ICU Communication Tool for Serious Injury
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests the Best Case/Worst Case-ICU Communication Tool, designed to improve conversations in the ICU for older adults with serious injuries. The study examines how this tool can enhance communication quality, reduce clinician stress, and potentially shorten ICU stays. Participants include patients aged 50 and older who have been in the ICU for at least three days due to major injuries. Family members involved in decision-making and clinicians working in the ICU also participate. As an unphased trial, this study allows participants to contribute to improving ICU communication and patient care.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What prior data suggests that the Best Case/Worst Case-ICU communication tool is safe for use in the ICU?
Research has shown that the Best Case/Worst Case-ICU communication tool improves conversations between healthcare providers and patients or their families in the ICU. This tool clarifies care decisions by illustrating different possible outcomes, such as the best and worst scenarios.
In terms of safety, this communication tool is neither a drug nor a medical procedure, so it poses no risks like side effects or physical harm. It enhances discussions between doctors and families about treatment options. Studies have demonstrated that it helps align decisions with a patient's wishes, leading to greater satisfaction for both families and healthcare providers.
For those considering joining a trial using this tool, it is reassuring to know that it is well-received and aims to enhance the care experience during a challenging time.12345Why are researchers excited about this trial?
Researchers are excited about the ICU Communication Tool for Serious Injury because it offers a more holistic approach to patient care. Unlike the standard of care, which often focuses on treating isolated problems without considering the patient's overall health trajectory, this tool encourages daily scenario planning. It helps healthcare providers discuss the best and worst case scenarios with patients, aligning treatments with patient preferences and improving decision-making. This can lead to more personalized care and potentially better outcomes by ensuring that medical interventions are in sync with what patients value most.
What evidence suggests that the Best Case/Worst Case-ICU communication tool is effective for improving communication and reducing clinician moral distress in the ICU?
Research has shown that the Best Case/Worst Case-ICU communication tool, which participants in this trial may experience, improves conversations about patient care in trauma ICUs. Studies indicate that this tool facilitates discussions between doctors and families about potential patient outcomes, helping everyone understand the best and worst possible scenarios. This approach supports clearer communication and may reduce stress for both doctors and families. Early findings suggest it also aids in planning care that aligns with the preferences of patients and families. While the tool aims to enhance communication, its impact on patient ICU stay duration and clinician stress remains under investigation.12367
Who Is on the Research Team?
Margaret L Schwarze, MD, MPP
Principal Investigator
University of Wisconsin, Madison
Are You a Good Fit for This Trial?
This trial is for older adults aged 50 or above who have been seriously injured and are staying in the ICU for at least three days. It's not specified, but typically people with certain medical conditions or treatments that could interfere with the study may be excluded.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Intervention Implementation
Training of trauma surgeons, trainees, and ICU clinicians to use the Best Case/Worst Case-ICU communication tool
Treatment
Participants receive care from a trauma team using the Best Case/Worst Case-ICU communication tool
Follow-up
Participants are monitored for outcomes such as ICU length of stay, quality of communication, and clinician moral distress
What Are the Treatments Tested in This Trial?
Interventions
- Best Case/Worst Case-ICU Communication Tool
Trial Overview
The study is testing a communication tool called Best Case/Worst Case-ICU to see if it improves how doctors talk about care, reduces stress on clinicians, and possibly shortens ICU stays. The trial will involve patients from multiple hospitals across the country.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Patients admitted to the trauma ICU after implementation of the intervention will receive care from a trauma ICU team trained to routinely use the Best Case/Worst Case-ICU communication tool. Family members will be exposed to the intervention through communication encounters that incorporate daily scenario planning and the Best Case/Worst Case-ICU graphic aid and will be asked to complete a one-time survey assessing quality of communication and goal-concordant care. Clinicians will receive Best Case/Worst Case-ICU training, incorporate the tool into routine communication practices, and complete surveys assessing moral distress and burnout.
Patients admitted to the trauma ICU prior to implementation of the intervention will receive usual care and communication from the trauma ICU team. Family members will receive standard communication regarding the patient's condition and treatment and will be asked to complete a one-time survey assessing quality of communication and goal-concordant care. Clinicians will continue their routine communication practices without Best Case/Worst Case-ICU training and will complete surveys assessing moral distress and burnout.
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Wisconsin, Madison
Lead Sponsor
Lehigh Valley Health Network
Collaborator
University of Maryland, Baltimore
Collaborator
National Institute on Aging (NIA)
Collaborator
Shock Trauma - University of Maryland Medical Center
Collaborator
University of California, Davis
Collaborator
Harborview Injury Prevention and Research Center
Collaborator
Lehigh Valley Health Network
Collaborator
Grady Memorial Hospital
Collaborator
Froedtert Hospital
Collaborator
Citations
Best Case/Worst Case Communication Tool for Trauma ICUs
This quality improvement study implements a tool supporting prognostic communication in 8 trauma intensive care units and assesses the reach ...
Best Case/Worst Case Communication Tool for Trauma ...
This quality improvement study implements a tool supporting prognostic communication in 8 trauma intensive care units and assesses the reach ...
Best Case/Worst Case Communication Tool for Trauma ...
This study found that implementation of BC/WC-ICU in trauma ICUs is feasible, supports prognostic communication, and can improve the ...
Clinician Experiences Using the Best Case/worst Case
Best Case/Worst Case-ICU (BC/WC-ICU) uses scenario planning to communicate prognosis for older adults with serious injury. Preliminary studies show measurable ...
Best Case/Worst Case-ICU: protocol for a multisite ...
We designed the Best Case/Worst Case-ICU tool to help visualise uncertainty, illustrate the interplay between major events and prognosis and describe how ...
Best Case/Worst Case for the Trauma ICU
“Best Case/Worst Case” (BC/WC) is a communication tool to support shared decision making in older adults with surgical illness.
Best Case/Worst Case: ICU
These Best Case/Worst Case training materials are intended for use by (1) physicians who care for patients admitted to the ICU after serious injury and (2) ...
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