Shared Decision Making in NeuroICU for Severe Acute Brain Injury (SABI)

Principal Investigator (UMASS): Susanne Muehlschlegel, MD MPH

Improving patient care in severe acute brain injury: a web/mobile/tablet-based communication and decision support tool for clinicians and families in the neuro-ICU

Several decades of research in patients with severe acute brain injury (SABI) from traumatic brain injury or large ischemic or hemorrhagic stroke admitted to the neurologic intensive care unit (neuroICU) and their surrogate decision makers (often family members) have revealed three major clinical and public health problems:

1) family members struggle in the role of surrogate, leading to lasting symptoms of psychological distress;

2) clinicians are poorly trained in communicating prognosis after SABI, inadequately preparing families for difficult decisions about the use of life support or withdrawal of life sustaining treatments; and

3) patients often receive burdensome treatments that they would not choose.

In this application we seek to address the urgent need for decision-making support for high stakes decisions in the neuroICU and overcome breakdowns in communication that contribute to these problems. We will develop and pilot test a web and mobile/tablet-based tool to improve shared decision making and communication between surrogates and clinicians in neuroICUs; if successful, the intervention has the potential to substantially improve the care for millions of Americans who suffer a SABI annually

 UMASS IRB docket number: H00024195

Federal Funding Agency: National Institute of Nursing Research (NINR)

Federal Award Number: 1R21NR020231-01