| Setting |
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Determine who will be present; emphasize individuals most likely to have direct impact on patient's care. Establish whether patient will participate in the meeting.
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Be seated. Introduce all team members, and describe their roles at the start of the discussion.
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Team discusses results, findings, and recommendations before meeting. Arrange for health interpreter if necessary. Manage personal interruptions (e.g., pagers off).
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Slides 16–17 |
| Perception |
|
Slide 19 |
| Involvement |
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Confirm meeting agenda. Encourage questions/comments; assure of other opportunities to meet/discuss.
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•
Be sensitive to family's culture, race, religious beliefs, and socioeconomic background.
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Slide 21 |
| Knowledge |
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Start with warning shot: “I have some difficult news to share.”
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Connect new information with information family already has. Pace information; limit to a few key points. Check family's understanding as information is shared.
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Use visual aids or handouts. Avoid jargon, euphemism, excessive bluntness, or prognostication.
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Emphasize positive findings when possible. Discuss possible outcomes; acknowledge future can be unclear.
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N/Aa
|
| Emotion/ empathy |
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•
Use empathic responses after observing family's emotional response: “I can see how upsetting this is for you,” “I can tell you were not expecting to hear this,” “I know this is not good news for you,” “I was hoping for a better result.”
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Use exploratory questions to clarify thoughts and feelings expressed by family: “What do you mean?”, “Tell me more about it,” “Could you tell me what you're worried about?”
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Use validating responses for emotions and reactions: “I can understand how you feel that way.”
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Slide 25 |
| Summary/ strategy/self-reflection |
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•
Ask if family is ready to discuss treatment plan or next steps; assure family they will participate in care decisions. Encourage discussion; offer recommendations for particular treatment based on medical judgment. Verify family understands the treatment plan; use “teach back” as necessary.
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Balance hope with realism, and discuss palliative care, if appropriate. Summarize mutual goals, time line. Offer help sharing information with others.
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Provide information about support services. Document meeting and plans in medical record.
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Team members distribute responsibilities for follow-up with patient/family.
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Reflect upon and process team members’ emotions/reactions; discuss what worked, what could be improved.
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Slide 27 |
