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.