Patient/Family-level challenges | Clinician-level challenges | System-level challenges |
Patient too unstable; other care priorities Patient or family language barrier Perception that family is too distressed Patient has no family or friend available | Clinicians unsure of how to explain form. Clinicians concern that it will not be well received. Clinicians too busy to hand out or review form or abstract information for whiteboard. Perceived nursing ownership of the whiteboard; other clinicians reluctant to write on board. | Completed forms not kept in consistent location. Form and whiteboard completion not considered mandatory or enforced. Considered unnecessary for patients who are able to communicate themselves. Considered unnecessary for patients with a very short ICU stay. |
ICU, intensive care unit.