title: Building trust through communication in the intensive care unit: HICCC.
abstract: OBJECTIVE
  The goal of this study was to explore the role of communication in building trust between intensivists and parents in the pediatric intensive care unit.
  
  
  METHODS
  Semistructured qualitative interviews were administered to English-speaking parents of children who were admitted to the pediatric intensive care unit for at least 48 hrs. Parents were asked about the factors impacting trust and communication in the pediatric intensive care unit. Qualitative data were managed with NVIVO software (QSR International, Southport, UK) and analyzed for themes.
  
  
  RESULTS
  Participants were 122 parents (41% black, 40% white). Most parents articulated that communication is integral to building trust. Specifically, parents described that they wanted healthcare workers to communicate in ways that were Honest, Inclusive, Compassionate, Clear and Comprehensive, and Coordinated, which can be summarized using the acronym, HICCC. In addition, nonwhite parents were more likely than white parents to report instances when they felt doctors did not listen to them (p = 0.0083). Parents from minority groups reported instances of self-experienced or observed discrimination in healthcare with greater frequency than white parents. When asked to identify their pediatric intensive care unit doctor, 46% of parents were either unable to do so or named doctors from other hospital departments.
  
  
  CONCLUSIONS
  Communication is vital to building trust in the pediatric intensive care unit. Developed from parents' own observations and perspectives, HICCC is an accessible framework that can help doctors to remember what parents value in communication in the acute care setting. In addition, pediatric intensivists would benefit from targeted cultural competency training to reduce physician bias.
authors.affiliation: Department of Pediatric Critical Care, University of Chicago Medical Center and the Pritzer School of Medicine, Chicago, IL, USA.
authors.forename: Destinee
authors.initials: D
authors.lastname: DeLemos
authors.forename: Minna
authors.initials: M
authors.lastname: Chen
authors.forename: Amy
authors.initials: A
authors.lastname: Romer
authors.forename: Kyla
authors.initials: K
authors.lastname: Brydon
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kastner
authors.forename: Benjamin
authors.initials: B
authors.lastname: Anthony
authors.forename: K Sarah
authors.initials: KS
authors.lastname: Hoehn
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D035502:Trust