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Evaluating the quality of communication with patients' relatives in critical care

Introduction

Good communication with patients' relatives has humanitarian, professional and medico-legal benefits. The NHS Litigation Authority requires clear information documentation and monitoring that this is satisfactory [1]. This review was performed to ascertain relatives' opinions regarding the current standard of communication received from medical staff.

Methods

A paper questionnaire was made available to relatives after discussion with a member of the medical staff. Data for the first month are discussed below, based on an average 50 admissions/month. The questionnaire was at the main reception desk, and staff also offered them to relatives after each professional contact. Closed questions with single answers chosen from five options (including one neutral option) were asked along with space for free comment.

Results

Eighteen questionnaires were completed: to our knowledge no relatives refused completion. Thirteen out of 18 discussions took place between 8 am and 6 pm, Monday to Friday, three between 8 pm and 6 am weekdays, and two at the weekend. All 18/18 respondents felt the doctor had explained their role in care. Thirteen out of 18 discussions took place in the dedicated interview room, four at the bedside and one by telephone. Seventeen out of 18 rated the service as very good for information given, clarity and the effect of the exchange on overall impressions of care; one questionnaire rated the service as good.

Conclusions

Relative communication is highly subjective but is known to influence impressions formed of overall quality of care. National audit frameworks emphasise objective quantifiable standards, which do not capture the quality of interaction [2]. We have monitored service quality based on subjective relative impressions, however the response rate (<40%) has potential for a positive bias in our favour. Many discussions are complex and there is a possibility that questionnaires were not offered in certain situations. Additionally, despite full anonymity of the form, relatives may have been concerned about what was written impacting on their family member's care. It is known that benefits in the processes of clinical care leading to improvements in quality can arise purely from measurement; that is, performing service reviews such as this one [3]. If targets are to be used to benchmark quality of care in this area, there is a need for more consideration of the appropriate targets or alternatively an acceptance that there is the potential to have lower data capture in these areas.

References

  1. 1.

    NHSLA Risk Management Standards[http://www.nhsla.com/NR/rdonlyres/EC2E2A20-C905-4A4A-9D71-AF989F736C7B/0/Introductiontomanual.pdf]

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    Humble SR, et al.: Intensive Care Med. 2007, 33: S209. 10.1007/s00134-006-0465-2

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    Wright J, Shojania KG: Br Med J. 2009, 38: 783-784.

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Correspondence to S Siddiqui.

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Siddiqui, S., Scott, C. & Bryden, D. Evaluating the quality of communication with patients' relatives in critical care. Crit Care 14, P596 (2010). https://doi.org/10.1186/cc8828

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Keywords

  • Medical Staff
  • Positive Bias
  • Quantifiable Standard
  • Closed Question
  • Paper Questionnaire