title: Multidisciplinary family meetings in the ICU facilitate end-of-life decision making.
abstract: OBJECTIVE
  The aim of this study was to assess the feasibility of establishing a multi-disciplinary family meeting (MDFM) program and the impact of such a program on the end-of-life decision making in the setting of an ICU.
  
  
  METHODS
  During the study period MDFMs were scheduled for patients requiring mechanical ventilation for 5 or more days. The meeting followed a structured format. The pertinent details of the meeting as well as the treatment goals were recorded.
  
  
  RESULTS
  Twenty-nine patients were enrolled in this study. Thirty-five MDFM's were held on 24 patients. A meeting could not be arranged for four patients. All meetings addressed patient's diagnosis, prognosis and goals of care. Fifteen (52%) patients (9 of whom had metastatic malignancy) had life support withdrawal and died a mean of 4.8 + 4.2 days after the first family meeting. In the remaining 9 patients (3 with localized cancer and 6 with non-cancer diagnoses), the plan following the family meeting was to continue supportive care; all of these patients survived to hospital discharge.
  
  
  CONCLUSIONS
  Proactive MDFM's improve communication and understanding between patients' family and the treating team and facilitates end-of-life decision making.
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University Philadelphia, Pennsylvania 19107, USA.
authors.forename: Enrique
authors.initials: E
authors.lastname: Machare Delgado
authors.forename: Amy
authors.initials: A
authors.lastname: Callahan
authors.forename: Galia
authors.initials: G
authors.lastname: Paganelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Reville
authors.forename: Susan M
authors.initials: SM
authors.lastname: Parks
authors.forename: Paul E
authors.initials: PE
authors.lastname: Marik
mesh_terms: D016009:Chi-Square Distribution; D003142:Communication; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology; D003657:Decision Making; D004282:Documentation; D005190:Family / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration*; D015143:Philadelphia; D010865:Pilot Projects; D011368:Professional-Family Relations; D016730:Program Development; D015397:Program Evaluation; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D028761:Withholding Treatment / Q000706:statistics & numerical data