Ethical conflicts are commonplace within intensive care units (ICUs). The primary source of ethical conflicts during critical illness pertain to the delivery of value-concordant care. Because most critically ill patients lack decisional capacity, critical care clinicians collaborate with the patient’s surrogate decision makers to determine the plan of care that best aligns with the patient’s preferences. However, this collaboration, known formally as shared decision-making, is difficult to execute. Surrogate decision makers may possess prognostic expectations that differ from those of critical care providers or may lack communication skills needed to advocate for the patient. As a result, patients often receive aggressive care inconsistent with their preferences, and surrogate decision makers experience persistent psychological distress.Despite the negative clinical and psychological outcomes for critically ill patients and their surrogate decision makers, effective interventions that focus on reducing ethical conflicts during critical illness are lacking. In response, the authors of this EBR article conducted a pre-post quasi-experimental study to examine the effect of an ethics intervention on a series of clinical outcomes for each admission among 6 ICUs from 3 academic medical centers. The intervention had 3 components: (1) a daily Ethics Early Action Protocol, (2) an interactive protocol orientation, and (3) a supportive ethics application. The primary (formal family meetings, code discussions, and ethics consultations) and secondary (social work, chaplain, and palliative care visits) clinical outcomes were abstracted from the electronic medical record. Poststudy focus groups were conducted to improve subsequent delivery of the intervention.Data were collected for 1712 admissions (672 admissions before the intervention, 438 admissions 3 months after the intervention, and 602 admissions 6 months after the intervention). The majority of the patients were white (74%) and male (56%), and the mean age of the sample was 60 years. Compared with the preintervention period, cases examined 3 months after the intervention were 2.5 times more likely to receive a family conference and 1.6 times more likely to receive a chaplain visit. Similarly, the cases examined 6 months after the intervention were 1.8, 1.7, and 1.3 times more likely to receive a family conference, chaplain visit, and social work referral, respectively. Compared with the preintervention period, the elapsed time to the first family conference was significantly shorter for both postintervention time points. No significant differences were found for other clinical outcomes or other timing variables. The authors conclude that the intervention enhanced formal communication between family members and clinicians, which can enhance the delivery of value-concordant care for critically ill patients.Carol L. Pavlish, phd, rn, faan, lead author of the study highlighted in this EBR article, has provided additional information about the study. Her professional background in critical care and oncology, as well as volunteer work, sparked her passion for clinical ethics. These experiences highlighted the role that nurses serve in patient advocacy and cemented a devotion to multidisciplinary collaboration. Dr Pavlish adds, “nurses need to include as many voices as possible—and especially those who are most affected by the issue.”Guided by this insight, Dr Pavlish acknowledges how this multidisciplinary approach was paramount to the successful completion of the project: “This study was collaborative from its inception … This study could not have been conducted without the interest and actions of the unit leadership and bedside nurses at each of the sites … ” This collaboration involved the coordinated efforts of statisticians, critical care clinicians, ethicists, and scientists from across the United States to rigorously develop, design, and test this ethics intervention.Dr Pavlish hopes that this work can enhance patient-centered care by promoting team-based approaches to shared decision-making during critical illness. She hopes to develop a similar intervention for neonatal and pediatric patients. Despite the work that remains, Dr Pavlish says her devotion to promoting “the best [care] for patients and their families—as well as the clinicians who care for them …” keeps her inspired. In fact, she maintains a sense of gratitude: “I am truly grateful for what I learned from the project.”Dr Pavlish believes that this work possesses practical application for bedside practitioners. Because of this work, she stands by the significance of assessing, documenting, and considering patients’ treatment preferences “throughout the course of … treatment.” Furthermore, she emphasizes the need to incorporate team-based approaches to providing care for critically ill patients and their family members. Ultimately, she hopes that such changes in practice will promote honest communication, early and regular conduct of family meetings, and immersion of palliative care into critical illness and that the “distress felt by patients, family, and clinicians in … complex situations [will be] mitigated.”This feature briefly describes the personal journey and background story of the EBR article’s investigators, discussing the circumstances that led them to undertake the line of inquiry represented in the research article featured in this issue.Carol L. Pavlish, phd, rn, faan, has more than 40 years of nursing experience in critical care, oncology, home care, management, and academia. Her interest in clinical ethics was fueled in part by personal experiences caring for her cancer-stricken mother and for East African immigrants exposed to intimate partner violence, as well as her volunteer work with the American Refugee Committee. Before her work on the present project, she collaborated with community groups inside of refugee camps in Rwanda, Uganda, and South Sudan to design programs that reduce gender-based violence.These collective experiences informed the development of a model for collaborative research, which Dr Pavlish published in a book titled, Community-Based Collaborative Action Research: A Nursing Approach. Dr Pavlish believes that this collaborative model can be used “to design community or unit/hospital-based solutions to clinical problems.” Dr Pavlish acknowledges the difficulties of implementing collaborative research efforts; however, she encourages fledgling researchers to “start small” and provides a general reminder: “research can occur in steps as opposed to one study that is very broad in scope.”