Identifying High Priority Areas for Quality Improvement using Patient and Family Satisfaction Questionnaires
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AbstractINTRODUCTION Previous studies used family satisfaction in the intensive care unit (ICU) as a proxy for patient satisfaction1,2 but patients and their family may have different viewpoints about ICU care.
OBJECTIVES To identify high priority areas for ICU quality improvement from the patients’ and their family’s perspectives.
METHODS After critically ill patients were discharged to the general wards, the 24-item Family Satisfaction in the ICU (FS-ICU) questionnaire1 and its adapted patient version (PS-ICU) were given to participants. Important performance analysis (IPA)3 plots were drawn to identify areas of high priority for quality improvement in ICU (quadrant I). We also estimated the intra-class correlation for consistency between PS-ICU and FS-ICU.
RESULTS We recruited 232 critically ill patients (mean (SD) age: 59 (12.6) years; 165 (71%) males; 192 (83%) surgical admissions) and their family (mean (SD) age: 49 (14.4) years; 115 (50%) males). Using IPA, we identified common areas for improvement (quadrant I): agitation management, ease of getting information from ICU staff and honesty of information (Fig 1-2).

Patients also indicated they need more communication with ICU nurses. Families wanted more consistent and complete information about progress of the patients, and understand the information provided better. Critically ill patients and their family were generally satisfied with ICU care but they have inconsistent perspectives. Poor to moderate consistency in satisfaction scores are shown in Table 1.
Table 1. Intra-class correlation (ICC) for satisfaction levels by groups
ICU Satisfaction level Patients Family ICC (95% CI)
Mean (SD) Mean (SD)
Overall ICU care 72.9 (17.5) 72.0 (17.0) .60 (.49 - .69)
Information/decision-making 70.9 (14.7) 70.4 (16.1) .43 (.27 - .56)
Overall satisfaction 72.1 (15.1) 71.4 (15.6) .57 (.45 - .67)

CONCLUSIONS Overall, our participants were satisfied with the quality of care in our unit but with different views. We used PS-ICU and FS-ICU scores to identify and prioritize areas for quality improvement: agitation management, ease of getting information from ICU staff and provision of honest information.

REFERENCES 1. Wall RJ, et al. Crit Care Med 2007;35:271-9. 2. Dodek PM, et al. Crit Care Med 2004;32:1922-7. 3. Martilla J & James J. J Mark 1997;41:77-9.
GRANT ACKNOWLEDGMENT This work was supported by the Department of Anaesthesia & Intensive Care, CUHK.
Acceptance Date09/02/2018
All Author(s) ListV.K.W. Lai, W.-T. Wong, C.D. Gomersall, G.M. Joynt, A. Lee
Name of Conference2nd EuroAsia Conference Hong Kong (ESICM EUROASIA 2018)
Start Date of Conference11/04/2018
End Date of Conference14/04/2018
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
LanguagesEnglish-United States

Last updated on 2018-10-10 at 15:06