CLEVELAND A growing population of chronically critically ill (CCI) patients use approximately half of all hospital intensive care unit (ICU) resources at a cost of an estimated $50 billion annually. In turn, health care providers pass those costs onto the consumer. But researchers at Case Western Reserve University's Frances Payne Bolton School of Nursing are testing a relatively simple communications intervention which may save cost and length of an ICU stay.

Because of the complexity of both the medical and social situations of patients and long stays in hospital intensive care units (ICUs), gaps in communication, misunderstandings and a lack of consensus between families and health care providers about goals of care are frequent, and therefore, escalating costs, adding to the stress of difficult situations. And, on occasion, strained relationships can develop between families and the health care team.

"Disagreements not only occur between professionals and families, but also within the health care team," said lead investigator Barbara J. Daly, associate professor of nursing at Case and clinical ethics director at University Hospitals of Cleveland. "What is needed in the best interest of patients and their families is a simple yet comprehensive communication system that addresses decision-making with CCI patients."

That's why Daly and her research team are designing and testing a system that will address family decision-making with CCI patients, as well as provide the families comfort and support. The study, being conducted at University Hospitals of Cleveland and Cleveland's MetroHealth Medical Center with a $2 million grant from the National Institute for Nursing Research of the National Institutes of Health, implements an intensive communication system for the family of CCI patients on patient and family outcomes and resource use in ICUs of varying specialties.

So far, the research team has enrolled 58 families in the study. The team is
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Contact: Laura Massie
laura.massie@case.edu
216-368-4442
Case Western Reserve University
1-Mar-2006

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