Family meetings can be challenging, requiring a range of skills and participation. We sought to identify tools available to aid the conduct of family meetings in palliative, hospice, and intensive care unit settings.
Methods:
We systematically reviewed PubMed for articles describing family meeting tools and abstracted information on tool type, usage, and content.
Results:
We identified 16 articles containing 23 tools in 7 categories: meeting guide (n = 8), meeting planner (n = 5), documentation template (n = 4), meeting strategies (n = 2), decision aid/screener (n = 2), family checklist (n = 1), and training module (n = 1). We found considerable variation across tools in usage and content and a lack of tools supporting family engagement.
Conclusion:
There is need to standardize family meeting tools and develop tools to help family members effectively engage in the process.
von GuntenCFFerrisFDEmanuelLL. The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills. JAMA. 2000;284(23):3051–3057.
2.
MularskiRACurtisJRBillingsJA. Proposed quality measures for palliative care in the critically ill: a consensus from the Robert Wood Johnson Foundation Critical Care Workgroup. Crit Care Med. 2006;34(11 suppl):S404–S411.
3.
LankenPNTerryPBDelisserHM. An official American Thoracic Society clinical policy statement: palliative care for patients with respiratory diseases and critical illnesses. Am J Respir Crit Care Med. 2008;177(8):912–927.
4.
TruogRDCampbellMLCurtisJR. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College of Critical Care Medicine. Crit Care Med. 2008;36(3):953–963.
5.
WeissmanDEMeierDE. Operational features for hospital palliative care programs: consensus recommendations. J Palliat Med. 2008;11(9):1189–1194.
6.
National Consensus Project for Quality Palliative Care. Clinical Practice Guidelines for Quality Palliative Care, Third Edition. Pittsburgh, PA: National Consensus Project for Quality Palliative Care; 2013.
7.
LautretteADarmonMMegarbaneB. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med. 2007;356(5):469–478.
8.
DeteringKMHancockADReadeMCSilvesterW. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ. 2010;340:c1345.
9.
LillyCMDe MeoDLSonnaLA. An intensive communication intervention for the critically ill. Am J Med. 2000;109(6):469–475.
10.
GlavanBJEngelbergRADowneyLCurtisJR. Using the medical record to evaluate the quality of end-of-life care in the intensive care unit. Crit Care Med. 2008;36(4):1138–1146.
11.
CampbellMLGuzmanJA. Impact of a proactive approach to improve end-of-life care in a medical ICU. Chest. 2003;123(1):266–271.
12.
CurtisJRWhiteDB. Practical guidance for evidence-based ICU family conferences. Chest. 2008;134(4):835–843.
13.
ButlerDJHollowayRLGottliebM. Predicting resident confidence to lead family meetings. Fam Med. 1998;30(5):356–361.
14.
JubelirerSJWelchCBabarZEmmettM. Competencies and concerns in end-of-life care for medical students and residents. W V Med J. 2001;97(2):118–121.
15.
NelsonJEAngusDCWeissfeldLA. End-of-life care for the critically ill: A national intensive care unit survey. Crit Care Med. 2006;34(10):2547–2553.
16.
BryanCBorenSA. The use and effectiveness of electronic clinical decision support tools in the ambulatory/primary care setting: a systematic review of the literature. Inform Prim Care. 2008;16(2):79–91.
17.
HenrySBMorrisJAHolzemerWL. Using structured text and templates to capture health status outcomes in the electronic health record. Jt Comm J Qual Improv. 1997;23(12):667–677.
18.
HalesBMPronovostPJ. The checklist--a tool for error management and performance improvement. J Crit Care. 2006;21(3):231–235.
19.
DexheimerJWTalbotTRSandersDLRosenbloomSTAronskyD. Prompting clinicians about preventive care measures: a systematic review of randomized controlled trials. J Am Med Inform Assoc. 2008;15(3):311–320.
20.
HartzTVerstHUeckertF. KernPaeP - a web-based pediatric palliative documentation system for home care. Stud Health Technol Inform. 2009;150:337–341.
21.
LindnerSADavorenJBVollmerAWilliamsBLandefeldCS. An electronic medical record intervention increased nursing home advance directive orders and documentation. J Am Geriatr Soc. 2007;55(7):1001–1006.
22.
RussSRoutSSevdalisNMoorthyKDarziAVincentC. Do safety checklists improve teamwork and communication in the operating room? A systematic review. Ann Surg. 2013;258(6):856–871.
