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Communication in the ICU: Holding a family meeting

Authors
Gordon J Wood, MD
Elizabeth Chaitin, DHCE
Robert M Arnold, MD
Section Editors
Polly E Parsons, MD
Thomas L Schwenk, MD
Deputy Editor
Geraldine Finlay, MD

INTRODUCTION

Family meetings facilitate communication between health care providers and families of patients in the intensive care unit (ICU). Effective communication improves family satisfaction, clinical decision-making, and the psychological well-being being of family members [1-4]. As a result, research agendas and lists of quality indicators are increasingly recognizing the importance of good communication with families [5-10]. Multiple large quality improvement efforts have being undertaken to improve communication with families in the ICU with positive results [11,12].

The benefits of communication and issues related to conducting a family meeting will be reviewed here. Throughout the discussion, "family" refers to any person of importance in the patient's life who might attend a conference related to the patient's care, whether they are related or not. Decision making by surrogates and informed consent are discussed elsewhere. (See "Advance care planning and advance directives" and "Ethics in the intensive care unit: Informed consent".)

IMPORTANCE OF COMMUNICATION

The receipt of honest, intelligible, and timely information is among the primary concerns of family members of patients in the ICU [13-17]. In addition, they need support, comfort, proximity, and reassurance [18]. Families want to feel that there is hope and they generally want to know the prognosis [19].

Unfortunately, the evidence indicates that communication with health care providers often leaves much to be desired [20]. Observational studies have found that communication issues with clinicians are the number one source of complaints among families of deceased patients, with as many as 30 percent of family members feeling dissatisfied with communication in the ICU [21-23]. Contributing factors include inadequate time spent communicating with clinicians, lack of consistent information, and information provided by multiple health care providers [24]. Poor communication can affect family satisfaction, clinical decision-making, and the psychological outcomes of family members.

Guidelines have been issued by the American Thoracic Society for shared decision-making which are in keeping with the issues discussed in this topic review [17].

                     

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Literature review current through: Nov 2016. | This topic last updated: Fri Jun 24 00:00:00 GMT+00:00 2016.
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