Fast Fact and Concept #16: Conducting a Family Conference

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Title: Fast Fact and Concept #16: Conducting a Family Conference

Author(s): Ambuel, B.; Weissman, D.

This Fact Fact and Concept gives a detailed outline of the essential steps in running a family conference. The material can be used during rounds, to precept a trainee or as part of a teaching conference.

Educational Objective(s):
Learn the key steps in conducting a family conference.
Case scenario: Bill is a 63-year-old man admitted following a massive MI. In the ER he is stabilized, intubated and transferred to the ICU. By history he experienced an unknown period of anoxia prior to arrival of the EMTs. On exam he remains unresponsive to deep pain after 3 days. On the third day of hospitalization, Bill's wife Susan, and three children join you for a family conference to discuss his treatment. How do you run a family conference? What do you teach residents?

I. Why: Clarify conference goals in your own mind.

II. Where: A room with comfort, privacy and circular seating.

III. Who: Patient (if capable to participating); legal decision maker/health care power of attorney; family members; social support; key health care professionals.

IV. How:

A. Introduction B. Review medical status C. Family Discussion w/ Decisional Patient D. Family Discussion w/ Non-Decisional Patient E. When there is no consensus: V. Wrap-up:
  1. Summarize consensus, disagreements, decisions and plan.
  2. Caution against unexpected outcomes.
  3. Identify family spokesperson for ongoing communication.
  4. Document in the chart -- who was present, what decisions were made, follow-up plan.
  5. Don't turf discontinuation of treatment to nursing.
  6. Continuity: Maintain contact with family and medical team. Schedule follow-up meetings as needed.

Key teaching points:

References: Ambuel, B. Conducting a family conference. In DE Weissman & B Ambuel, Improving End-of-Life Care: A resource guide for physician education. The Medical College of Wisconsin, Milwaukee, 1999.

Fast Facts and Concepts are developed and distributed as part of the National Internal Medicine Residency End-of-Life Education project, funded by the Robert Wood Johnson Foundation.

Disclaimer Concerning Medical Information:
Health care providers should exercise their own independent clinical judgment. Accordingly, official prescribing information should be consulted before any product is used.

Contact: David E. Weissman, MD, FACP Palliative Care Program Director Medical College of Wisconsin (P) 414-805-4607 (F) 414-805-4608 [email protected]

Copyright Notice: Users are free to download and distribute Fast Facts for educational purposes only. Citation for referencing: Weissman, D. Fast Fact and Concepts #16: Conducting a Family Conference. June, 2000. End-of-Life Physician Education Resource Center www.eperc.mcw.edu.

Disclaimer: Fast Facts provide educational information, this information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.

Creation Date: 6/2000

Format: Handouts

Purpose: Instructional Aid, Teaching

Training: 1st/2nd Year Medical Students, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6, Physicians in Practice
Specialty: Anesthesiology, Emergency Medicine, Family Medicine, General Internal Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN, Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery
Non-Physician: Clergy/Chaplains, Lawyers, Nurses, Social Workers

ACGME Competencies: Interpersonal and Communication Skills, Patient Care

Keyword(s): Decision making capacity/surrogates, Discussing hospice care, Family conference, Giving bad news, Negotiating treatment goals, Prognosis, Treatment withdrawal, Treatment withholding

The Fast Facts series is distributed for educational use only and does not constitute medical advice. For the most current version of Fast Facts visit the EPERC web site at www.eperc.mcw.edu. This mirror version is provided subject to copyright restrictions for educational use within the Inter-Instutional Collaborating Network on End-of-Life Care (IICN).