Multidisciplinary family meetings in the ICU facilitate end-of-life decision making

Am J Hosp Palliat Care. 2009 Aug-Sep;26(4):295-302. doi: 10.1177/1049909109333934. Epub 2009 Apr 24.

Abstract

Objective: The aim of this study was to assess the feasibility of establishing a multi-disciplinary family meeting (MDFM) program and the impact of such a program on the end-of-life decision making in the setting of an ICU.

Methods: During the study period MDFMs were scheduled for patients requiring mechanical ventilation for 5 or more days. The meeting followed a structured format. The pertinent details of the meeting as well as the treatment goals were recorded.

Results: Twenty-nine patients were enrolled in this study. Thirty-five MDFM's were held on 24 patients. A meeting could not be arranged for four patients. All meetings addressed patient's diagnosis, prognosis and goals of care. Fifteen (52%) patients (9 of whom had metastatic malignancy) had life support withdrawal and died a mean of 4.8 + 4.2 days after the first family meeting. In the remaining 9 patients (3 with localized cancer and 6 with non-cancer diagnoses), the plan following the family meeting was to continue supportive care; all of these patients survived to hospital discharge.

Conclusions: Proactive MDFM's improve communication and understanding between patients' family and the treating team and facilitates end-of-life decision making.

Publication types

  • Evaluation Study

MeSH terms

  • Chi-Square Distribution
  • Communication*
  • Cooperative Behavior
  • Critical Care* / organization & administration
  • Critical Care* / psychology
  • Decision Making*
  • Documentation
  • Family / psychology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palliative Care* / organization & administration
  • Palliative Care* / psychology
  • Patient Care Team / organization & administration*
  • Philadelphia
  • Pilot Projects
  • Professional-Family Relations
  • Program Development
  • Program Evaluation
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Withholding Treatment / statistics & numerical data