Table 3.

Identified barriers to effective communication and suggested mitigation strategies

Participant-identified Communication Barriers	Strategies to Improve Communication
Time constraints for clinicians (e.g., physicians and nurses) to update families	Use an ICU navigator (e.g., liaison, social worker, medical student, resident) to facilitate communication, set up virtual visits and family meetings, provide family education and support, and act as an information liaison between the family and more-senior clinical team members
Miscommunications (e.g., describing patient’s clinical condition over the phone)	Facilitate adequate videoconferencing technology tools (e.g., iPads, Facetime, Skype) to enable the family to see the clinical condition of the patient, ensure communication occurs between the family and more-senior members of the clinical team, and use an ICU navigator to offer clarifications and facilitate more in-depth reliable communication
Risk of confidentiality breaches	Policy definitions for privacy-protected virtual visitations and/or family conferences
Access to additional technology supports for communication	Procurement of additional tablets or temporary communication devices for families to facilitate equitable access; device on wheels during patient rounds to include families virtually; free and reliable Wi-Fi

Definition of abbreviation: ICU = intensive care unit.