Family meetings are important events in the care of hospitalized patients to ensure that patients and families understand what is happening medically, to support them emotionally, and to promote shared decision-making. Common topics include delivering bad news, discussing care goals, and clarifying the plan of care and patient disposition.
Pre-meetings huddles among relevant clinicians are helpful for family discussions to run smoothly.
Huddles have been used for improving care in different settings. Evidence suggests they identify safety challenges, decrease laboratory and pharmacy costs, and improve family and provider satisfaction.
The huddle typically occurs just prior to family meeting, ideally in a private setting. Along with the primary medical team, it may include key specialists, consulting team members and members of the palliative interdisciplinary team. Huddles often take between 5-15 minutes.
1. The task of the huddle is to ensure that everyone has the same updated information about what is happening medically, what kind of interventions/options are appropriate to offer the patient/family, and what range of likely outcomes should be outlined. If health care providers have divergent thoughts, it is helpful to discuss the best and worst-case scenarios: the goal is to generate a consensus to present this information to the patient/family in a cohesive fashion.
2. The huddle participants should come to an agreement regarding the meeting’s purpose, incorporating what is known about the patient’s / family’s hopes for the meeting. It is a goal to make sure the patient/family leave the meeting better informed about the situation/options, and feel heard and valued. It is also important to clarify in advance if decisions about the plan of care need to be made urgently.
3. The huddle is the time for health care providers to share information about the family structure and how the patient/family make decisions. Given not all huddle members have met all family members, the huddle can update everyone on family dynamics.
4. It is important to decide who will lead the family meeting, taking into account who the patient/family may have the strongest therapeutic relationship with, and to name key roles in the meeting as relevant.
See reference for more information
Adapted from Bhatnagar M, Arnold, R. The pre-family meeting huddle. Palliative Care Network of Wisconsin. Fast facts and concepts #368. Internet. Accessed on January 20, 2019