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All of the authors are healthcare providers (HCPs) who provide FCC and some also receive ICU care as patients and/or family members. Moreover, they reflect the clinical expertise of the interprofessional authorship team comprised of physicians (psychiatry, pulmonary and critical care medicine, hematology, and oncology), psychologists (couple and family, clinical, and clinical health), and bedside nurses. Further, they build upon existing guidelines on FCC in this unique context based on a systematic review ( 4, 7). They also capitalize on a systemic framework, which is subsequently overviewed. These best practices are the outgrowth of an informal narrative review of the literature on FCC in general and its merits in the ICU, which are summarized briefly at the outset of the paper. To help transform this reality, the goal of this paper is to provide healthcare leaders and interprofessional healthcare teams systemically-informed best practices for FCC in the ICU that aim to facilitate family presence, support family members, communicate optimally with families, seek helpful consultations, and optimize operations and the environment. However, we also recognize this rarely is the reality in this setting. Thus, this interprofessional authorship team that is comprised of physicians from multiple specialties (e.g., psychiatry, pulmonary and critical care, hematology), bedside ICU nurses, and family and clinical psychologists concur with other experts ( 4) that family-centered care (FCC) is essential and an ethical imperative ( 5, 6), in the ICU. As a result, family members serve as surrogate decision-makers ( 3). Unfortunately, given the critically ill status of patients in the intensive care unit (ICU), these individuals often cannot communicate or participate in shared decision-making, the sine qua non of PCC. This holistic model emphasizes an empathic, respectful relationship between the healthcare team and patient ongoing bidirectional communication and collaborative decision-making regarding care planning that is responsive to the preferences, traditions, and sociocultural backgrounds of patients and family members ( 2). Patient-centered care (PCC) is a hallmark of quality care ( 1). Making Family-Centered Care for Adults in the ICU a Reality We encourage healthcare leaders and interprofessional ICU healthcare teams to adopt these best practices and modify them for the specific healthcare needs of the patients they serve and their families. These best practices reflect an integration of the existing literature and previously published guidelines as well as our experiences as healthcare providers, family members, and patients.

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This systemic framework combined with previous guidelines for FCC in the ICU are used to inform the series of recommended best practices for FCC in the ICU that balance the needs and realities of patients, families, and the interprofessional healthcare team. It then offers a systemic framework for conceptualizing FCC in this challenging environment, as such a model can help guide the implementation of this invaluable approach. Consistent with this goal, this article begins by overviewing FCC and its merits and challenges in ICUs. This article aims to increase the likelihood that ICU-based care incorporates best practices for FCC.

4Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United Statesĭespite the value of family-centered care (FCC) in intensive care units (ICUs), this approach is rarely a reality in this context.

3Department of Nursing, Grady Health System, Atlanta, GA, United States.

2Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.Simon 1 †, Alvaro Velasquez 2 †, David Garner 3 †, Duc Quang Tran Jr.

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