Families and loved ones: valuable allies for healthcare teams

Increasingly, the Fonds Brigitte-Perreault of the CHUS Foundation aims to support projects that involve the caregivers of patients, whether they are family members or friends,” explains Dr. Dusanka Grbic, head of the Fund. “Caregivers are a wealth of information and invaluable allies during a hospitalization or when preparing for discharge. This type of project makes perfect sense for our Fund, which is particularly dedicated to the humanization of care.”

A Model to Follow: Intensive Care

The intensive care unit was one of the first to take this approach, allowing patients’ families to take part in the daily medical rounds.

Dr. Marc-André Leclair has been the head of intensive care at the CIUSSS de l’Estrie-CHUS for nearly 15 years. Shortly after taking office, he implemented the daily medical round, ensuring that the entire team comes together at a specific time each day to discuss each patient's condition.

“You have to understand that intensive care patients are the sickest in the hospital,” says Dr. Leclair. “They require minute-by-minute care and undergo interventions every hour. Some of them are living their final moments, meaning critical decisions must be made. Nurses, pharmacists, doctors, resident physicians, nutritionists, physiotherapists, occupational therapists, and respiratory therapists all need to be on the same page and work together in the same direction.”

Although effective, these medical rounds initially did not include patients’ families. Feelings of helplessness, frustration, and anxiety were common, as loved ones often felt excluded from a situation that deeply concerned them.

“I remember how difficult it was for us, as a family, to have to watch the medical team discuss our mother from a distance without really knowing what was happening,” recalls Cynthia Dubé, whose mother passed away in intensive care 10 years ago. “We knew the medical team was doing their best, but when the most important person in your life is in a coma, it’s tough to be left out and to feel like you’re disturbing the team just to get answers.”

That kind of situation is now a thing of the past. “We ask families to designate a representative who can stay informed about the patient’s condition, understand the progression of the illness, ask questions, and participate in decisions during medical rounds,” explains Dr. Leclair. “As a doctor, I know the science and all the medical aspects, but I don’t necessarily know the patient’s values and wishes. The number one advantage of this approach is that decisions are made based on the patient’s wishes. A strong sense of trust is built with the family. This approach also does not exclude the possibility of holding another meeting later in the day with the family.”

Dr. Leclair believes that dedicating this time to families is worthwhile, even if it means medical rounds can last up to an hour longer. “But the bet we’re making is that the time invested in families is regained throughout the day. We see improvements in the way loved ones understand the patient’s condition, and we notice that they are much more satisfied,” he observes.

This shift in the intensive care unit is part of a pilot project focused on collaboration with families and caregivers, which has taken place across eight units of the CIUSSS de l’Estrie-CHUS. The financial support provided by the Fonds Brigitte-Perreault will enable the deployment of additional initiatives in various units of Hôtel-Dieu and Hôpital Fleurimont, including the creation of awareness tools such as short videos for patients’ families.