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RES10
Critical Communication: Issues Of Reporting And Documenting Details Of Family Conferences
By:Kasuya, T., Whitney, J. & Wong, S.; Harborview Medical Center, Seattle, WA
For further information, please contact: tkasuya@u.washington.edu
Purpose: A staff survey was completed to identify problems around documenting and reporting the discussions during family conferences.
Background/Significance: Decisions about code status, care transition and end of life are generally made at formal family conferences. Accurate dissemination of information to all members of the care team is problematic; often leading to confusion and delays. Methods: Over a 3 month period, nurses in SICU, CICU and palliative care team members completed a survey after participating in family conferences. Data were collected through a 10 question survey focusing on documentation and verbal reporting aspects of details from the conferences. Questions were either narrative or used a Likert-type scale with the response range from 0-10, with 0 being lowest.
Results: Findings from the survey showed low ratings of documentation of family conference discussions. Adequacy of nurse documentation was 3.9 ± 3.4, and adequacy of MD documentation was 1.8 ± 2.5. Important topic areas included outcomes and family views. Despite poor rating of documentation, verbal communications among clinicians before and after conferences were rated fairly highly. Rating of nurse shift report was 5.7 ± 2.6. MD/Nurse communication before conference was 5.5± 3.2 and after conference was 6.2 ± 6.3. Participants identified the following issues which need to be clarified before conferences: the clinician’s opinion about prognosis, recommended care plan, and family’s level of understanding. Also, a majority mentioned the importance of revising and following up on the care plan after family conference.
Conclusions: This study showed detail of family conference were poorly documented, but fairly well reported. However, it is unclear how accurate the family conference discussion topics are passed on verbally. It is important to establish format to document critical details of family conference discussion.
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