• Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, and David Y Hwang.
• From Yale College, New Haven, CT (KBH); Yale School of Medicine, New Haven (UW, NA, BN); Yale-New Haven Hospital, New Haven (JJ, KP); Yale School of Nursing, New Haven (AKK); Fairfield University School of Nursing, Fairfield (CB); Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven (KNS, DYH); Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven (KNS, DYH).
• J Am Board Fam Med. 2018 Jan 1; 31 (1): 64-72.

PurposeAn intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not.MethodsBetween March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients. We compared the mean score for the survey subsection regarding shared decision making (graded on a 100-point scale), as well as individual survey items, between those who reported the patient's PCP involvement in any medical decision making versus those who did not.ResultsAmong 263 respondents, there was no difference in mean overall decision-making satisfaction scores for those who reported involvement (81.1; SD = 15.2) versus those who did not (80.1; SD = 12.8; P = .16). However, a higher proportion reporting involvement felt completely satisfied with their 1) inclusion in the ICU decision making process (75.9% vs 61.4%; P = .055), and 2) control over the care of the patient (73.6% vs 55.6%; P = .02), with no difference regarding consistency of clinical information provided by the medical team (64.8% vs 63.5%; P = 1.00).ConclusionsFamilies who report involvement of a patient's PCP in medical decision making for critically ill patients may be more satisfied than those who do not with regard to specific aspects of ICU decision making. Further research would help understand how best to engage PCPs in shared decisions.© Copyright 2018 by the American Board of Family Medicine.

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