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

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.

KEYWORDS:

• Interprofessional team
• family engagement
• collaborative care
• ethnography
• health services research
• interprofessional collaboration

Supplemental data

Supplemental data for this article can be accessed on the publisher’s website.

Acknowledgments

The authors would like to thank the participants and study ICU for their willingness to participate.

Declaration of interest

The authors do not disclose any conflicts of interest.

Data sharing

Given the single site nature of our study and the risk of identifying participants, we are unable to share the final dataset.

Additional information

Funding

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).

Notes on contributors

Emily M. Boltey

Dr. Emily Boltey is currently a registered nurse at UPMC Shadyside Hospital. She completed her PhD at the University of Michigan in 2019.

Nathan Wright

Mr. Nathan Wright is a qualitative research associate at the University of Michigan School of Nursing. He has a Masters in Cultural Anthropology from University of Kentucky.

Elizabeth A. Mosley

Dr. Elizabeth Mosley is a post-doctoral fellow at Emory University; she was a research assistant and qualitative analyst on this study.

Matthew R. White

Mr. Matthew White is a registered nurse in the ICU at Scripps Mercy Hospital and was a research assistant on this study.

Theodore J. Iwashyna

Dr. Theodore Iwashyna is a practicing intensivist who studies long-term outcomes in critically ill patients and post-ICU care syndrome.

Milisa Manojlovich

Dr. Milisa Manojlovich is a nurse researcher who studies nurse and physician communication.

Deena Kelly Costa

Dr. Deena Kelly Costa is a nurse researcher who studies dynamics of ICU teams and how patients and families are included in the team. The work presented here was funded by a grant (PI Costa, Co-Is Manojlovich and Iwashyna) to study patient and family engagement in the ICU.