Integrating the Choosing Wisely five questions into family meetings in the Intensive Care Unit: a randomised controlled trial investigating the effect on family perceived involvement in decision making.

Background Family members often act as surrogate decision makers for patients in the Intensive Care Unit (ICU). The use of printed prompts may assist with families feeling empowered to fulfil this role and allow them to make enduring decisions for their loved one. Methods Randomised controlled trial in three ICUs in Western Australia. In the intervention arm, families received the Choosing Wisely five questions as printed prompts prior to a family meeting with clinicians, and the control arm did not receive any prompts. The primary outcome was family perceived involvement in decision making. Secondary outcomes measured included how well supported the family felt, whether they understood explanations they received, duration of the meeting and if they had adequate decision making time. Outcomes were measured using a survey delivered to family and ICU staff following the meeting. Results 60 families participated in the study. The majority of families reported feeling ‘very included’ in decision making, with no significant differences between the two groups. The study showed that use of the Choosing Wisely five questions did not slow the meetings and was not found to be unhelpful by the ICU staff. Conclusions These results suggest room for future study or implementation of the Choosing Wisely five questions in the ICU to assist families in their decision making.