Writing in the Washington Post this week, infectious-disease physician Manoj Jain explains how hospitals nationwide are adopting more open ICU policies in an effort to embrace patient-centered care.
The Institute of Medicine has made patient-centered care—where patients and their families are involved in medical decisions—one of its six goals in redesigning the U.S. health care system. In an effort to reach that goal and move "toward greater transparency," some hospitals are opening their ICUs to family members and finding ways to keep family members present during difficult situations.
For example, the ICU at Geisinger Medical Center in Danville, Pa., adopted an open ICU policy almost 10 years ago. Staff initially found the policy to be disruptive and altered it so family could only visit in 30 minute intervals, six times per day. Geisinger was able to fully reopen in the ICU in 2003 after developing an extensive communication program for family and staff.
At Jain's hospital, which recently implemented an open ICU policy, nurses have found ways to handle family members if a patient's condition rapidly deteriorates. During difficult situations in the ICU, family members can get in the way of necessary equipment and become distressed by the condition of their loved one. When an ICU patient requires urgent care at Jain's hospital, the family is asked to step out of the room. If they chose to stay in the room, a nurse stands with them to the side and explains the situation in real time.
In addition to comforting patients and families, Jain notes that a 1997 study found that open visitations had a positive effect on 67% of patients and 88% of families (Jain, Post, 8/29).