Asking the Question 'What Matters to You?' in a London Intensive Care Unit.

Abstract

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international "What Matters To You?" (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on a regular basis during each of the study phases comprising PDSA cycles.

Results: Project results confirmed that the introduction of this poster/tool, alongside resource- and staff engagement-focused interventions, enabled the ICU to offer more than 50% of patients a WMTY conversation, as compared to zero at the start of the project. Consistently, 100% of staff surveyed (n=46 over all cycles) felt the posters were a useful addition to the ICU and confirmed they learned something new about their patients that they didn't know already.

Conclusions: This novel poster design successfully summarized patients' responses to the question "What matters to you?" for ICU staff and would be transferable to other ICUs.