• Courtenay R Bruce, Alana D Newell, Jonathan H Brewer, Divina O Timme, Evan Cherry, Justine Moore, Jennifer Carrettin, Emily Landeck, Rebecca Axline, Allison Millette, Ruth Taylor, Andrea Downey, Faisal Uddin, Deepa Gotur, Faisal Masud, and Donna S Zhukovsky.
• Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX, USA; Houston Methodist System, Bioethics Program, Houston, TX, USA. Electronic address: crbruce@bcm.edu.
• J Crit Care. 2017 Dec 1; 42: 223-230.

BackgroundThe heterogeneity with regard to findings on family meetings (or conferences) suggests a need to better understand factors that influence family meetings. While earlier studies have explored frequency or timing of family meetings, little is known about how factors (such as what is said during meetings, how it is said, and by whom) influence family meeting quality.Objectives(1) To develop an evaluation tool to assess family meetings (Phase 1); (2) to identify factors that influence meeting quality by evaluating 34 family meetings (Phase 2).Materials And MethodsFor Phase 1, methods included developing a framework, cognitive testing, and finalizing the evaluation tool. The tool consisted of Facilitator Characteristics (i.e., gender, experience, and specialty of the person leading the meeting), and 22 items across 6 Meeting Elements (i.e., Introductions, Information Exchanges, Decisions, Closings, Communication Styles, and Emotional Support) and sub-elements. For Phase 2, methods included training evaluators, assessing family meetings, and analyzing data. We used Spearman's rank-order correlations to calculate meeting quality. Qualitative techniques were used to analyze free-text.ResultsNo Facilitator Characteristic had a significant correlation with meeting quality. Sub-elements related to communication style and emotional support most strongly correlated with high-quality family meetings, as well as whether "next steps" were outlined (89.66%) and whether "family understanding" was elicited (86.21%). We also found a significant and strong positive association between overall proportion scores and evaluators' ratings (rs=0.731, p<0.001).ConclusionsWe filled a gap by developing an evaluation tool to assess family meetings, and we identified how what is said during meetings impacts quality.Copyright © 2017 Elsevier Inc. All rights reserved.

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