The Critical Care Family Assistance Program: Caring For Those Who Care

Abstract

(CHEST 2005; 128:65S–75S) D uring the past 20 years, a new focus has begun to emerge in medical literature dealing with the ICU. Numerous articles have appeared asking questions with a different dimension. The focus of this research has not been to discover whether medical skill or modern technology was doing all it could to save lives or ameliorate suffering. The research did not have as its primary subject patients or hospital staff. Rather, it was focused on the family members of patients in the ICU. Several hundred studies and articles over the past 2 decades have focused on the environmental and social issues of anxious family members awaiting the outcome of a relative’s stay in an ICU. While research continues to explore numerous dimensions of this issue, existing studies have already created a growing awareness among administrators, physicians, nurses, and staff that attending to the needs of these family members is a responsibility that no hospital can ignore. Researchers have studied the status of these families in a variety of ways. They have sought to discover whether the needs of the families of patients were being addressed and whether family members were satisfied with the way both the patient and the family were treated. Questions were posed cautiously at first, as researchers attempted to define more precisely the dimensions of the problems they were examining. Over time, virtually every area of the ICU was studied. Generally, it was discovered that increased communication, improved support systems, and a friendlier physical environment reduced feelings of frustration and contributed to an overall positive feeling of satisfaction. The findings presented a challenge to the health-care system. Hospitals were designed and staffed to care for patients; extending this care to others would require some fundamental changes in vision and organization. Not all who were involved in this research and the dissemination of its results were in a position to make suitable changes. Individual ICUs made some modifications in their approach, but, generally, no broad or far-reaching changes were instituted. The leaders at The CHEST Foundation, the philanthropic arm of the American College of Chest Physicians, had followed this research closely and reasoned that, with broad support, something could be done to impact this problem on a national level. If a model was developed, and resources and leadership were provided, designated hospitals would have the opportunity to follow this research to its logical progression. Out of this decision emerged the Critical Care Family Assistance Program (CCFAP). The CCFAP commenced as a collaboration between The CHEST Foundation and the Eli Lilly and Company Foundation, which played an integral role in monetarily supporting the development of the program. The CCFAP was introduced into two hospitals in 2002; by the fall of 2004, it had been implemented in a total of six hospitals. Each of these hospitals, along with its ICU, customized its program to integrate well within its culture, and the success of the program has been documented for further replication. This supplement is an effort to share the unique stories of the CCFAP model sites, not merely as an historical record, but as a stimulus to others who might desire to follow the same path.