Interprofessional Teamwork When Meeting with a Family in the Pediatric Cardiac Intensive Care Unit (FR441A)

Abstract

•Identify the recommended roles of team members in conducting family meetings as presented in the literature and identify patterns of team behavior in the pediatric critical care unit.•Identify what constitutes empathic opportunities and responses in a family meeting, how to assess parental understanding and understand the difference between open and closed ended questions. Parents of children in the pediatric cardiac intensive care unit (CICU) report inadequate communication and a lack of empathy during conversations with their clinicians. To evaluate communication behaviors and inter-professional team interactions during family meetings in the pediatric CICU. Meetings of family members and CICU clinicians were audio recorded. We used quantitative case-coding to compare the duration of contributions made by attendees, and used the SCOPE codebook to measure assessment of parental understanding, closed and open-ended questions, and empathic statements in response to opportunities. Qualitative coding identified major themes regarding content discussed in the meetings. In the 10 meetings, CICU attendings spoke for an average of 64% of each meeting (SD=17%), parents 17% (SD=12%), registered nurses 7% (SD=6%), social workers 3% (SD=5%), and nurse practitioners 1% (SD=1%). In two meetings, parental understanding was assessed at the beginning of the meeting; in no meeting was this assessed at the end. Clinicians asked parents 132 closed-ended questions (86%) and 21 open-ended questions (14%). The team missed empathic opportunities seven out of 17 (41%) occasions. CICU attendings had the highest number of expressions of empathy at 12 (57%), followed by social workers at 2 (10%). Social workers were the team member most likely to initiate discussions about parents’ worries or concerns. Nurses’ contributions were largely to clarify a CICU attending’s statement or to elicit any questions about nursing from the parents. Clinical information is often given without checking for parental understanding but empathic opportunities were responded to frequently. Team members seem to serve different roles in the meetings, with physicians speaking for two-thirds of the time.