Letter to the Editor
In reply to “Improvement opportunities for communication in the ICU”
En respuesta a «Oportunidades de mejora de la comunicación en UCI»
Read
4387
Timeswas read the article
2090
Total PDF
2297
Total HTML
Share statistics
array:25 [ "pii" => "S2173572718301061" "issn" => "21735727" "doi" => "10.1016/j.medine.2017.11.002" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1149" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:323" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1015 "formatos" => array:3 [ "EPUB" => 219 "HTML" => 377 "PDF" => 419 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0210569117302310" "issn" => "02105691" "doi" => "10.1016/j.medin.2017.08.007" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1107" "copyright" => "Elsevier España, S.L.U. y SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:322-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1803 "formatos" => array:3 [ "EPUB" => 215 "HTML" => 860 "PDF" => 728 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Improvement opportunities for communication in the ICU" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "322" "paginaFinal" => "323" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oportunidades de mejora de la comunicación en UCI" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Estella" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Estella" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173572718301061" "doi" => "10.1016/j.medine.2017.11.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301061?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569117302310?idApp=WMIE" "url" => "/02105691/0000004200000005/v1_201805290410/S0210569117302310/v1_201805290410/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173572718300894" "issn" => "21735727" "doi" => "10.1016/j.medine.2018.04.005" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1000" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Intensiva. 2018;42:e7-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2044 "formatos" => array:3 [ "EPUB" => 186 "HTML" => 774 "PDF" => 1084 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>" "titulo" => "Analysis of three cases of diffuse alveolar hemorrhage: False-negative results in pulmonary ultrasound" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e7" "paginaFinal" => "e8" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de 3 casos de hemorragia alveolar difusa: resultados falsos negativos en la ecografía pulmonar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1348 "Ancho" => 1800 "Tamanyo" => 345779 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.A. Gorordo Delsol, A. Jiménez Ruiz, G.D. Hernández López" "autores" => array:3 [ 0 => array:2 [ "nombre" => "L.A." "apellidos" => "Gorordo Delsol" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Jiménez Ruiz" ] 2 => array:2 [ "nombre" => "G.D." "apellidos" => "Hernández López" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569116302492" "doi" => "10.1016/j.medin.2016.10.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116302492?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300894?idApp=WMIE" "url" => "/21735727/0000004200000005/v1_201805310404/S2173572718300894/v1_201805310404/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173572718301036" "issn" => "21735727" "doi" => "10.1016/j.medine.2017.08.012" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1107" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:322-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 928 "formatos" => array:3 [ "EPUB" => 159 "HTML" => 313 "PDF" => 456 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Improvement opportunities for communication in the ICU" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "322" "paginaFinal" => "323" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oportunidades de mejora de la comunicación en UCI" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Estella" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Estella" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301036?idApp=WMIE" "url" => "/21735727/0000004200000005/v1_201805310404/S2173572718301036/v1_201805310404/en/main.assets" ] "asociados" => array:1 [ 0 => array:18 [ "pii" => "S2173572718301036" "issn" => "21735727" "doi" => "10.1016/j.medine.2017.08.012" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1107" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:322-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 928 "formatos" => array:3 [ "EPUB" => 159 "HTML" => 313 "PDF" => 456 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Improvement opportunities for communication in the ICU" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "322" "paginaFinal" => "323" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oportunidades de mejora de la comunicación en UCI" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Estella" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Estella" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301036?idApp=WMIE" "url" => "/21735727/0000004200000005/v1_201805310404/S2173572718301036/v1_201805310404/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "In reply to “Improvement opportunities for communication in the ICU”" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "323" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.M. Furqan, S. Zakaria" "autores" => array:2 [ 0 => array:3 [ "nombre" => "M.M." "apellidos" => "Furqan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "S." "apellidos" => "Zakaria" "email" => array:1 [ 0 => "szakari2@jhmi.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Medicine, Harvard Medical School, Boston, MA, United States" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "En respuesta a «Oportunidades de mejora de la comunicación en UCI»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Dr. Estella for his thoughtful letter.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> We agree that the specific strategies evaluated in previous communication studies may not be universally generalizable for all worldwide intensive care units. However, we believe that the weight of the supporting evidence for enhanced communication is globally applicable. Enhanced communication, regardless of the method, helps intensive care unit (ICU) professionals achieve the widely-shared goal of optimally caring for patients and their loved ones in a manner that respects their autonomy, minimizes their anxiety, and facilitates good medical decision-making. In our viewpoint, we emphasize that enhanced communication helps achieve these goals, rather than focusing on unproven financial savings or questionable changes in ICU length of stay.