DescriptionAnnually, in the United States alone, over 5.7 million patients are admitted and treated in intensive care units (ICUs) with associated costs totaling over $80 billion. Patients and/or surrogate decision makers in ICUs are expected to make complex medical decisions that can have irreversible effects on healthcare outcomes. Literature review reveals that 1) communication practices in ICUs are poor, 2) that ICU nurse report inadequate skill, training and discomfort as barriers to quality communication, 3) that lack of education, varying degrees of experience and inconsistent communication strategies contribute to dissatisfaction with communication practices and 4) less than 60% of critical care family members were satisfied with communication practices. A comprehensive communication improvement initiative was developed including communication education for ICU bedside nurses and the implementation of a nurse-drive communication protocol/ documentation bundle. Results were evaluated using a pre- and post- survey design measuring nurses' reports on communication practices using a 1-10 scale. Post-intervention surveys revealed that participants reported statistically significant (p <0.05) increases in both comfort discussing prognosis with patients/family members and with the self-reported quality of communication between themselves and patients /family members. Post- intervention surveys revealed that implementation did not significantly affect 1) witnessed communication quality observed between healthcare providers and patients/family members, 2) nurses' comfort discussing goals of care with patients/family members, 3) communication quality between the participant and members of the healthcare team, 4) the consistency of communication from healthcare providers to patients/ family members and 5) the level of confidence arranging a family meeting.