• Jennifer Im, BlakeneyErin Abu-RishEACambia Palliative Care Center of Excellence at UW Medicine (J.I., E.A.R.B., D.D., A.U., E.N., C.C., R.A.E., J.R.C.), University of Washington, Seattle, Washington, USA; Department of Biobehavioral Nursing and Health Informatics (E.A, Danae Dotolo, Anna Ungar, Rebecca Barton, Bryan J Weiner, Kathryn I Pollak, Elizabeth Nielsen, Lisa Hudson, Nancy Kentish-Barnes, Claire Creutzfeldt, Ruth A Engelberg, and CurtisJ RandallJRCambia Palliative Care Center of Excellence at UW Medicine (J.I., E.A.R.B., D.D., A.U., E.N., C.C., R.A.E., J.R.C.), University of Washington, Seattle, Washington, USA; Division of Pulmonary (D.D., A.U., R.B., E.N., L.H., R.A.E., J.R.C.),.
• Cambia Palliative Care Center of Excellence at UW Medicine (J.I., E.A.R.B., D.D., A.U., E.N., C.C., R.A.E., J.R.C.), University of Washington, Seattle, Washington, USA; Department of Health Systems and Population Health (J.I., B.J.W.), School of Public Health, University of Washington, Seattle, Washington, USA. Electronic address: imjenn@uw.edu.
• J Pain Symptom Manage. 2025 Jan 3.

ContextCritically-ill patients and their families often experience communication challenges during their ICU stay and across care transitions. An intervention using communication facilitators may help address these challenges.ObjectivesUsing clinicians' perspectives, we identified facilitators and barriers to implementing a communication intervention.MethodsUsing purposive sampling, we conducted semi-structured interviews with 17 clinicians from an intensive care unit at an academic health center that participated in a randomized trial of communication facilitators. We used the Consolidated Framework for Implementation Research (CFIR) to guide data collection and analysis.ResultsCFIR constructs of relative advantage, communication, and critical incidents facilitated the intervention's implementation. CFIR constructs of access to knowledge and information, relational connections, and clinician knowledge and belief hindered its implementation. Clinicians reported that facilitators provided continuity to patients and families, support in a trusting and proactive manner over transitions of care, and bridged communication between families and clinicians particularly during the Covid-19 pandemic. Limited information about the intervention prevented clinicians from working with facilitators earlier in the course of the intervention. Differences in beliefs regarding facilitator involvement during family meetings also hampered the intervention's implementation.ConclusionsFuture studies should incorporate implementation strategies that help connect facilitators to clinicians early in the intervention period which may improve role clarity and enhance collaboration.Copyright © 2025 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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