Critical illness is often a stressful and isolating time for patients and their loved ones. Family engagement through a variety of mechanisms has been associated with better outcomes including reduced rates of anxiety, depression, and PTSD for patients and family members and improved satisfaction with care.  Family presence, whether in-person or virtually, has also been associated with decreased prevalence of delirium in critically ill patients with COVID-19 and with decreased duration of delirium in other ICU populations.

While keeping patients and families connected in the ICU is paramount to providing humanistic care and improving outcomes, there are barriers to optimizing family engagement. Family members cannot always be at the bedside and patients in the ICU often cannot use standard tools for communication due to cognitive impairment, sedation, mechanical ventilation, and weakness. Facilitating communication through traditional means, such as video or phone calls, is often time-, resource-, and labor- intensive for ICU staff. VoiceLove is a novel, HIPAA-compliant mobile app created in response to the communication crisis of the COVID-19 pandemic. Similar to a walkie-talkie, it enables family members to send voice messages from their own phone that are played in real-time for ICU patients via a bedside-mounted phone, without requiring staff coordination.

In this randomized control trial, we will randomize (1:1, stratified by age <65 or >65) 100 patients who need mechanical ventilation in the medical or cardiovascular ICUs at Vanderbilt to receive the VoiceLove intervention or standard of care for communication for up to 15 days. This study will look at the feasibility of implementing this new communication technology in the ICU. Aim 1 of the study is to assess how VoiceLove implementation impacts patient and family engagement and perceptions of communication. This will be assessed through unique patient and family facing surveys collected at the time of ICU and hospital discharge. Aim 2 is to assess the effects of VoiceLove implementation on delirium prevalence and duration.