(370) Implementing Structured Multidisciplinary Family Meetings in the ICU

Introduction: The quality of care in the Intensive Care Unit (ICU) is paramount, especially for patients at high risk of prolonged stays or mortality. Literature highlights the benefits of multidisciplinary family meetings, showing improvements in patient outcomes, satisfaction scores, and resource utilization 1,2. However, a structured, standardized approach to these meetings is often lacking and evidence suggests that family meetings in the ICU fail to occur in a timely manner 2,3,4.
We hypothesize that implementing a structured, multidisciplinary family meeting protocol in the ICU will increase the timely number of multidisciplinary family meetings, improve physician-to-family communication, and reduce ICU length of stay, thereby optimizing ICU resource utilization.

Methods: A multidisciplinary team comprising key stakeholders was formed, followed by a comprehensive literature review to establish criteria for qualifying patients. The protocol aimed for meetings within three days of ICU admission, utilizing the SPIKES Model for communication . Family meetings were held for high-risk patients with either the patient and/or next of kin or medical power of attorney on ICU Day 3 for 30 minutes, allowing for at most a total of four multidisciplinary family meetings per day. An EMR template was developed for standardized documentation. Data on meeting compliance and outcomes were collected for analysis.

Results: The number of multidisciplinary family meetings increased from 0% in October 2022 to 100% compliance by December 2023. Data from May through December 2023 indicated a significant increase in hospice conversions, suggesting effective communication of illness severity and prognosis. Patient satisfaction scores, measured via HCAPS, showed notable improvement in physician communication.

Conclusions: The results underscore the effectiveness of structured multidisciplinary family meetings in enhancing communication and decision-making in the ICU. The high rate of hospice conversions, while not a primary goal, indicates successful conveyance of critical information to families, leading to informed decisions.