Analyzing clinical and system drivers of satisfaction in the intensive care unit as a component of high quality care

Abstract

Background: Quality improvement in the intensive care unit has transitioned from focusing on mortality to improving care and reducing morbidity.

Objective: This study prospectively investigated clinical and system drivers of family satisfaction in a large quaternary hospital ICU.

Methods: A validated tool was distributed to family members and a registry chart analysis was conducted. The aims were to assess associations with high or low family satisfaction to evaluate unit-level satisfaction. Candidate predictors were selected from univariate logistic regressions and finalized in a multivariate model by a stepwise selection approach.

Results: Overall, 75% (n = 188) of respondents (n = 250) indicated high satisfaction. Respondents with higher satisfaction had a Plan of the Day posted (OR = 3.3, 95% CI: 1.63, 6.89, p = 0.001), and did not live with the patient (OR =0.5, 95% CI: 0.25, 0.96, p = 0.044).

Conclusion: This study indicates that communication and transparency of plans contributes to family satisfaction with ICU care.

Keywords: Communication; Patient-centered care; Quality improvement; Satisfaction.