• Ann Palliat Med · Dec 2017

    Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at the end of life.

    • Christine R Sanderson, Philippa J Cahill, Jane L Phillips, Anne Johnson, and Elizabeth A Lobb.
    • Calvary Health Care Kogarah, Kogarah, New South Wales, Australia; The School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
    • Ann Palliat Med. 2017 Dec 1; 6 (Suppl 2): S195-S205.

    BackgroundFamily meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard.MethodsThis pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team. Newly admitted patients to an Australian in-patient specialist palliative care unit were invited to ask anyone they wished to join them in a meeting with the palliative care team and to identify issues they wished to discuss. Consenting inpatients were interviewed shortly after admission; participated in a family meeting and re-interviewed 2-3 days after the meeting. Family members provided feedback at the end of the meeting. A focus group was held with staff for feedback on this new approach for family meetings. Meetings were observed, documented and thematically analyzed.ResultsThirty-one newly admitted patients were approached to participate in a family meeting. Eighty-four percent had family meetings and the majority (96%) was attended by the patient. Thematic analysis revealed 69% of patient-centered meetings raised end-of-life concerns and 54% were "family-focused".ConclusionsPatient-centered family meetings in palliative care were shown to be feasible and acceptable for staff, patients and family members. Many patients and families spontaneously shared end-of-life concerns. A patient-centered approach to family meetings that includes active patient involvement may provide additional and valued opportunities for patients and families to: express mutual concerns, deliver messages of comfort and appreciation, and prepare for death. Further investigation of this approach, including families' bereavement outcomes, is warranted.

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