Family engagement in patient care is an essential aspect of adult intensive care unit (ICU) practice. The approach includes family members in multidisciplinary care rounds, allowing them to contribute to medical decision-making while being present for their loved ones—yet systemic and individual-level barriers often get in the way. But what if families of ICU patients could participate in rounds without ever stepping foot in the hospital? A virtual approach may overcome these issues while still benefiting patient outcomes.

In a recent publication in the Journal of Critical Care, Michael Goldfarb, associate professor and physician at McGill’s Department of Medicine and researcher at the Lady Davis Institute, investigated the feasibility of virtual family participation in adult ICU rounds. Motivated by the lack of measurable evidence demonstrating how family member involvement actually improves patient outcomes, Goldfarb aimed to advance this field of research by providing data that could ultimately persuade clinicians to alter their practice.

“There’s not a lot of quantitative evidence in this field,” Goldfarb said in an interview with The Tribune. “A lot of it has been qualitative, involving interviews and focus groups with family members in the ICU […] but what I set out to do was [quantitatively] measure how family member involvement in care actually improves outcomes, and that information will be much more persuasive to the people who work in the ICU.”

Goldfarb emphasized the pivotal role played by family members in patient care and outcomes. He explained that familial involvement can facilitate better communication with the healthcare team, thus creating more effective treatment plans, as well as helping alleviate patients’ fear through a sense of support.

“[The ICU] is more concerned about the best medical management, what medications to use, what therapies to do. But the family members are the integral part of the care team, and in many ways can actually contribute to the patient’s care and outcomes,” Goldfarb explained. “They know the patient best.”

To determine the feasibility of implementing virtual family participation in ICU rounding, 84 participants were given the opportunity to engage via videoconference during ICU rounds across five hospitals in Montreal. Feasibility metrics included recruitment rate, intervention uptake, technical issues, and follow-up rate.

“It allowed people who were at home and couldn’t come to the hospital for various reasons to be more involved in their loved ones’ care,” Goldfarb said.

The results showed that 72 out of 84 participants engaged in at least one virtual round, and they experienced no technical issues in 113 out of 132 rounds.

“We were able to have a high number of successful rounds with very few technical issues,” he noted. “The vast majority of the ICU health care team workers, physicians, nurses, and other allied health members, were willing to participate in rounds with family members virtually, so the overall finding was that it was feasible.”

Not only do these findings indicate that virtual participation by family members in ICU rounds is feasible, but more importantly, it is associated with improved family engagement and high satisfaction scores.

Goldfarb also highlighted that similar results were replicated across five hospitals, speaking to the study’s validity.

“Each centre has its own culture and own team dynamics, so the fact that we’re able to show [this finding] at several centres means it’s potentially generalizable to a larger number of [hospitals] and shows strength to the study,” he said.

Despite these findings, Goldfarb stressed the importance of reassessing these results by conducting a randomized control experimental study in order to determine causation.

“Everyone got the same intervention, which means that we really need studies where people are randomized to the intervention or to the usual [non-virtual rounding] care, to see that this [treatment] actually makes a difference in improving outcomes,” Goldfarb said.

Overall, Goldfarb’s study points to a promising future of virtual rounding in ICUs, where families can care for their loved ones no matter where they are, ensuring the patient receives comfort and support despite the distance.