chest through leadership,
education, research, and communication. For more information about the ACCP, please visit the
ACCP Web site at www.chestnet.org.
Contact:
Jennifer Stawarz, (847) 498-8306
Deana Busche, (847) 498-8387
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