title: A Typology of ICU Patients and Families from the Clinician Perspective: Toward Improving Communication.
abstract: This paper presents an exploratory case study of clinician-patient communications in a specific clinical environment. It describes how intensive care unit (ICU) clinicians' technical and social categorizations of patients and families shape the flow of communication in these acute care settings. Drawing on evidence from a year-long ethnographic study of four ICUs, we develop a typology of patients and families as viewed by the clinicians who care for them. Each type, or category, of patient is associated with differing communication strategies, with compliant patients and families engaged in greater depth. In an era that prioritizes patient engagement through communication for all patients, our findings suggest that ICU teams need to develop new strategies for engaging and communicating with not just compliant patients and families, but those who are difficult as well. We discuss innovative methods for developing such strategies.
authors.affiliation: a Johns Hopkins Medicine , Armstrong Institute for Patient Safety and Quality.
authors.forename: Myles
authors.initials: M
authors.lastname: Leslie
authors.affiliation: b Leslie Dan Faculty of Pharmacy , University of Toronto.
authors.forename: Elise
authors.initials: E
authors.lastname: Paradis
authors.affiliation: c Department of Anesthesia and Perioperative Care , University of California San Francisco.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gropper
authors.affiliation: d Division of Pulmonary and Critical Care , Georgetown University Medical Center.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Milic
authors.affiliation: e Department of Innovation in Medical Education , University of Ottawa.
authors.forename: Simon
authors.initials: S
authors.lastname: Kitto
authors.affiliation: f Centre for Health & Social Care Research , Kingston University & St George's, University of London.
authors.forename: Scott
authors.initials: S
authors.lastname: Reeves
authors.affiliation: a Johns Hopkins Medicine , Armstrong Institute for Patient Safety and Quality.
authors.forename: Peter
authors.initials: P
authors.lastname: Pronovost
mesh_terms: D000884:Anthropology, Cultural; D003142:Communication; D005190:Family / Q000523:psychology*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007362:Intensive Care Units; D011368:Professional-Family Relations