Patient and family engagement in patient care and research in Canadian intensive care units: a national survey

• Published in: Canadian journal of anesthesia 2022-12, Vol.69 (12), p.1527-1536
• Main Authors: Burns, Karen E. A., McDonald, Ellen, Debigaré, Sylvie, Zamir, Nasim, Vasquez, Moises, Piche-Ayotte, Mikael, Oczkowski, Simon
• Format: Article
• Language: English
• Subjects: Adult; Anesthesiology; Canada; Cardiology; Child; Critical Care; Critical Care Medicine; Cross-Sectional Studies; Family; Humans; Intensive; Intensive care; Intensive Care Units; Medicine; Medicine & Public Health; Pain Medicine; Patient Care; Patients; Pediatrics; Pneumology/Respiratory System; Questionnaires; Reports of Original Investigations; Surveys and Questionnaires
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/s12630-022-02342-w

Purpose While patient and family engagement may improve clinical care and research, current practices for engagement in Canadian intensive care units (ICUs) are unknown. Methods We developed and administered a cross-sectional questionnaire to ICU leaders of current engagement practices, facilitators, and barriers to engagement, and whether engagement was a priority, using to an ordinal Likert scale from 1 to 10. Results The response rate was 53.4% (124/232). Respondents were from 11 provinces and territories, mainly from medical surgical ICUs (76%) and community hospitals (70%). Engagement in patient care included bedside care (84%) and bedside rounds (66%), presence during procedures/crises (65%), and survey completion (77%). Research engagement included ethics committees (36%), protocol review (31%), and knowledge translation (30%). Facilitators of engagement in patient care included family meetings (87%), open visitation policies (81%), and engagement as an institutional priority (74%). Support from departmental (43%) and hospital (33%) leadership was facilitator of research engagement. Time was the main barrier to engagement in any capacity. Engagement was a higher priority in patient care vs research (median [interquartile range], 8 [7–9] vs 3 [1–7]; P < 0.001) and in pediatric vs adult ICUs (10 [9–10] vs 8 [7–9]; P = 0.003). Research engagement was significantly higher in academic vs other ICUs (7 [5–8] vs 2 [1–4]; P < 0.001), and pediatric vs adult ICUs (7 [5–8] vs 3 [1–6]; P = 0.01). Conclusions Organizational strategies and institutional support were key facilitators of engagement. Engagement in patient care was a higher priority than engagement in research.