• David A Gruenewald, Michelle Gabriel, Dorothy Rizzo, and Carol A Luhrs.
• David A. Gruenewald is medical director, Palliative Care and Hospice Service, Geriatrics and Extended Care Service, Veterans Affairs Puget Sound Health Care System, and associate professor of medicine, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington. Michelle Gabriel is director of process improvement, Office of Quality, Safety and Value, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Dorothy Rizzo is hospice and palliative care coordinator, Geriatrics and Extended Care Service, Salem Veterans Affairs Medical Center, Salem, Virginia. Carol A. Luhrs is chief, Hematology/Oncology Section, Department of Medicine, Veterans Affairs New York Harbor Healthcare System; director, Veterans Affairs Comprehensive End of Life Care Implementation Center; and associate professor of clinical medicine, Hematology/Oncology Division, Department of Medicine, State University of New York at Brooklyn, Brooklyn, New York. david.gruenewald@va.gov dgruen@uw.edu.
• Am. J. Crit. Care. 2017 Jul 1; 26 (4): 303-310.

BackgroundFamily meetings in the intensive care unit are associated with beneficial outcomes for patients, their families, and health care systems, yet these meetings often do not occur in a timely, effective, reliable way.ObjectiveThe Department of Veterans Affairs Comprehensive End-of-Life Care Implementation Center sponsored a national initiative to improve family meetings in Veterans Affairs intensive care units across the United States. Process measures of success for the initiative were identified, including development of a curriculum to support facility-based quality improvement projects to implement high-quality family meetings.MethodsIdentified curriculum requirements included suitability for distance learning and applicability to many clinical intensive care units. Curriculum modules were cross-mapped to the "Plan-Do-Study-Act" model to aid in planning quality improvement projects. A questionnaire was e-mailed to users to evaluate the curriculum's effectiveness.ResultsUsers rated the curriculum's effectiveness in supporting and achieving aims of the initiative as 3.6 on a scale of 0 (not effective) to 4 (very effective). Users adapted the curriculum to meet local needs. The number of users increased from 6 to 17 quality improvement teams in 2 years. All but 3 teams progressed to implementation of an action plan.ConclusionUsers were satisfied with the effectiveness and adaptability of a family-meeting quality improvement curriculum to support implementation of a quality improvement project in Veterans Affairs intensive care units. This tool may be useful in facilitating projects to improve the quality of family meetings in other intensive care units.©2017 American Association of Critical-Care Nurses.

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