Outcome
| Type |
Measure |
Description |
Time frame |
Safety issue |
| Other |
Practitioner Opinion Survey |
To evaluate the implementation of the intervention, trauma surgeons will be asked for their impressions of the Best Case/Worst Case-ICU communication tool using a 12-item questionnaire upon study completion. Each question is measured on an ordinal, 5-point Likert scale where 1 is 'strongly disagree' and 5 is 'strongly agree.' |
at study completion (estimated up to 2 years) |
|
| Primary |
Family-reported Quality of Communication (QOC) within 5-7 days of ICU admission |
Family-reported quality of communication will be measured using the 20-item Quality of Communication (QOC) scale. The QOC is a validated self-report instrument. The average composite score will be given with a possible range of 0-10. Higher scores indicate higher perceived quality of communication. |
up to 10 days after patient admission, one-time survey for family members |
|
| Secondary |
Family-reported General Quality of Communication (QOC), within 5-7 days of ICU admission |
Family-reported general quality of communication will be measured using the 6-item general communication subscale of the 20-item quality of communication (QOC) scale. The QOC is a validated self-report instrument. The average item score will be given with a possible range of 0-10. Higher scores indicate higher perceived quality of communication. |
up to 10 days after patient admission, one-time survey for family members |
|
| Secondary |
Family-reported End-of-Life (EOL) Quality of Communication (QOC), within 5-7 days of ICU admission |
Family-reported quality of end-of-life communication will be measured using 7-item end-of-life communication subscale of the 20-item Quality of Communication scale. The QOC is a validated self-report instrument. The average item score will be given with a possible range of 0-10. Higher scores indicate higher perceived quality of communication. |
up to 10 days after patient admission, one-time survey for family members |
|
| Secondary |
Family-reported proportion of Goal Concordant Care (GCC) at 5-7 days post ICU admission |
Family-reported goal-concordant care will be assessed by 2 survey questions taken from the SUPPORT study. (Question 1 - Preferences for Care: If you had to make a choice at this time, would you prefer a course of treatment for your loved one that focuses on extending life as much as possible, even if it means having more pain and discomfort, or would you want a plan of care that focuses on relieving pain and discomfort as much as possible, even if that means not living as long? Question 2 - Current Receipt of Care Consistent With Preferences: Would you say that your loved one's current medical care is more focused on extending life as much as possible, even if it means having more pain and discomfort, or on relieving pain and discomfort as much as possible, even if that means not living as long?) If participant gives the same answer to both questions, this will be considered concordant. If the answers to the two questions are different, this will be considered discordant. |
up to 10 days after patient admission, one-time survey for family members |
|
| Secondary |
Clinician-reported Measure of Moral Distress for Healthcare Professionals (MMD-HP) |
As a proximate measure of the intervention effect on ICU conflict, the investigators will use the Measure of Moral Distress for Health Care Professionals (MMD-HP) to measure center-level distress at the beginning and the end of the study. Frequency and level of distress of clinician experiences are each rated on a 0-4 scale where 0 is 'never' and 4 is 'very frequently' and 0 is 'none' and 4 is 'very distressing,' respectively. The total possible range of scores is 0-432 (the product of the frequency times the level of distress for 27 items) with higher scores indicating more moral distress. |
3 months prior to each implementation wave and again 12 months later |
|
| Secondary |
Clinician-reported Emotional Exhaustion (EE) - Maslach Burnout Inventory (MBI) |
Clinician emotional exhaustion will be measured with the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), a 22-item inventory scored on a 7 point Likert scale from 0-6 where 0 is 'never' and 6 is 'everyday'. The EE subscale includes 9 items for a total possible range of scores from 0-54, higher scores indicate increased emotional exhaustion. |
3 months prior to each implementation wave and again 12 months later |
|
| Secondary |
Clinician-reported Depersonalization (DP) - Maslach Burnout Inventory (MBI) |
Clinician depersonalization will be measured with the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), a 22-item inventory scored on a 7 point Likert scale from 0-6 where 0 is 'never' and 6 is 'everyday'. The DP subscale includes 5 items for a total possible range of scores from 0-30, higher scores indicate increased depersonalization. |
3 months prior to each implementation wave and again 12 months later |
|
| Secondary |
Clinician-reported Personal Accomplishment (PA) - Maslach Burnout Inventory (MBI) |
Clinician personal accomplishment will be measured with the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), a 22-item inventory scored on a 7 point Likert scale from 0-6 where 0 is 'never' and 6 is 'everyday'. The PA subscale includes 8 items for a total possible range of scores from 0-48, higher scores indicate decreased personal accomplishment. |
3 months prior to each implementation wave and again 12 months later |
|
| Secondary |
Patient ICU Length of Stay (LOS) |
ICU LOS will be measured as the cumulative amount of time each study qualified patient spent in the ICU during the post-injury hospital admission. Each partial or full day is measured as one calendar day. |
during hospitalization, provided by TQIP at study completion (estimated up to 2 years) |
|
| Secondary |
Patient Total Time on Ventilator |
Patient total time on ventilator will be measured as the cumulative amount of time each study qualified patient spent on a ventilator during the post-injury hospital admission. Each partial or full day is measured as one calendar day. |
during hospitalization, provided by TQIP at study completion (estimated up to 2 years) |
|
| Secondary |
Patient Time to In-hospital Death |
Dichotomous variable (alive or deceased) at hospital discharge |
during hospitalization, provided by TQIP at study completion (estimated up to 2 years) |
|
| Secondary |
Patient 6-month Mortality |
The procedure for death ascertainment at 6 months after admission includes chart review, attempt to reach listed patient contacts, and internet search. Patients without documentation of death will be presumed alive. Dichotomous variable (presumed alive or confirmed deceased). |
6 months after patient admission, provided by TQIP at study completion (estimated up to 2 years) |
|
| Secondary |
Patient Time to Withdrawal of Life Supporting Treatment |
Withdrawal of life-supporting treatment will be measured as the cumulative amount of time between each study qualified patients' admission and withdrawal of life supporting treatment at the end of life. Each partial or full day is measured as one calendar day. |
during hospitalization, provided by TQIP at study completion (estimated up to 2 years) |
|
