Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy.


Journal Article

PURPOSE: Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. MATERIALS AND METHODS: We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. RESULTS: Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. CONCLUSIONS: Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements.

Full Text

Cited Authors

  • Wysham, NG; Mularski, RA; Schmidt, DM; Nord, SC; Louis, DL; Shuster, E; Curtis, JR; Mosen, DM

Published Date

  • June 2014

Published In

Volume / Issue

  • 29 / 3

Start / End Page

  • 450 - 454

PubMed ID

  • 24456811

Pubmed Central ID

  • 24456811

Electronic International Standard Serial Number (EISSN)

  • 1557-8615

Digital Object Identifier (DOI)

  • 10.1016/j.jcrc.2013.12.006


  • eng

Conference Location

  • United States