Grant: Operating Grant: Knowledge to Action

<html> <body> <p>Research on best practices for patient and family involvement has shown that such involvement improves care quality in intensive care unit (ICU) settings and helps to reduce medical errors leading to adverse events. While many ICUs promote the principle of &ldquo;patient centered care&rdquo; and family member involvement, there is a significant gap between knowledge about these processes and their translation into practice. One of the reasons for this challenge includes the lack of research on the experiences of family members within the day-to-day clinical context of the ICU. Additionally, few studies have explored the different ways in which &ldquo;patient/family involvement&rdquo; is defined by clinician knowledge-users themselves, in diverse groups such as nurses, physicians, and allied health professionals.<br> <br> Over a two-year period, the project team conducted the largest-scale ethnographic study of intensive care units (ICUs) to date. This included over 1000 hours of ethnographic observation of 8 ICUs in North America to investigate interprofessional collaboration and the role of patient family involvement in the delivery of care. 80 clinician interviews and 37 patient family member interviews were conducted over a period of one year. The results from this study informed the development of our tool, &ldquo;Defining and Improving Patient Family Involvement in the ICU&rdquo; (DIPFI).<br> <br> The DIPFI tool provides a direct and simple way for family members to convey to health care professionals (HCP) their desired level of involvement is. Additionally, it allows the unit to reflect critically upon their own understanding about family involvement and acknowledge the range of possible definitions of involvement offered by patient family members. The workshop component of the tool affords knowledge-users an ongoing opportunity to learn about how patient family members experience the ICU.<br> <br> The goal of the KTA grant is to implement this patient and family involvement knowledge-based tool in order to facilitate patient and family involvement in ICUs&mdash;thus, improving the delivery of care. Additionally, we aim to facilitate HCP reflexivity about how they define and experience patient family member involvement in their daily practice, and provide research-based solutions to obstacles to this involvement. This process will further enable us to further adapt the tool to their specific clinical context and contribute to the much-needed knowledge about the meaning and practices of &ldquo;patient centered care&rdquo; and family member involvement.<br> <br> We will use a mixed-method approach to observe the implementation of the tool, and conduct interviews and focus groups with knowledge-users in the four participating ICUs. We will work with knowledge-user team members at each site to <b>implement</b> the DIPFI tool and use ethnographic methods and behavioural assessment techniques to observe the impact of the tool. Data collected over this period will be jointly <b>analyzed and interpreted</b> by knowledge-user team members, which include past ICU patients, patient advocates, and HCPs. This analysis will inform the <b>refinement of the tool</b>. This refined version of the tool will then be implemented in the final two ICUs.<br> <br> End of grant KT: The final phase of the project will once again bring together researchers, knowledge users, and collaborators to develop a KT plan to disseminate key findings and the tool widely.</p> </body> </html>