Addressing Palliative Care Needs Among Intensive Care Unit Family Members

PATIENTS Inclusion Criteria: * ≥18 years of age * Receive mechanical ventilation in a study ICU for ≥48 hours under care of a study ICU physician Exclusion Criteria (pre-consent): * Decisional capacity * Death expected within 24 hours * Admission to an ICU at the index hospital \>14 days * Comfort care or withdrawal of treatment planned * Imprisoned * Extubated and possess decisional capacity prior to informed consent * Died before T2 survey complete * No known family or surrogate * Care assumed by a non-study ICU attending after consent by patient/family but before T1 * Care assumed by non-study ICU attending \<3 days after T1 but before T2 * Study ICU attending physicians from different groups (i.e., intervention or control) caring for patient change \<3 days after T1 completed by family Exclusion Criteria (post-consent): * Patient regains decision making capacity before T2 * Patient dies before T2 FAMILY MEMBER Inclusion Criteria: * ≥18 years of age * Self-described as the individual (related or unrelated) who provides the most support and with whom the patient has a significant relationship (per definition of 'family' described in the Society of Critical Care Medicine 2016 Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU) Exclusion Criteria (pre-consent): * Lack a knowledge of English such that the potential participant is not confident that they could complete study tasks (app viewing, surveys) * Imprisoned * Unable to complete surveys for any reason * Describe their race as neither White nor Black\* * Describe their ethnicity as Hispanic\* * Note that this study explicitly targets issues of racial disparities in healthcare, particularly of Black / African-Americans. Hispanics are excluded because of the pervasive nature of US residents' general belief that 'Hispanic' is a racial category. Exclusion criteria (post-consent): * If the assigned randomized ICU attending physician either leaves ICU service or is replaced by a non-participating ICU physician \<= 2 calendar days after family member completes T1 survey * Low need burden (NEST score \<15)\* ICU PHYSICIANS Inclusion Criteria: * ≥18 years of age * Attending physician in a study ICU Exclusion Criteria: \- None \*The NEST score cutoff was changed on June 26, 2019. At this point, 3 patients had been randomized. This change was based on our review of data (NEST + psychological distress symptoms) from a parallel cohort study of \>50 family members of ICU patients who met nearly identical eligibility criteria as for the ICUconnect trial. This was a larger cohort than the pilot study on which we based the NEST cutoff.