Evaluation of ICU end-of-life and bereavement care by relatives of deceased ICU patients

Introduction: The aim of the study was to evaluate the quality of ICU 'end-of-life care' as well as the current bereavement support strategies in a large tertiary hospital, reported by bereaved family members of patients who were admitted to ICU who received bereavement support. Methods: A cross-sectional single site study was conducted, in which two (online) questionnaires (eumQ2 and a customized version of the ARREVE questionnaire) were sent to relatives of deceased ICU patients at one time-point, ranging from 1 week to +/- 16 months after a follow-up phone call, which is part of the standard care procedure. Results: We sent 139 questionnaires and 95 questionnaires were returned (response rate 68.3%). Overall, the quality of care was rated as good, with excellence in 'concern and caring by ICU staff towards the patient, consideration of the needs of the family members, ease of getting information and the completeness of information about what is done. Points for improvement include the presence at bedside, consistency of information and the overall quality of information given by the physicians. The follow-up call 2-3 months after the loss was appreciated and beneficial for the family members. Point of improvement was asking if they wanted to have a scheduled phone call or a spontaneous one at the beginning of the follow-up call, since participants can have a preference for a planned (22.4%) or unplanned (28.2%) call. However, 49.4% of the participants had no preference. Conclusion: In general, the quality of care, and 'end-of-life care' in the ICU was good, as assessed by relatives of deceased ICU patients. To optimize the 'quality of end-of-life care' in the ICU, improvements in terms of information provision and possibilities to visit the patient can be made.