Communication Skills for Critical Care Family Meetings

Excellent communication is a foundation of shared decision making. As discussed throughout this book, shared decision-making is a collaborative process of (1) exchanging medical and personal information about patients’ values, goals and preferences, (2) deliberation about how to apply these values to the clinical situation and (3) development of a treatment plan that reflects these values. This process is a very complex communication task. Unskilled clinicians may leave decisions largely to the discretion of surrogates without providing adequate support, and surrogates may struggle to make patient-centered decisions rather than decisions based on their own values, resulting in higher levels of post-traumatic stress disorder and depression.1 Conversely, in a recent study of recorded family meetings regarding ICU decision-making, fewer than one-half included deliberation about how to apply a patient’s values and preferences to the clinical situation.