A new joint study by a clinician-researcher at Kingston General Hospital and the University of Calgary aims to create a framework to assist intensive care physicians in partnering with patient’s families, to enable and empower them as advocates and participants in patient care.
Dr. Daren Heyland, a critical care doctor at KGH, and University of Calgary researcher Tom Stelfox, have begun a four-year Canadian Institutes of Health Research (CIHR) project aimed at gathering evidence-based insights into late life healthcare issues that are becoming more urgent as the population ages.
“We’ve continually observed deficiencies in care provided to older patients admitted to intensive care units,” says Dr. Heyland, who is also a professor of Critical Care Medicine at Queen’s University. “As we orient our healthcare system more and more towards patient or family-centered care, the issue becomes how to partner with families to enable them to advocate for their loved ones and participate in their care. We created a multidisciplinary team that will support the design and implement a care pathway and a set of best practices that will improve the outcomes of both critically ill patients and their families.”
The study, which will be conducted in Calgary, Toronto, and Ottawa, as well as in the U.S. and Australia, builds on Dr. Heyland’s previous work incorporating family members’ perspectives into best practices for care of elderly patients in intensive care. Many of these best practices have been developed with the assistance of KGH patient and family representatives.
Most Canadians of advanced age will experience a serious or critical illness. As technology has improved, life-saving and sustaining procedures have created new challenges for physicians in managing aging and critical care. In addition to these challenges, patients’ families are playing a larger role as partners in providing care.
Tasked with the research component of the grant, Dr. Heyland will look to address areas of weakness in existing family partnership frameworks. Over the course of multiple studies and trials, the researchers will examine whether an on-line support tool (myicuguide.com) can help patients’ families in making informed decisions about the care of their loved ones. It will also look at whether a set of educational materials, including videos, can enable families to advocate for best nutrition practices.
The team grant will also look at creating a handover tool to ensure patient care is maintained leading up to and following their discharge from hospital, as well as a tool to screen and assist patient family members who might be experiencing spiritual distress.
Dr. Heyland says this project is a continuation of the gradual acknowledgement of the role of the family as a care partner. He says this program will be the first to examine the optimal way to include family members in the care process and empower them to take on an advocacy role for their loved ones.
“Over the last several years, we’ve shifted in our view of the family from a passive recipient to a more active partner involved in rounds and engaged in decision-making,” says Dr. Heyland. “Formal research on the process has been sort of slow to emerge and that’s where our group is showing leadership. How do we know how to include family in the care process and measure its effect? I think that’s the role of the researcher – to develop appropriate interventions and outcome measures to evaluate what effect that has on patient care.”
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