Highlight
The Best Case/Worst Case-ICU (BC/WC-ICU) communication tool enables structured and consistent prognostic discussions between trauma ICU clinicians and families.
Implementation across eight high-volume US trauma centers shows feasibility with high clinician adherence and effective family reach.
Barriers such as competing clinical demands, communication discomfort, and doubts about innovation impact long-term maintenance.
Effective use of BC/WC-ICU reduces moral distress among clinicians and supports improved aligned decision-making by families.
