Family Conference Studies

Improving Clinician-Family Communication in the ICU
Principal Investigator:  JR Curtis
Research Grant:  National Institute of Health / NINR, October 1999 to September 2002

The long-term goal of this proposal has been to improve the quality of communication between clinicians (nurses and physicians) and families about end-of-life care in the intensive care unit (ICU).  The primary objectives were: 1) to describe the content and process of clinician-family communication about end-of-life care occurring as part of ICU family conferences using qualitative analysis and 2) to evaluate the quality of clinician-family communication about end-of-life care occurring as part of ICU family conferences using a combination of qualitative and quantitative methods.  Secondary objectives were to examine the reliability and validity of a questionnaire assessing the quality of clinician-family communication about end-of-life care in the ICU and to develop curricula for nurses and physicians to improve the quality of clinician-family communication about end-of-life care in the ICU.

Improving the Quality of Clinician-Family Communication in the ICU for Non-English Speaking Families
Principal Investigator:  JR Curtis
Research Grant:  Open Society Institute Project on Death in America, August 2001 to July 2003

The long term goal was to identify effective strategies for cross-cultural communication around end-of-life care and develop expertise in cross-cultural health care research.  The specific objectives were:  1) to assess the content of clinician-family communication about end-of-life care during ICU family conferences involving interpreters and compare it to communication in family conferences without interpreters; 2) to assess the quality of physician-family cross-cultural communication about end-of-life care during family conferences involving interpreters and compare it to communication in family conferences without interpreters; and 3) to examine the perspective of language interpreters on cultural competence of clinicians conducting ICU family conferences.

Publications from these studies include:

White DB, Engelberg RA, Wenrich MD, Lo B, Curtis JR.  The language of prognostication in intensive care units.
Med Decis Making. 2010; 30:76-83. Epub 2008 Aug 27. [#145]

White DB, Malvar G, Karr J, Lo B, Curtis JR.  Expanding the paradigm of the physician’s role in surrogate decision-making: an empirically derived framework.  Crit Care Med. 2010; 38:743-750. [#144]

Engelberg RA, Wenrich MD, Curtis JR.  Responding to families’ questions about the meaning of physical movements in critically ill patients.  J Crit Care. 2008 Dec;23(4):565-71. [#118]

Thornton JD, Pham K, Engelberg RA, Jackson JC, Curtis JR.  Families with limited English proficiency receive less information and support in interpreted intensive care unit family conferences.  Crit Care Med. 2009 Jan;37(1):89-95. [#117]

Curtis JR, White DB. Practical guidance for evidence-based ICU family conferences.  Chest. 2008 Oct;134(4):835-43. Review. [#115]

Selph RB, Shiang J, Engelberg R, Curtis JR, White DB.  Empathy and life support decisions in intensive care units.
J Gen Intern Med. 2008 Sep;23(9):1311-7. [#112]

Pham K, Thornton JD, Engelberg RA, Jackson JC, Curtis JR.  Alterations during medical interpretation of ICU family conferences that interfere with or enhance communication.  Chest. 2008 Jul;134(1):109-16. Epub 2008 Mar 17. [#101]

White DB, Braddock CH 3rd, Bereknyei S, Curtis JR. Toward shared decision making at the end of life in intensive care units: opportunities for improvement.  Arch Intern Med. 2007 Mar 12;167(5):461-7. [#89]

White DB, Engelberg RA, Wenrich MD, Lo B, Curtis JR. Prognostication during physician-family discussions about limiting life support in intensive care units. Crit Care Med. 2007 Feb;35(2):442-8. [#86]

Hsieh HF, Shannon SE, Curtis JR.  Contradictions and communication strategies during end-of-life decision making in the intensive care unit.  J Crit Care. 2006 Dec;21(4):294-304. [#85]

Stapleton RD, Engelberg RA, Wenrich MD, Goss CH, Curtis JR.  Clinician statements and family satisfaction with family conferences in the intensive care unit.  Crit Care Med. 2006 Jun;34(6):1679-85. [#74]

Norris WM, Wenrich MD, Nielsen EL, Treece PD, Jackson JC, Curtis JR.  Communication about end-of-life care between language-discordant patients and clinicians: insights from medical interpreters.  J Palliat Med. 2005 Oct;8(5):1016-24. [#66]

West HF, Engelberg RA, Wenrich MD, Curtis JR.  Expressions of nonabandonment during the intensive care unit family conference.  J Palliat Med. 2005 Aug;8(4):797-807. [#63]

Curtis JR, Engelberg, RA, Wenrich MD, Shannon SE, Treece PD, Rubenfeld GD.   Missed opportunities during family conferences about end-of-life care in the intensive care unit. J Respir Crit Care Med. 2005; 171: 844-849. [#55]

McDonagh JR, Elliott TB, Engelberg RA, Treece PD, Shannon SE, Rubenfeld GD, Patrick DL, Curtis JR.  Family satisfaction with family conferences about end-of-life care in the ICU: Increased proportion of family speech is associated with increased satisfaction.  Crit Care Med. 2004; 32:1484-1488. [#50]

Curtis JR, Engelberg RA, Wenrich MD, Nielsen EL, Shannon SE, Treece PD, Tonelli MR, Patrick DL, Robins LS, McGrath BB, Rubenfeld GD.  Studying communication about end-of-life care during the ICU family conference: development of a framework.  J Crit Care. 2002;17:147-160. [#35]

Curtis JR, Patrick DL, Shannon SE, Treece PD, Engelberg RA, Rubenfeld GD.  The family conference as a focus to improve communication about end-of-life care in the ICU: opportunities for improvement.  Crit Care Med. 2001; 29:N26-33. [#26]