Exploring the process of information sharing in an adult intensive care unit: an ethnographic study

• Type of Material: Article
• Authors: Emily M Boltey, UPMC Shadyside Surgical Intensive Care Unit; Nathan Wright, University of Michigan School of Nursing; Elizabeth Mosley, Emory University; Matthew R White, Scripps Mercy Hospital; Theodore J Iwashyna, University of Michigan; Milisa Manojlovich, University of Michigan; Deena Kelly Costa, University of Michigan
• Language: English
• Date: 2022-01-01
• Publisher: Informa UK Limited
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Rights managed by Taylor & Francis
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1080/13561820.2021.1899147
• Title of Journal or Parent Work: Journal of Interprofessional Care
• Volume: 36
• Issue: 2
• Start Page: 168
• End Page: 176
• Grant/Funding Information: Supported in part by Center for Complexity and Self-Management of Chronic Disease (P20NR015331) pilot funding, and the Agency for Healthcare Research and Quality (K08HS024552)
• Keywords: Intensive Care Units; Information Dissemination; Humans; health services research; Interprofessional team; Family; interprofessional collaboration; Interprofessional Relations; ethnography; Adult; family engagement; Anthropology, Cultural; collaborative care; Qualitative Research

Abstract

Information sharing, a component of patient and family engagement (PFE), is an important process that may contribute to intensive care unit (ICU) quality of care. Yet, virtually no studies explore how the process of information sharing unfolds in the ICU from the interprofessional team and family member perspectives. To better understand the process of information sharing, we conducted ethnographic fieldwork in a 20-bed medical ICU, focusing on behaviors and interactions of the interprofessional team and family members (May 2016–October 2016). We completed 17.5 observation hours, 6 shadowing sessions, and 12 semi-structured interviews with 17 total participants. We used thematic content analysis and iterative inductive coding to identify three themes about the information sharing process: 1) family factors (health literacy and past experience with the ICU environment) influence information sharing; 2) clinicians strategies can support engagement in the process of information sharing (assessing families’ need for information, understanding a families’ hope, using rounds as an opportunity for information sharing); 3) the process of information sharing allows for trust building between families and the ICU team. Our findings suggest that information sharing is a crucial process that may serve as a catalyst for effective patient and family engagement in the ICU.