title: The use of family conferences in the pediatric intensive care unit.
abstract: BACKGROUND
  Data about pediatric intensive care unit (PICU) family conferences (FCs) are needed to enhance our understanding of the role of FCs in patient care and build a foundation for future research on PICU communication and decision making.
  
  
  OBJECTIVE
  The study's objective was to describe the use and content of PICU FCs.
  
  
  METHODS
  The study design was a prospective chart review comparing patients who had conferences with those who did not, and a sub-analysis of patients with chronic care conditions (CCCs).
  
  
  METHODS
  The study setting was an academic PICU from January 2011 through June 2011.
  
  
  METHODS
  Medical events under consideration were placement of tracheostomy or gastrostomy tube; initiation of chronic ventilation; palliative care involvement; use of extracorporeal membrane oxygenation, continuous renal replacement, or cardiopulmonary resuscitation; care limitation orders; death; length of stay; and discharge to a new environment.
  
  
  RESULTS
  From 661 admissions, we identified 74 conferences involving 49 patients. Sixty-four conferences (86%) were held about 40 patients with CCCs. Having a conference was associated with (p<0.05): length of PICU admission; palliative care involvement; initiation of chronic ventilation; extracorporeal membrane oxygenation; cardiopulmonary resuscitation; death; discharge to a new environment; and care limitation orders. Twenty-nine percent of patients who had a new tracheostomy or gastrostomy tube placed had a conference. We identified two categories of discussion topics: information exchange and future management.
  
  
  CONCLUSIONS
  Most identified FCs involved complex patients or patients who faced decisions affecting the child's quality of life or dying. For many patients who faced life changing decisions we did not identify a FC. Further research is needed to understand how to best utilize FCs and less formal conversations.
authors.affiliation: 1 Division of Critical Care Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago , Chicago, Illinois.
authors.forename: Kelly Nicole
authors.initials: KN
authors.lastname: Michelson
authors.forename: Marla L
authors.initials: ML
authors.lastname: Clayman
authors.forename: Natalie
authors.initials: N
authors.lastname: Haber-Barker
authors.forename: Claire
authors.initials: C
authors.lastname: Ryan
authors.forename: Karen
authors.initials: K
authors.lastname: Rychlik
authors.forename: Linda
authors.initials: L
authors.lastname: Emanuel
authors.forename: Joel
authors.initials: J
authors.lastname: Frader
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003657:Decision Making; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D008485:Medical Audit; D011368:Professional-Family Relations; D011446:Prospective Studies; D014481:United States; D055815:Young Adult