Activity report on a critical care mediator team in emergency and intensive care units

Abstract

Following the 2022 revision of the medical payment system, “Critical Care Mediators”, which promote dialogue between patients/families and healthcare providers to support appropriate decision-making, are spreading throughout Japan. This paper aims to report on the activities of a multidisciplinary mediator team at a general hospital in Shibuya, Tokyo. Between April 1, 2023, and March 31, 2024, interventions were conducted for 60 critically ill patients, aged 0 to 89 years, with a mean age of 55 years. Primary diagnoses included brain disease (35.0%), infectious diseases (18.3%), and heart disease (15.0%), with 63.3% resulting in death discharge. Key support included facilitating disease understanding (26.7%), supporting in treatment decision-making (50.0%), confirming willingness to donate organs (5.0%), and providing grief care to families (18.3%). Approximately 70% of cases received early intervention within 72 hours of admission. Enhancing multidisciplinary collaboration is essential for promptly responding various needs. Further research is required to validate the effectiveness of these interventions.