Qualitative Analysis of Satisfaction with Care of Families of Survivors and Nonsurvivors in a NICU (P3.226)

OBJECTIVE/BACKGROUND:Survey studies using Likert scales suggest that families of patients dying in intensive care units (ICUs) are more satisfied with their ICU experience than families of survivors. Differences in satisfaction with care between these two groups have been less well explored using qualitative methods.The free-response sections from a survey of families of ICU patients made comfort measures only (CMO) are more likely to contain a higher proportion of positive statements regarding care, compared to the same sections from surveys of families of ICU survivors. DESIGN/METHODS: From March 2014 to July 2015, we administered the Family Satisfaction ICU survey (FS-ICU 24), with additional questions, to English-speaking family members of patients in a single academic NICU. One family member of each survivor with admission longer than 72 hours was surveyed at discharge, while one family member of every patient made CMO was surveyed by mail one month after death. Two reviewers coded statements from free-response sections, using a previously published FS-ICU coding structure. The coded statements graded positive versus negative were calculated for six pre-specified themes and compared between groups. RESULTS:We collected 50[percnt](150/298) of all possible survivor surveys and 31[percnt](34/110) of all possible CMO surveys. The proportions of positive statements within each of the six themes were as follows: (1) gratitude and satisfaction [survivors=99[percnt] (83/84), CMO=89[percnt] (17/19)]; (2) overall quality of medical care provided [survivors=64[percnt] (41/65), CMO=92[percnt] (11/12)]; (3) communication [survivors=53[percnt] (56/105), CMO=50[percnt] (10/20)]; (4) compassion and respect shown to the patient and family [survivors=92[percnt](47/51), CMO=93[percnt](13/14)], (5) inclusion of family in decision making [survivors=75[percnt](33/44), CMO=83[percnt](5/6)], (6) and competence and dedication of staff [survivors=88[percnt](42/48), CMO=100[percnt](12/12)]. CONCLUSIONS: The free-response sections from our CMO surveys contained a higher proportion of positive statements regarding quality of care, inclusion in decision making, and staff competence; compared to the same sections from our survivor surveys. Disclosure: Dr. Nhundu has nothing to disclose. Dr. Huang has nothing to disclose. Dr. Knies has nothing to disclose. Dr. Weber has nothing to disclose. Dr. Robinson has nothing to disclose. Dr. Anderson has nothing to disclose. Dr. Akgun has nothing to disclose. Dr. Hwang has received research support from the American Brain Foundation Practice Research Training Fellowship.