A Communication Tool to Improve Communication in the ICU

The purpose of this study is to test the effectiveness of the Best Case/Worst Case-ICU communication tool on quality of communication, clinician moral distress, and ICU length of stay for older adults with serious traumatic injury. Investigators will follow an estimated 4500 patients aged 50 years and older who are in the ICU for 3 or more days and survey 1500 family members and up to 1600 clinicians from 8 sites nationwide.

Patients Inclusion Criteria: * aged 50 and older * admitted to the ICU for 3 or more days after serious injury Exclusion Criteria: * none Family Members Inclusion Criteria: * aged 18 and older * patient's family member or informally designated "like family" or primary surrogate decision maker * speak English or Spanish Exclusion Criteria: * does not have decision-making capacity Clinicians Inclusion Criteria: * provide care in the trauma ICU (including attending trauma surgeons, fellows, residents, advance practice providers, bedside nurses and medical assistants, respiratory techs and physical therapists, social workers, and chaplains) Exclusion Criteria: * do not provide care in the trauma ICU