Mitigating Racial Disparities in Shared Decision Making in the Intensive Care Unit

This is a non randomized pilot trial aimed to:Test the feasibility of an intervention to support intensive care unit clinicians in conducting shared decision making conversations with families of patients with acute respiratory failure. The goal of this intervention is to mitigate racial disparities in shared decision making.

Physician inclusion criterion:- ICU attending physician with at least 6 weeks of clinical service time in the 12 months preceding and following enrollmentPhysician exclusion criterion:- Board certified in palliative care medicinePatient inclusion criteria:Admitted to the ICUBeing treated by a study physician currently and at least for the next 48 hours≥ 18 years of age upon admission to hospitalMechanically ventilated ≥ 7 days continuouslyPatient exclusion criterion:Tracheostomy tube present or decision to pursue tracheostomy within next 7 daysHas decision making capacity as assessed by medical teamExtubation planned or death anticipated in next 24 hoursPatients who are prisoners or are pregnantAwaiting organ transplantation during this hospitalizationAcute respiratory failure due to progression of chronic neuromuscular diseaseNo family decision maker availableFamily member inclusion criteria:Identified by medical team as person most involved in medical decision making for the patientConfirmed to be patient's legally authorized representativeSelf-identifies as non-Hispanic Black or White≥ 18 years of age at time of consentConfirms conversational fluency in English