Consistency of communication among intensive care unit staff as perceived by family members of patients surviving to discharge ☆ , ☆☆ David Y. Hwang, MD a, b, ⁎ , 1 , Daniel Yagoda, MPH c, 1 , Hilary M. Perrey c , Tara M. Tehan, MSN, MBA, RN, NE-BC d , Mary Guanci, MSN, RN, CNRN d , Lillian Ananian, BSN, MSN e , Paul F. Currier, MD, MPH e, f , J. Perren Cobb, MD c, f , Jonathan Rosand, MD, MSc d, f a Neuroscience Intensive Care Unit, Yale–New Haven Hospital, New Haven, CT b Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT c Critical Care Center, Massachusetts General Hospital (MGH), Boston, MA d Division of Neurocritical Care and Emergency Neurology, MGH, Boston, MA e Medical Intensive Care Unit, MGH, Boston, MA f Harvard Medical School, Boston, MA abstract article info Keywords: Intensive care Family Communication Personal satisfaction Decision making Purpose: We hypothesize that intensive care unit (ICU) families frequently perceive that they have received inconsistent information from staff about their relatives and that these inconsistencies influence abilities to make medical decisions, as well as satisfaction. Materials and Methods: We performed a prospective cohort study in the neurosciences and medical ICU at a university hospital. One hundred twenty-four family members of adult patients surviving to ICU discharge completed a questionnaire regarding perceptions of inconsistent information. Results: Of 193 eligible patients, 64.2% had family complete the survey. Thirty-one respondents (25.0%; 95% confidence interval, 7.7) reported at least 1 instance of inconsistent information during their family member's admission, with no difference between the neurosciences ICU (21.5%; 9.3) and the medical ICU (31.1%; 14.1; P = .28). Of those who did receive inconsistent information, 38.7% (95% confidence interval, 18.2) reported multiple episodes and 74.2% (16.3) indicated that episodes occurred within the first 48 hours of admission. These episodes had an adverse effect, with 19.4% (14.7) indicating that they affected satisfaction and 9.7% (11.0) indicating that they made decision making difficult. Conclusions: Episodes involving inconsistent information from staff as perceived by families may be quite prevalent and may influence decision-making abilities and satisfaction. © 2014 Elsevier Inc. All rights reserved. 1. Introduction Following a 2001 recommendation by the Institute of Medicine that health care systems become patient centered [1], a taskforce of the American College of Critical Care Medicine and Society for Critical Care Medicine released practice guidelines for family support in intensive care units (ICUs) [2]. These guidelines recommended that all members of an ICU team be informed of treatment goals for any particular patient, so that the messages given to the family are consistent [2]. Although studies have focused on ICU conflicts from the physician and nursing perspective [3–6], the literature regarding families' perceptions of the consistency of information that they receive is sparse. The Family Satisfaction-ICU survey instrument, a widely validated tool for assessing ICU family satisfaction, does contain an item that assesses the consistency of information provided by staff on a 5-point Likert scale [7–10]. However, the US critical care literature has yet to examine in depth the prevalence of discrete episodes of inconsistent information being given to families and, importantly, whether these events affect patient and family care. This article reports data from a single-center cohort study using a novel questionnaire that was distributed to family members of patients surviving to discharge from the neurosciences ICU (neuro- ICU) and medical ICU (MICU) of an academic teaching hospital. The questionnaire was designed to assess how often families detected inconsistencies in the information that they received from various care providers. Furthermore, for those family members who did Journal of Critical Care 29 (2014) 134–138 ☆ Institution at which work was done: Massachusetts General Hospital (MGH). ☆☆ Conflicts of Interest and Source of Funding: This study was supported by the MGH Critical Care Center and the MGH Neurosciences Intensive Care Research Fund. The study sponsors were not involved in the study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. The authors have no conflicts of interest to declare. ⁎ Corresponding author. Department of Neurology, Yale School of Medicine, PO Box 208018, New Haven, CT 06520-8018. Tel.: +1 203 737 8051; fax: +1 203 737 4419. E-mail address: david.hwang@yale.edu (D.Y. Hwang). 1 Co–first authors. 0883-9441/$ – see front matter © 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jcrc.2013.09.009 Contents lists available at ScienceDirect Journal of Critical Care journal homepage: www.jccjournal.org