Trial reportAnnals of the American Thoracic Society2016
Economic Feasibility of Staffing the Intensive Care Unit with a Communication Facilitator.
Trial report in Annals of the American Thoracic Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of Surrogate Decision-making Interventions for Critically Ill Adults With Patient, Family, and Resource Use Outcomes: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- The FICUS cluster randomized controlled trial of a family support intervention in adult intensive care units: mental health and family functioning outcomes.Intensive care medicine · 2026Trial
- Nurse-Led Family Support Intervention for Families of Critically Ill Patients: The FICUS Cluster Randomized Clinical Trial.JAMA internal medicine · 2025Trial
- A randomised controlled trial of a nurse facilitator to promote communication for family members of critically ill patients.Intensive care medicine · 2024Trial
- Improving Outcomes Measurement in Palliative Care: The Lasting Impact of Randy Curtis and his Collaborators.Journal of pain and symptom management · 2022Article
- Facilitating communication for critically ill patients and their family members: Study protocol for two randomized trials implemented in the U.S. and France.Contemporary clinical trials · 2021Article
- Validation and Analysis of the European Quality Questionnaire in Italian Language.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
rationaleIn the intensive care unit (ICU), complex decision making by clinicians and families requires good communication to ensure that care is consistent with the patients' values and goals.
objectivesTo assess the economic feasibility of staffing ICUs with a communication facilitator.
methodsData were from a randomized trial of an "ICU communication facilitator" linked to hospital financial records; eligible patients (n = 135) were admitted to the ICU at a single hospital with predicted mortality ≥30% and a surrogate decision maker. Adjusted regression analyses assessed differences in ICU total and direct variable costs between intervention and control patients. A bootstrap-based simulation assessed the cost efficiency of a facilitator while varying the full-time equivalent of the facilitator and the ICU mortality risk. MEASUREMENTS AND MAIN
resultsTotal ICU costs (mean 22.8k; 95% CI, -42.0k to -3.6k; P = 0.02) and average daily ICU costs (mean, -0.38k; 95% CI, -0.65k to -0.11k; P = 0.006)] were reduced significantly with the intervention. Despite more contacts, families of survivors spent less time per encounter with facilitators than did families of decedents (mean, 25 [SD, 11] min vs. 36 [SD, 14] min). Simulation demonstrated maximal weekly savings with a 1.0 full-time equivalent facilitator and a predicted ICU mortality of 15% (total weekly ICU cost savings, $58.4k [95% CI, $57.7k-59.2k]; weekly direct variable savings, $5.7k [95% CI, $5.5k-5.8k]) after incorporating facilitator costs.
conclusionsAdding a full-time trained communication facilitator in the ICU may improve the quality of care while simultaneously reducing short-term (direct variable) and long-term (total) health care costs. This intervention is likely to be more cost effective in a lower-mortality population.
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