title: Communication in palliative medicine: a clinical review of family conferences.
abstract: OBJECTIVE
  Family conferences are an important forum for communication, particularly for those with serious illnesses.
  
  
  METHODS
  The strength of evidence was assessed by patient, intervention, comparator, and outcome (PICO).
  
  
  METHODS
  We searched electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, PubMed), published articles, and multidisciplinary resource textbooks.
  
  
  RESULTS
  Four areas investigated family conferences: acute care, family medicine/geriatrics, intensive care units (ICU), and oncology/palliative medicine. A unifying theme was the importance of improved communication. A single randomized controlled ICU study demonstrated that family conferences positively influenced bereavement outcomes. A prospective (but single-arm) ICU study and several family medicine/geriatrics cohort studies, found that family conferences reduced hospital length of stay and/or decreased resource utilization. Other articles proposed guidelines or methods for the practical conduct of family conferences.
  
  
  CONCLUSIONS
  ICU studies supported the benefit of a family conference to the family, health care team, and hospital administration. The family conference in other clinical areas was not supported by a strong evidence base. Well-designed prospective studies are needed in multiple medical settings to assess the proposed and observed patient and financial benefits of the family conference, and determine their generalizability.
authors.affiliation: 1 Section of Palliative Medicine and Supportive Oncology, Cleveland Clinic Foundation , Cleveland, Ohio.
authors.forename: Ruth
authors.initials: R
authors.lastname: Powazki
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.forename: Katherine
authors.initials: K
authors.lastname: Hauser
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
mesh_terms: D003142:Communication; D006801:Humans; D065126:Palliative Medicine; D011368:Professional-Family Relations