TABLE 2.

The Three “E’s” of Effective Communication.

Engage	•Champion patient and family as key care team members   ○“You know your child better than anyone else. We value your insight and want to know when you are worried.”  •Leverage primary oncology team in times of transition   ○“If we need to talk about something serious, who do you want to make sure is part of the conversation?”   ○“Who from your team at home is important to include in important conversations?”
Explore	•Ask about preference and information needs of the family  •Ask about prior experiences and how this shapes expectations   ○“When your child first went through treatment, what did you find most challenging?”   ○“At your hospital near home, were there people or other services that helped you when you were struggling?”   ○“What worked well in your relationship with your team at home?”   ○“What do you already know about CAR T-cell therapy?”  •Ask about hopes and goals of therapy   ○“What is your understanding of the goal of CAR T-cell therapy for your child?”   ○“Beyond hoping for a cure, what else do you hope for?”   ○“Would it be helpful to talk about the chances of cure (or of meeting other goals)?”  •Ask about worries and sources of distress   ○“What worries you most about the treatment course ahead?”
Edit	•Revisit conversations often  •Schedule next conversation   ○“Some families find it helpful to talk about (chance of cure/symptoms/what the future may look like) when things are otherwise going well. How would you feel about talking about this at our next appointment?”  •Schedule “check-in” visits with family, CAR T-cell therapy team, and primary oncology team to re-evaluate new concerns and needs.