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> We also should highlight the importance of customizing enhanced communication strategies to fit the culture of individual ICUs, since it is well-known that ICUs are remarkably different from each other, even if they are in the same hospital, city, or country.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We also want to emphasize that intensivists retain a leading role in communicating with patients. We strongly agree with the letter writer that intensivists have the duty and obligation to clearly communicate with patients and family members and need to be able to effectively lead multidisciplinary family meetings. Thus, intensivists, along with other ICU staff, need extensive training in communication skills. Experiential training leads to greater familiarity and comfort with family meetings and allows intensivists to smoothly lead discussions.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> Ultimately, this may lead to increased patient and family satisfaction, as well as possible improvements in medical decision-making processes.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3,4</span></a> In addition, we believe that ICU staff with different professional backgrounds are also needed, because they can significantly augment the intensivist's communication efforts, resulting in enhanced overall communication and social support. Social workers, chaplains, and additional nurses all have unique skills and further insights valued by patients and their family members. They are also critical in arranging multidisciplinary family meetings, gathering the concerns of patients and families beyond the usual conversation of rounds, coordinating discharge plans, and participating in goals-of-care discussions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In summary, we agree with Dr. Estella's major points. Effective communication is important, needs to be emphasized, and should be led by intensivists. We also support the hiring of additional allied ICU personnel, not to lead family meetings, but to help facilitate communication and to offer additional support for patients and families. Finally, we encourage ICU leaders to think about more innovative strategies to enhance communication and remind them to tailor evidence-based strategies for their particular ICUs.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improvement opportunities for communication in the ICU" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Estella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2017.08.007" "Revista" => array:2 [ "tituloSerie" => "Med Intensiva" "fecha" => "2017" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Challenges in the implementation of strategies to increase communication and enhance patient and family centered care in the ICU" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.M. Furqan" 1 => "S. Zakaria" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2017.01.011" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "365" "paginaFinal" => "367" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28318678" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multidisciplinary team training to enhance family communication in the ICU" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.J. Shaw" 1 => "J.E. Davidson" 2 => "R.I. Smilde" 3 => "T. Sondoozi" 4 => "D. Agan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e3182a26ea5" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2014" "volumen" => "42" "paginaInicial" => "265" "paginaFinal" => "271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24105452" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of communication skills training on outcomes in critically ill patients with life-limiting illness referred for intensive care management: a before-and-after study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.R. Orford" 1 => "S. Milnes" 2 => "N. Simpson" 3 => "G. Keely" 4 => "T. Elderkin" 5 => "A. Bone" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "BMJ Support Palliat Care" "fecha" => "2017" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004200000005/v1_201805310404/S2173572718301061/v1_201805310404/en/main.assets" "Apartado" => array:4 [ "identificador" => "64604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004200000005/v1_201805310404/S2173572718301061/v1_201805310404/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301061?idApp=WMIE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 13 | 21 |
| 2024 October | 33 | 44 | 77 |
| 2024 September | 45 | 33 | 78 |
| 2024 August | 50 | 36 | 86 |
| 2024 July | 35 | 20 | 55 |
| 2024 June | 48 | 44 | 92 |
| 2024 May | 37 | 23 | 60 |
| 2024 April | 49 | 33 | 82 |
| 2024 March | 38 | 26 | 64 |
| 2024 February | 38 | 33 | 71 |
| 2024 January | 35 | 35 | 70 |
| 2023 December | 24 | 41 | 65 |
| 2023 November | 38 | 24 | 62 |
| 2023 October | 36 | 24 | 60 |
| 2023 September | 23 | 36 | 59 |
| 2023 August | 27 | 18 | 45 |
| 2023 July | 26 | 24 | 50 |
| 2023 June | 27 | 15 | 42 |
| 2023 May | 36 | 27 | 63 |
| 2023 April | 20 | 18 | 38 |
| 2023 March | 60 | 30 | 90 |
| 2023 February | 37 | 32 | 69 |
| 2023 January | 20 | 24 | 44 |
| 2022 December | 39 | 33 | 72 |
| 2022 November | 41 | 29 | 70 |
| 2022 October | 52 | 35 | 87 |
| 2022 September | 30 | 34 | 64 |
| 2022 August | 26 | 39 | 65 |
| 2022 July | 26 | 24 | 50 |
| 2022 June | 18 | 22 | 40 |
| 2022 May | 33 | 34 | 67 |
| 2022 April | 28 | 42 | 70 |
| 2022 March | 50 | 43 | 93 |
| 2022 February | 29 | 27 | 56 |
| 2022 January | 23 | 34 | 57 |
| 2021 December | 53 | 43 | 96 |
| 2021 November | 36 | 27 | 63 |
| 2021 October | 35 | 62 | 97 |
| 2021 September | 23 | 23 | 46 |
| 2021 August | 19 | 35 | 54 |
| 2021 July | 15 | 36 | 51 |
| 2021 June | 31 | 23 | 54 |
| 2021 May | 33 | 53 | 86 |
| 2021 April | 83 | 62 | 145 |
| 2021 March | 67 | 26 | 93 |
| 2021 February | 29 | 23 | 52 |
| 2021 January | 43 | 19 | 62 |
| 2020 December | 25 | 13 | 38 |
| 2020 November | 23 | 15 | 38 |
| 2020 October | 29 | 25 | 54 |
| 2020 September | 43 | 27 | 70 |
| 2020 August | 17 | 20 | 37 |
| 2020 July | 30 | 18 | 48 |
| 2020 June | 39 | 15 | 54 |
| 2020 May | 16 | 17 | 33 |
| 2020 April | 25 | 14 | 39 |
| 2020 March | 15 | 15 | 30 |
| 2020 February | 36 | 53 | 89 |
| 2020 January | 20 | 22 | 42 |
| 2019 December | 26 | 23 | 49 |
| 2019 November | 23 | 19 | 42 |
| 2019 October | 29 | 18 | 47 |
| 2019 September | 16 | 21 | 37 |
| 2019 August | 23 | 16 | 39 |
| 2019 July | 30 | 22 | 52 |
| 2019 June | 13 | 14 | 27 |
| 2019 May | 29 | 35 | 64 |
| 2019 April | 17 | 22 | 39 |
| 2019 March | 9 | 20 | 29 |
| 2019 February | 23 | 34 | 57 |
| 2019 January | 19 | 35 | 54 |
| 2018 December | 14 | 37 | 51 |
| 2018 November | 38 | 33 | 71 |
| 2018 October | 17 | 5 | 22 |
| 2018 July | 1 | 0 | 1 |
| 2018 June | 0 | 1 | 1 |
Show all
