578: DEVELOPING A COMMUNICATION TOOL FOR FAMILIES IN THE PEDIATRIC INTENSIVE CARE UNIT: A DELPHI STUDY

Abstract

Introduction: Effective communication is essential to delivering quality care in the pediatric intensive care unit (PICU). There is a growing body of literature supporting the use of communication tools in the adult ICU, neonatal ICU, and palliative care setting. There is no easily scalable tool that has been described to support families in communication in the PICU. We propose that engaging key stakeholders in the development of a PICU family communication tool via a Delphi study will result in consensus about pertinent items to include, resulting in a useful tool for families. Methods: The Delphi method was used to inform a five-part process: (1) drafting of potential items for the tool based on literature review, (2) focus group of experts in critical illness communication to refine and condense items to be included in a survey, (3) survey of key stakeholders including parents of children with previous PICU admission and PICU healthcare providers, (4) additional rounds of the survey via the Delphi method until consensus is reached, (5) final review of the tool by critical illness communication experts. The survey queries stakeholders using a 5-point Likert scale and qualitative feedback for each item. Items with a score of 4 or 5 by >70% of stakeholders are included in the next round of the Delphi with incorporation of qualitative feedback. Results: There were ten participants in the initial focus group consisting of nurses, physicians, and researchers, mostly practicing in an academic setting (50%), with most participants having greater than 10 years of experience in their specialty (80%). Twenty-six specific items were drafted for inclusion in the Delphi method survey under six major themes: questions about medical information, questions about the provision of care, questions about communication, questions about decision-making, discussing family and patient needs with the medical team, and discussing more information about their child with the medical team. Conclusions: The Delphi method provides a useful stepwise approach for the involvement of key stakeholders in the creation of a tool that supports families in communication with their healthcare providers in the PICU. Future research should trial efficacy of this tool.