Addressing Palliative Care Needs Among Intensive Care Unit Family Members

Exclusion Criteria

• •Decisional capacity
• •Death expected within 24 hours
• •Admission to an ICU at the index hospital \>14 days
• •Comfort care or withdrawal of treatment planned
• •Imprisoned
• •Extubated and possess decisional capacity prior to informed consent
• •Died before T2 survey complete
• •No known family or surrogate
• •Care assumed by a non-study ICU attending after consent by patient/family but before T1
• •Care assumed by non-study ICU attending \<3 days after T1 but before T2
• •Study ICU attending physicians from different groups (i.e., intervention or control) caring for patient change \<3 days after T1 completed by family
• •Patient regains decision making capacity before T2
• •Patient dies before T2
• •FAMILY MEMBER
• •Lack a knowledge of English such that the potential participant is not confident that they could complete study tasks (app viewing, surveys)
• •Imprisoned
• •Unable to complete surveys for any reason
• •Describe their race as neither White nor Black\*
• •Describe their ethnicity as Hispanic\*
• •* Note that this study explicitly targets issues of racial disparities in healthcare, particularly of Black / African-Americans. Hispanics are excluded because of the pervasive nature of US residents' general belief that 'Hispanic' is a racial category.
• •If the assigned randomized ICU attending physician either leaves ICU service or is replaced by a non-participating ICU physician \<= 2 calendar days after family member completes T1 survey
• •Low need burden (NEST score \<15)\*
• •ICU PHYSICIANS
• •\- None
• •\*The NEST score cutoff was changed on June 26, 2019. At this point, 3 patients had been randomized. This change was based on our review of data (NEST + psychological distress symptoms) from a parallel cohort study of \>50 family members of ICU patients who met nearly identical eligibility criteria as for the ICUconnect trial. This was a larger cohort than the pilot study on which we based the NEST cutoff.