Decision making in intensive care units in Qatar: A qualitative study

This is a qualitative study that aims to understand, explore, and identify factors that shape decision making, it’s implications, challenges and modifiers among families and health care providers (HCPs). The study will use the Biopsychosocial Model as a framework to explore how decisions are made in the intensive care unit (ICU). The ICU in Qatar is a context of interplay between several cultures, religions, languages, and medical conditions. It is a context of trauma where emotions take role in shaping the modalities of making decisions by the multidisciplinary staff. Hence, decision-making is structured through the interaction between biological, psychological, and social factors. Through a scoping review, ICU observations, and interviews with HCPs and families of patients, we aim to meet the following objectives: 1. Uncover what has been studied and published on decision making in the ICUs in the Arab region and identify gaps in knowledge related to this topic. This will be conducted through a scoping review. Findings will guide us in building themes for the qualitative study components. 2. Examine the perceptions of HCPs and families on decision making in ICUs in Qatar to help us reveal misconceptions (if any) and factors that shape behaviors of families, patients and HCPs in the ICU context. This objective will be met through open-ended semi-structured interviews with families and HCPs. 3. Explore the types and ways of making and communicating decisions in the ICU. This will be achieved through ICU observations and the semi-structured interviews with HCPs and families. 4. Identify biopsychosocial factors that shape decision making in ICUs and how these factors contribute to creating challenges, or being protective factors in some cases. These factors will be identified through ICU observations and semi-structured interviews with HCPs and families. 5. Outline principles and rules of decision making in ICUs in Qatar’s health care system. We will document rules of decision making as communicated and documented in the hospital’s formal regulations and in the official laws of Qatar. This will also enable us to identify gaps between written regulations, practices in real life scenarios and reasons behind these gaps, if any. This objective will be met through collecting and analyzing contents of archival data. The following outputs will be achieved: 1. A technical report summarizing our findings and presenting recommendations on future actions for empowering shared-decision making in ICUs will be presented to management teams. 2. A workshop for ICU-HCPs and decision makers at the management level to present our findings and explore ways to improve shared-decision making in the ICU. 3. Four peer reviewed academic articles, to be submitted to Q1 and Q2 journals 4. Findings will be presented at local, regional, and international conferences.

Hamad Bin Khalifa University (HBKU)