Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;62(3):e112-e119.
doi: 10.1016/j.jpainsymman.2021.04.008. Epub 2021 Apr 21.

The Role of a Liaison Team in ICU Family Communication During the COVID 19 Pandemic

Affiliations

The Role of a Liaison Team in ICU Family Communication During the COVID 19 Pandemic

Carmen Lopez-Soto et al. J Pain Symptom Manage. 2021 Sep.

Abstract

Context: In the name of public safety, a general suspension on hospital visiting was imposed in the U.K., prohibiting family and friends to visit hospitalized patients, even if they were critically ill.

Objectives: we aimed to assess the impact of the FLT on the communication with patients' family and friends (PFF), especailly around end-of-life care, and their interaction with CC clinicians.

Methods: A retrospective, mixed-methods analysis of a family liaison team (FLT) formed by redeployed clinicians in critical care (CC) during the first surge of the 2020 COVID 19 pandemic.

Results: The FLT was constituted predominantly of non-ICU consultants (30/39, 77%). Following two one-hourly webinars around basic communication skills, the FLT facilitated over 12,000 video and telephone calls with 172 patients' family and friends (PFF). The majority of the PFF interviewed were mostly, very or extremely satisfied with the frequency, ease, understanding, honesty, completeness, and consistency of the information provided. Approximately 5% of the interviewees reported to be slightly or very dissatisfied in one or more of the following 3 categories: frequency, consistency, and ease of getting the information. The thematic analysis identified 3 themes: 1) being there with/ for the patient; 2) breakdown in communication; 3) disbelief at the speed of deterioration. In 14.9% of cases there was documented discrepancy between the information transmitted by the CC team and that by the FLT, particularly around the severity of the patient's illness and their imminent death.

Conclusion: The formation of a dedicated FLT was feasible and associated with high levels of satisfaction by the PFF. Friction was created when communication was not consistent and did not convey the severity of the patient's condition, to prepare the PFF for a bad outcome.

Keywords: COVID pandemic; Critical care; End of life; Family communication.

PubMed Disclaimer

Figures

Fig 1
Fig. 1
Family and friend satisfaction with the FLT. FLT, family liaison team.
Fig 2
Fig. 2
Interprofessional collaboration between ICU staff and FLT. FLT, family liaison team; ICU, Intensive Care Unit. The Interprofessional Collaboration Scale question “Was one team usually willing to take into account the convenience of the other?” is not demonstrated.

Comment in

References

    1. Puntillo KA, Arai S, Cohen NH. Symptoms experienced by intensive care unit patients at high risk of dying. Crit Care Med. 2010;38:2155–2160. - PMC - PubMed
    1. Tzelepis F, Rose SK, Sanson-Fisher RW. Are we missing the institute of medicine’s mark? A systematic review of patient-reported outcome measures assessing quality of patient-centred cancer care. BMC Cancer. 2014;14:41. - PMC - PubMed
    1. Kon AA, Davidson JE, Morrison W, Danis M, White DB. Shared decision making in ICUs: an American College of Critical Care Medicine and American Thoracic Society Policy Statement. Crit Care Med. 2016;44:188–201. - PMC - PubMed
    1. Kiwanuka F, Shayan SJ, Tolulope AA. Barriers to patient and family-centred care in adult intensive care units: a systematic review. Nurs Open. 2019;6:676–684. - PMC - PubMed
    1. Mitchell ML, Coyer F, Kean S. Patient, family-centred care interventions within the adult ICU setting: an integrative review. Aust Crit Care. 2016;29:179–193. - PubMed