Meeting standards of high-quality intensive care unit palliative care: clinical performance and predictors.

Objectives: High-quality care for intensive care unit patients and families includes palliative care. To promote performance improvement, the Agency for Healthcare Research and Quality's National Quality Measures Clearinghouse identified nine evidence-based processes of intensive care unit palliative care (Care and Communication Bundle) that are measured through review of medical record documentation. We conducted this study to examine how frequently the Care and Communication Bundle processes were performed in diverse intensive care units and to understand patient factors that are associated with such performance.

Errors in identifying and expressing emotion in facial expressions, voices, and postures unique to social anxiety.

The purpose of the present study was to see if 7-10-year-old socially anxious children (n = 26) made systematic errors in identifying and sending emotions in facial expressions, paralanguage, and postures as compared with the more random errors of children who were inattentive-hyperactive (n = 21). It was found that socially anxious children made more errors in identifying anger and fear in children's facial expressions and anger in adults' postures and in expressing anger in their own facial expressions than did their inattentive-hyperactive peers. Results suggest that there may be systematic difficulties specifically in visual nonverbal emotion communication that contribute to the personal and social difficulties socially anxious children experience.

In their own words: patients and families define high-quality palliative care in the intensive care unit.

Objective: Although the majority of hospital deaths occur in the intensive care unit and virtually all critically ill patients and their families have palliative needs, we know little about how patients and families, the most important "stakeholders," define high-quality intensive care unit palliative care. We conducted this study to obtain their views on important domains of this care.

Design: Qualitative study using focus groups facilitated by a single physician.

Family meetings made simpler: a toolkit for the intensive care unit.

Although a growing body of evidence has associated the intensive care unit (ICU) family meeting with important, favorable outcomes for critically ill patients, their families, and health care systems, these meetings often fail to occur in a timely, effective, and reliable way. In this article, we describe 3 specific tools that we have developed as prototypes to promote more successful implementation of family meetings in the ICU: (1) a family meeting planner, (2) a meeting guide for families, and (3) a family meeting documentation template. We describe the essential features of these tools and ways that they might be adapted to meet the local needs of individual ICUs and to maximize acceptability and use.