23.
AzoulayEPochardFKentish-BarnesN. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171(9):987–994.
24.
CurtisJREngelbergRAWenrichMD. Studying communication about end-of-life care during the ICU family conference: development of a framework. J Crit Care. 2002;17(3):147–160.
25.
CurtisJREngelbergRAWenrichMDShannonSETreecePDRubenfeldGD. Missed opportunities during family conferences about end-of-life care in the intensive care unit. Am J Respir Crit Care Med. 2005;171(8):844–849.
26.
WhiteDBBraddockCHBereknyeiSCurtisJR. Toward shared decision making at the end of life in intensive care units: opportunities for improvement. Arch Intern Med. 2007;167(5):461–467.
27.
NelsonJEWalkerASLuhrsCACortezTBPronovostPJ. Family meetings made simpler: a toolkit for the intensive care unit. J Crit Care. 2009;24(4):626. e627–e614.
28.
PenrodJDLuhrsCALivoteEECortezTBKwakJ. Implementation and evaluation of a network-based pilot program to improve palliative care in the intensive care unit. J Pain Symptom Manage. 2011;42(5):668–671.
29.
HudsonPQuinnKO’HanlonBArandaS. Family meetings in palliative care: Multidisciplinary clinical practice guidelines. BMC Palliat Care. 2008;7:12.
30.
SharmaRKDySM. Cross-cultural communication and use of the family meeting in palliative care. Am J Hosp Palliat Care. 2011;28(6):437–444.
31.
BillingsJABlockSD. The end-of-life family meeting in intensive care part III: A guide for structured discussions. J Palliat Med. 2011;14(9):1058–1064.
32.
WeissmanDEQuillTEArnoldRM. Preparing for the family meeting #222. J Palliat Med. 2010;13(2):203–204.
33.
GueguenJABylundCLBrownRFLevinTTKissaneDW. Conducting family meetings in palliative care: themes, techniques, and preliminary evaluation of a communication skills module. Palliat Support Care. 2009;7(2):171–179.
34.
FinebergICKawashimaMAschSM. Communication with families facing life-threatening illness: a research-based model for family conferences. J Palliat Med. 2011;14(4):421–427.
35.
WeissmanDEQuillTEArnoldRM. The family meeting: starting the conversation #223. J Palliat Med. 2010;13(2):204–205.
DalyBJDouglasSLO’TooleE. Effectiveness trial of an intensive communication structure for families of long-stay ICU patients. Chest. 2010;138(6):1340–1348.
38.
BillingsJABlockSD. The end-of-life family meeting in intensive care part III: A guide for structured discussions. J Palliat Med. 2011;14(9):1058–1064.
39.
FinebergICKawashimaMAschSM. Communication with families facing life-threatening illness: a research-based model for family conferences. J Palliat Med. 2011;14(4):421–427.
40.
WeissmanDEQuillTEArnoldRM. Responding to emotion in family meetings #224. J Palliat Med. 2010;13(3):327–328.
41.
WeissmanDEQuillTEArnoldRM. The family meeting: causes of conflict #225. J Palliat Med. 2010;13(3):328–329.
42.
Machare DelgadoECallahanAPaganelliGRevilleBParksSMMarikPE. Multidisciplinary family meetings in the ICU facilitate end-of-life decision making. Am J Hosp Palliat Care. 2009;26(4):295–302.
43.
WhitmerMHughesBHurstSMYoungTB. Innovative solutions: family conference progress note. Dimens Crit Care Nurs. 2005;24(2):83–88.
44.
CurtisJREngelbergRAWenrichMDShannonSETreecePDRubenfeldGD. Missed opportunities during family conferences about end-of-life care in the intensive care unit. Am J Respir Crit Care Med. 2005;171(8):844–849.
45.
NortonSAHoganLAHollowayRGTemkin-GreenerHBuckleyMJQuillTE. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Crit Care Med. 2007;35(6):1530–1535.
46.
LankenPNTerryPBDelisserHM. An official American Thoracic Society clinical policy statement: palliative care for patients with respiratory diseases and critical illnesses. Am J Respir Crit Care Med. 2008;177(8):912–927.
47.
TruogRDCampbellMLCurtisJR. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College of Critical Care Medicine. Crit Care Med. 2008;36(3):953–963.
48.
DavidsonJEPowersKHedayatKM. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Med. 2007;35(2):605–622.
