International facilitators and barriers to family engagement in the ICU: Results of a qualitative analysis

Purpose: Patient and family engagement in the intensive care unit (ICU) is beneficial for patient recovery from critical illness. Yet limited information exists on facilitators and barriers from an international perspective. Materials and methods: As part of ongoing work from a task force of the World Federation of Intensive and Critical Care (WFICC) exploring international practices of family engagement from a survey of 345 healthcare clinicians from 43 countries, qualitative analysis was conducted for two open ended questions: 1) What are strategies that you and your colleagues have found helpful to promote patient and family-centered care/engagement in the ICU? and 2) What are potential barriers have you encountered in implementing patient and family-centered care/engagement in the ICU? Thematic content analysis was used to code data to identify major themes of facilitators and barriers of family engagement. Results: A total of 257 comments were provided from intensivist physicians (n = 107, 31.4%), ICU directors (n = 74, 21.7%), ICU nurse managers (n = 33, 9.7%), and others including fellows, nurse specialists and consultant anesthesiologists. Major themes that emerged related to team engagement, family engagement, communication, leadership, relationships, and structured process. Conclusions: Highlighting strategies can assist ICU clinicians globally to adopt and promote best practices for family engagement. © 2020