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An intervention in the paediatric cardiac ICU to standardise pre-family meeting huddles is feasible, acceptable, and improves clinician teamwork

Published online by Cambridge University Press:  07 February 2025

Jennifer K. Walter*
Affiliation:
Justin Ingerman Center for Palliative Care, Children’s Hospital of Philadelphia, Philadelphia, USA Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, USA
Arzu Cetin
Affiliation:
Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, USA
Colette Gramszlo
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, USA
Aaron G. DeWitt
Affiliation:
Cardiac Center, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
William Quarshie
Affiliation:
Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, USA
Heather Griffis
Affiliation:
Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, USA
Victoria Johnson
Affiliation:
Justin Ingerman Center for Palliative Care, Children’s Hospital of Philadelphia, Philadelphia, USA
Selena Nelson
Affiliation:
Justin Ingerman Center for Palliative Care, Children’s Hospital of Philadelphia, Philadelphia, USA
Justine Shults
Affiliation:
Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
Robert M. Arnold
Affiliation:
University of Pittsburgh Medical Center, Pittsburgh, USA
Amy Trowbridge
Affiliation:
Division of Bioethics and Palliative Care, Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, USA
Caroline Hurd
Affiliation:
Harborview Medical Center, University of Washington, Seattle, USA
Martha A.Q. Curley
Affiliation:
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA
Chris Feudtner
Affiliation:
Justin Ingerman Center for Palliative Care, Children’s Hospital of Philadelphia, Philadelphia, USA Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, USA
*
Corresponding author: Jennifer K. Walter; Email: [email protected]

Abstract

Introduction:

Interprofessional teams in the pediatric cardiac ICU consolidate their management plans in pre-family meeting huddles, a process that affects the course of family meetings but often lacks optimal communication and teamwork.

Methods:

Cardiac ICU clinicians participated in an interprofessional intervention to improve how they prepared for and conducted family meetings. We conducted a pretest–posttest study with clinicians participating in huddles before family meetings. We assessed feasibility of clinician enrollment, assessed clinician perception of acceptability of the intervention via questionnaire and semi-structured interviews, and impact on team performance using a validated tool. Wilcoxon rank sum test assessed intervention impact on team performance at meeting level comparing pre- and post-intervention data.

Results:

Totally, 24 clinicians enrolled in the intervention (92% retention) with 100% completion of training. All participants recommend cardiac ICU Teams and Loved ones Communicating to others and 96% believe it improved their participation in family meetings. We exceeded an acceptable level of protocol fidelity (>75%). Team performance was significantly (p < 0.001) higher in post-intervention huddles (n = 30) than in pre-intervention (n = 28) in all domains. Median comparisons: Team structure [2 vs. 5], Leadership [3 vs. 5], Situation Monitoring [3 vs. 5], Mutual Support [ 3 vs. 5], and Communication [3 vs. 5].

Conclusion:

Implementing an interprofessional team intervention to improve team performance in pre-family meeting huddles is feasible, acceptable, and improves team function. Future research should further assess impact on clinicians, patients, and families.

Type
Original Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press

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